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HomeMy WebLinkAbout1145 CARLSBAD VILLAGE DR; ; 71-91; Permit3ELECTRICAL PERMIT APPLICATION 7/-<7/ City of CARLSBAD, CALIFORNIA FE8_>71 SE«£ ^z** Applicant to complete numbered spaces only ~ JOB ADDR ESS LOT NO BLK TRACT, LEGAL [ DESCR OWNER MAIL ADDRESS Z 2 Shell Oil (QSEE ATTACHED SHEET) P PHONE