HomeMy WebLinkAbout1070 PALM AVE; ; 78-4240; PermitPLUMBING PERMIT APPLIC!(TION
City of CARLSBAD, CALIFORNIA 92008 ('"'
Applicant to complete numbered spaces only Phone 729-1181 Permit No
JOB ADO,-E$S
LE.GAL I 1 DC5CO,
LOT NO, I TOACT
2
3
4
7
OWNE!lt
CONTftACTOft MAIL AODPttSS
APlCHI TECT Oft 0[51GN£" MAIL ADDRt.55
EHGIN[tR MAIL ADORCSS
USE o, BUILDING ·-oi f -1
I
:I.-, ~:t. nii ""4'""' , ... ,,,._., ·:rtr ,. ,. :.. " ·-.. l~•L.,.'-'!c
8 Class of work: □ NEW 0 ADDITION □ ALTERATION
9 Describe work:
I
SPECIAL CONDITIONS:
....
APPLICATION ACCEPTEO 8Y PLANS CHECl\,~O 8Y APPIIOVE O FO~ •SSUANCE BY
DATE
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC·
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED.
I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS APPLICATION ANO KNOW THE SAME TO Bf TRUE ANO CORRECT. ALL PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
/J ---.,,,, I It. .. .,
.'' .
(DATEI
SIGNATUNt 0,-OWN[.1111 1, OWN[IIIJ IIUIL.0C"J IDATEJ
IIP PHONE
PHONE STATE LIC, NO, __ ,,.
i .... ---
PHONE LIC [N.SE NO,
PHONE LICENSC NO.
.... &PIA.NCH
I
' □ REPAIR
PERMIT FEES
No. Type of Fixture or Item
WATER CLOSET (TOILET)
BATHTUB
LAVATORY (WASH BASIN)
SHOWER
KITCHEN SINK & OISP
DISHWASHER
LAUNDRY TRAY
CLOTHES WASHER
..:. WATER HEATER
URINAL
DRINKING FOUNTAIN
FLOOR-SINK OR DRAIN
C SLOP SINK " .
GAS SYSTEMS, NO.OUTLETS
WATER PIPING & TREATING EQUIP.
WASTE INTERCEPTOR
VACUUM BREAKERS
LAWN SPRINKLER SYSTEM
SEWER NUMBER CLEAN0UTS
CESSPOOL
SEPTIC TANK,_ PIT
ROOF DRAINS
ISSUANCE FEE
TOTAL FEES
WHEN PROPERLY VALIDATED IIN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O.
INSPECTOR
CITY LIC, NO.
Fee
$
$ ~· ,,
$ ,, ~ •.
CASH