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Home My WebLink About1126 LARKSPUR LN; MULTI-PERMIT FILE; CB112370; Permitr 11-07-2011 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB 112370 Building Inspection Request Line (760) 602-2725 1126 LARKSPUR LN CBAD PME 2054300200 Lot #: 0 DUNATE RES-REPLACE WTR HTR Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 11/07/2011 LSM 11/07/2011 11/07/2011 CALIFORNIA DEL TA MECHANICAL CAVENEY YVONNE M SUITE# 27 12440 OAK KNOLL RD 92064 866-898-0008 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES 8809 E HERNDON AVE CLOVIS CA 93619 $150.00 $0.00 $0.00 $0.00 $150.00 Total Fees: $150.00 Total Payments To Date: $150.00 Balance Due: Inspector: EXPIRED PERMIT PERMIT HAS F.XPIRED IN ACCOR!>ANCE WIT SECTION 106.4A As AMENoi:i tw c. c. ::~:1c. OATEJl_i1~IGNATURE77'-f9~--- FINAL APPROVAL Date: Clearance: $0.00 NOTICE: Please take NOTICE that approval of your project includes the ~Imposition" of fees, dedications, reseivations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 clays from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Car!sbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/e)(actions DOES NOT APPLY to water and sewer connection tees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any 'h City of Carlsbad 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 Building Permit Application JOB ADDRESS 1126 Larkspur Ln. Plan Check No.C8 I I ,:l "S 70 Est. Value Plan Ck. Deposit Date 1l 7 SUITE#/SPACE#/UNIT# APN CT/PROJECT# LOT# PHASE# # OF UNIT$ # BEDROOMS #BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) Replace existing like for alike water heater EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS {SF) I DECKS (SF) 1:IREPLACE I AIR CONDITIONING I FIRE SPRINKLERS YES[), N<O ves0No0 vrnONoO CONTACT NAME (If Different Fom Applicant) California Delta Mechanical APPLICANT NAME Galina Pavlova -- ADDRESS -ADDRESS 6056 E. Baseline road suite# 155 6056 E. Baseline road suite# 155 CITY STATE ZIP CITY STATE ZIP Mesa AZ. 85206 mesa az 85206 ------IFAX PHONE PHONE 858-361-6495 1-858-240-6677 480-898-0007 IFAX 1-480-218-5645 ---- EMAIL EMAIL california@deltamechanical.com galiapavlovabg@yahoo.com PROPERTY OWNER NAME Cathleen Dunate CONTRACTOR BUS. NAME California Delta Mechanical ADDRESS ADDRESS 1126 Larkspur Ln 6056 East Baseline rd # 155 CITY STATE ZIP CITY STATE ZIP Carlsbad CA 92008 Mesa AZ. 85206 PHONE IFAX PHONE I FAX 559-299-5369 480-898-0007 EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS r STATE LIC. # STATE LIC.# lCLASS !°'TY BUS. LIC1214281 811114 c36 (Sec. 7031.5 Business and Professions Code: Any City or Coun_ty whtch requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such per_mit to file a signed statement that he is hcensed pursuant to the provisions of the Contractor's License Law /Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code} or that he ls exempt therefrom, and the basis for the alleged exemption. Any violation of Section 1031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500)). Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations: [2] I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued 0 I have and will maintain workers' compensation, as required by Sectkm 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co Policy No, 1697823 Expiration Date 07101/2012 ~section need not be completed if the permit is for one hundred dollars ($100) or less. lLJ Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an emp1oyerto criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damages as provided fo i on 3706 of the Labor code, Interest and attorney's fees. RS CONTRACTOR SIGNATURE • I hereby affirm that/ am exempt from Contractor's License Law for the following reason: □ □ □ I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not. apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the proje(:I (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). I am exempt under Section ____ Business and Professions Code for this reason: 1, I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0Yes 0No 2. I (have I have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction (include name address I phone/ contractors' license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name I address I phone / contractor.;' license number)· 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name I address I phone/ type of work): RS PROPERTY OWNER SIGNATURE DATE :'F•f~ti:«T1f rilios !il!C:TION Fnit woN-1tilli!f:oii11t'itAt ti11u12'uni PIIAl',NTs ONLY , ' "', ' 1 " -~ ' ~ " ' -"' -j s the applicant or future building occupant required to submit a business •. acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Jresley-Tanner Hazardous Substance Account Act? D Yes LJNo s the applicant or future buildirig occupant required to obtain a permit from the air pollution control district or a\[..9,!/,ality management district? Des O No s the facility to be constructed within 1,000 feel of the outer boundary of a school site? 0Yes LJNo F ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF :MERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. certify that I have readtheappllcatlon and state that the above Information is correct and that the Information on the plans is accurate. I agree to comply with all Cityon:llnanc:es and State laws relating to building construction. hereby authorize representative of the City of Ccrtsbad to enter upon the above mentioned property for inspection purposes. 1 ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD \GAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE Of THE GRANTING OF THIS PERMIT )SHA: An OSHA pennit is required for excavations over 5'0' deep c11d demolition or coostruction of structures over 3 stories in height. :XPIRA TION: Every permit issued by the Building Official under the provisions of this Code shall expire by !irritation cild become null ood void if the building or 'AOrk authorized by such permit is not commenced 'MIilin 80 days from the date of such pemlt or if the buiding or work oothorized by such perm~ is suspended or abandoned at any time after the VJOO<. is rommenced for a period of 180 days (Section 106.4.4 Uniform Building Code). KS APPLICANT'S SIGNATURE DATE /-' ~ /4 ., z 0 ~ .. :5 [rl C .. 0 ~ ~ .. ~ z 0 " .. .. C -' 5 I .. z ! z 0 ~ z "' .. ,. 0 " ., ir "' " .. ~ ![ ,ereby alllrm that I am licensed under ,rovlslons of Chapter 9 {commencing with Section 7000) of Division 3 of the Business and Professions Code, and me¾licen is in full force and effect. '" '" ?f/3'JCi1'"' ~ ~ I hereby afl,rm lha1 I am exempt lrom the ConIrac- tor's License Law lor the Jollow1ng reason iSec 7031 J Business and Profess,ons CDOe Any cIIy or county wh,~~ re qu,res a perrrn! IO construct alter. improve. demolish. or repa,r any structure. prior to ,ts issuance also requires !heap- plicant for sud perm,t to hie a s,qned statement that he ,s licensed pursuant to the prov,sIons of !he ConTractor s L•cense Law IChap1er g commenc,ng w1Ih Sect,on 7000 of D1v1s1on 3 oJ !he Business and Proless1ons Code) or that ,s e,- ernpl therelrom and the basis for the alleged exemption Any v1olat1on of Section 7031.5 by an applicant for a perm,1 sub Iects the applicant 10 a cIvII penalty of not more 1han five hun dred dollars ($500) I, as owner of !he property, or my employees w,th wages as me1r sole compensation, will do the work. and lhe s1ruc- 1ure Is not 1nIended or o!lerei.l for sale (Sec 7044, Business and Pro1ess1ons Code. The Contractor's L,cense Law does not apply to an owner ot property who builds or improves lhereon and who does such work himself or through his own employees, provided 1hat such improvements are not intend- ed or _o!lered for _sale 11. however. the building or improve- ment Is sold w1th1n one year o1 completion. 1he owner-builder w,I: have the burden 01 proving that he did not bu,ld or Im prove for the purpose o1 sale) '1 I, as owner o1 the property. am excluswely contracting with licensed con1ractors to construct 1he proIect (Sec 7044 Business and Professions Code. The Contractor's License Law does not apply to an owner o1 propeny who builds or im- proves thereon. and who contracts !or each proJects with a contrac1or(sl l1cenS<l pursuant to the Contractor's License Law) fl As a homeowner I am improving my home, and the lollow- mg conclItIons exist 1. The work ,s being performed prior to sale 2 I have lived In my home for twelve months pr,or to completion ot this work I have not cla1mecl this exemption during the las! three years t! lamexemptunderSec -----1---,B&PC 1or thts reason ieieby affirm th Comsell-insure. 0/1~ ha-.,e a cerii!i (Sec ~.,,on lnsuranc cer1,l,cate \if Labor 1'i o, a ceri,hed\, Workers POLICY NO r ,_?~..5 3 o;_ thereof co•~ , 'J £.a'Too,os<,Led~~ D the c,ty Cer11!,ed c opy is he,eby !um,shed CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Th,s section n~d not be completed ,1 The perm,t ,s !or one hundred dollars ($1001 or lessI 0 I <.:er1,ty tha! m 1he perlu,manLe ot lhe "'0"" lor wh,ch th,s perm,! Is ,ssued. I shall not employ any person ,n any manner so as to become subIect lu the Wofl,,ers· Gompens.a1,on Laws ot Cal,forn,a NOTICE TO APPLICANT 11 a!ler makrnJ th,s Cer1, f1ca1e ot Exemp!,on. you should become sutJIec1 !') the Worllers Gompensat•on pro.-,s,ons of Ine Lat>or Code. you must for1hw1th comply w'1h sucn provIs,ons or !his perm,! shall be deemed rE'>')ked D I hereby aflirm In.ii lhere ,s a cor,;I,uct,o" iend,ng agency •or lhe perlormance ot The won< 'or wh•ch 1n,s perm,! ,s ,ssued ,Sec 1097 (,,,, Code, Lenders Name ___________ _ Lenders Address __________ _ USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. CARLSBAD BUILDING DEPARTMENT 1200 Elm. Carlsbad. California 9~08-198~19) 438-5525 AP~lf9AT10N & PERMIT q /rf.; JOBADOrJeo LOT 1-..a,r-{<::s NEAREST CROSS ST. SVBOI \l'lS!ON ZONE --.SNAMEat~ ~~ 5 BLOCK VALUATl~N PLAN 1.0. # ~ PERMIT NUMBER I ii: i" 53/ ~ 0 0. E m f-BLOG USE CODE I OWNER'S MAILING ADDRESS , , ". _ _. ~ ~,f ,#-.__.,,V -----,: , , 1 "'' _ ~--~ c.,• _ 1 . _ C.ar!st-,....... JJ 1 _-, ~ _. OE~IGNER , LICENSE# , -L l .,.«.p ~ ~I( lA,,,I" 1-..11 . , ' ~ \..., -,-,Z/'JtjJ • DE"Saft~f1a,,,i_QF V,,Oftid --, ' ' " , ', -; STANDARD PLAN# D BUILDING SO. FOOTAGE I 0 CJ .• ......... )i!y •·····•····. . t · . " · · ~ •• · · . . I oES<GNEa·s AooaEss .' .. 6£}/EJ.ct:;. ~--·~ . . . -F/P FLA ELEV. . , . r I Nb STORIES ,j, ~Slgt,!ER'~ PHONE OCC GP EDU 3/24/H6504S o,_:!.15043 3/24186 5/24/V!Jb04~ 20,0 j"! 4 □~0" Tf 0. 20~lJ f!P GRADING PERMIT ISSUED vO NO REDEVELOPMENT AREA OCC LOAD I FIRE SPF! ~ C CeNSUS ,RAO I Ge CANO USE I 'ARK,NG 5'ACC RES UN"5 I ¥0 N 0 vO NO TYPE CONST v□ r-.O N~/,X;,///Ji~ ~./!::in, Ce,rdied TO~iJ I SP OTlf PLUMBING PERMIT· ISSUE '7.sdl QTY. MECHANICAL PERMIT· ISSUE ~ SUM MARY/ACCOUNT NUMBER EACH FIXTURE TRAP II I INSTALL FURN DUCTS iJP TO 100.000 BTU ,/ BUILDING PERMIT 01-00-00-8220 SIGN PFAMIT 01-00-00-8221 EACH BUI LO ING SEWER ____ I_____ OVER 100 000 BTU _ / I EACH WATER HEATER AN-0,QR VENT l O BOILER/COMPRESSOR UP TO] HP' C7 L.-+1----'.--Jl--'oCC;~.:.·:,.:.e=,,.:.:coC:".'._ _____ _.:'.::_":c'""..'"":.C-J-i --·- !'L/-11~ 1.,nt:l,I\ 01-00-00·8806 £ACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3 15 HP ,,.,,~L TnTll.l DLUMBW,G 01-00-00-8222 _I!;}, 0-0 ~- EACH GAS SYSTEM 5 OR MORE •-1---J~:.'..:'.:..'..:'.:.::'..c':"":. __ ,L ;::;_;::,:;~ EACH INST AL ALTER, REPAIR WATER PIPE ______ +---CT ____ ._ "' 0•·' RICA~ 01-00-00-8223 MECHANICAL~ 01-00-00·B224 EACH VACUUM BREAKER MOBILEHOME ~ 01-00-00-B225 WATER SOFTNER II I RELoc>V<g__N OF EA FURNACE/HEATER MOBILEHOME PARK IN~ EACH ROOF DRAIN !INSIDE! II I ?---' SOLAR, ____ _ I ,,.._ . /ha TOTI.L MECHANICAL STRONG MOTION TOTAL PLUMBING I / IJ • - flRE SPRINKLERS QTY. ELECTRICAL PERMIT· ISSUE ~ ,%QTY SOLAR · ISSUE PUBLIC FACILITIES FEE BRIDGE FEE -00-8933 ·------, . .....,,.. -NEW CONST EA AMP 'SWT BK R COLLECTORS SCHOOL FEE -DISTRICT ____ _ I CH 3 PH I STORAGE TANKS Carlsbad 80-92-21-0519 EXIST BLDG EA AMP·SWT BKR / ROCK STORAGE / I II Encinitas 80·92·22-0519 I PH 3 PH_/ PUMP / I II San Oieguito 80-92-23-0519 REMODEL ALHR PER Cl!}J,,tl'H PLAN CHECK FEE / I II San Marcos 80-92-24-0519 TEMPPOLE 20UAMP_V / OVER 200 AMPS ANCY 130 DAYS) ! CREDIT DEPOSIT TOTAL HECTRICAL 1 : TOTAi SOLAR TOTAL FEES PAYABLE I /0. cro HAVE CAREFULLY EXAMINED THE COMPLETED ··APPLICATION ANO_-PERMff'' AN6 06 'i'.t€RE8Y CEATlf;Y UNDER PENALTY OF P£AJUAY THAT-ALL INFOAMATl6~·HERE0N INCLtJQ!NG THI: * AN OSttAPEAMIT tS AEOUIRED,FOR EXCAVATK>NS OYEFI 5· 0" odP Aki) 0£M0LITM)N OR COHSTRUCTION OF STRUCTURES OVER l STOfllES tN HEIGHT DECLARATIONS ARE TRUE AND CORRECT AND J FURlHl:R CEATI~ ·ANO Aefij;:E tt= ~ PERMIT IS ~ISSUEO:.,TQ COMPLY vi«rt.H,At.LCITY,COilNTV AND STATE LAWS GOVERNING BUILrnNG,CON• SfRUCTION,' WtfETHERSPEClf)EO lif:.REtN OA,NOT. I ALSO AGREE TO SAVE INOEMNJFY AN KEEP ~ARMLESS THE ql.TY,Of CARLSBAD ,@.G,A!NST All 4Al:31llTl~S, JUOGMENTS, COSTS A DATE EXPEN$,ES .. ~H MA'4tN A~"'f:,!il_l/!.,~EA~3AtNSTSAIO'CITY,INCON'Sf;OUENC£,0FT _J'"'''.'"' / 1 o1' GR~T~'OF:TI:dSJ;>,ER.WT,,v,,--0-· + • ,-~ -:::::,,---✓,b 0 w w "' w w <{ I ~ 0 " ,.. w w m '-' 0 a: ro 'iii 0 ~ w '-' C ro C ii: ,:. C w ~ CJ 0 u m 0. w C ~ re ;: TYPE , DATE INSPECTOR BUILDING , FOUNDATION , FIELD INSPECTION RECORD REINFORCED STEEL , MASONRY , GUNITE OR GROUT , REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES INSPECTION REO IF INSPECTORS DATE CHECKED APPROVAL FLOOR & CEILING SUB FRAME I SOILS COMPLIANCE SHEATHING □ ROOF □ SHE'AR PRIOR TO ---· FRAME , FOUNDATION INSP EXTERIOR LATH , STRUCTURAL CONCRETE: OVER 2000 PSI INSULATION , PRESTRESSEO CONCRETE INTERIOR LATH & DRYWALL , POST TENSIONED , CONCRETE ' PLUMBING , FIELD WELDING SEWER AND BUCO ·□IPUCO , UNDERGROUND . □ WASTE □ v/{ATER TOP OUT □ WASTE □ WATER HIGH STRENGTH ·,Jl· BOL Ts .. ;·,-: I ,. SPECIAL MASONRY. \: TUB AND SHOWER PAN , ~ .. f -.;~ GAS TEST , , PILES CAISSON'.:: .•,; □ WATER HEATER □ SOLAR WATER .'>' , ELECTRICAL : <f □ ELECTRIC UNDERGROUND □ l!IFFER ROUGH ELECTRIC I □ ELECTRIC SERVICE □ TEMPO!l!ARY □ BONDING □ POOL I . I MECHANICAL I □ DUCT & PLEM., □ REF. PIPING HEAT -AIR COND. SYSTEMS I , VENTILATING SYSTEMS I ' I CALL FOR FINAL /NSPECT:CJN WHEN ALL APPROPRIATE ITEMS ABOVE HAV BEEN APPROVED. · · - FINAL I PLUMBING , . - ELECTRICAL , MECHANICAL , GAS , BUILDING , SPECIAL CONDITIONS ' • PLU Bl G 0 • • City of CARLSBAD, CALIFORNIA NOV16·70 5~ 819** .. , lit-i .5 PERMIT # -cc 0 • MN PERMIT APPLICATION 2 0 Applicant to complete numbered spaces only. " • • JOaA//s~ L /4a.r. 'c;,OHY ,,{ "Y7 -1~ J ~ LOT NO. BLK / I TIIIACT tOsu: ATTACHED SHEET) I~ ,-J LEGAL I 1 DESCIII. 1 2ow•w, / /, ~ 'n-7 Pv-1-MAIL ADDIIESS "' PHONE ~ " --..... '11~--9,:2fJot' ~t\ COHTftACTOR • MAIL ADDl'IESS ' PHONE LICENSE NO. 3 t"\) 1A} 'J-1 p J,_- , ' ' AIIICHITECT OR OE91GN£R MAIL ADDl'IESS PHONE LICENSE NO. t~ 4 ~. ENG IN EE MAIL ADDRESS PHONI: LICENSE NO, ' 5 LENDEIII MAIL ADDRESS 11111:ANCH t ~ 6 ' ,.:.. USE OF' 8U1LDING ~t.\. 7 - J0'ADDITID~ '\ ' 8 Class of work: □NEW □ ALTERATION □ REPAIR • ,, 1, Describe work: ~fi ,,{ ,,£✓-,, .. \ /4 \ \ I.. 9 '/ ./ of,,~ £i ,, ,I,, . ., ---_.....C ' I ~~-{/ / V l (/ -PERMIT FEES No. Type of Fixture or Item Fee SPECIAL CONDITIONS: WATER CLOSET (TOILET) $ BATHTUB LAVATORY (WASH BASIN) SHOWER KITCHEN SINK & DISP. DISHWASHER APPLICATION ACCEPTED BY: PLANS CHECKED BY· f1/Y~y LAUNDRY TRAY rv~ CLOTHES WASHER ... / _,,,:JI UL.-,() / WATER HEATER / c,. t', NOTICE URINAL THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC· DRINKING FOUNTAIN TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF FLOOR-S·INK OR CRAIN CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM· SLOP SINK 7 z::, MENCED. I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS / GASSVSTEMS:NO.OUTLETS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. WATER PIPING & TREATING EQUIP. ALL PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED WASTE INTERCEPTOR HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE VACUUM BREAKERS PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. LAWN SPRINKLER SYSTEM SEWER CESSPOOL SEPTIC TANK & PIT ...-;,J .,,--· ) SIGNATURE 01" ~AUTH~_/ (OAT£) ~ ' . PERMIT $ '7 L.,7) . //-//-70 -,,r // ~ ~ TOTAL FEE IGNAT ER II'" 0 '" ' ' I0ATE) ,, 'Y:J . WHafPROPERLY VALIDATED IIN THIS SPACE! THIS IS YOUR PERMIT PLAN CHECK VALIDATION ~K, M.O. CASH PERMIT VALIDATION CK. M.O. CASH INSPECTOR Form 100.2 9-69 RE0III0EIII FROM: INTERNATIONAL CONFERENCE OF BUILDING OFFICIALS e ISO so. LOS IIIO!ILES e PASAOENA, CALll"ORNIA Q1101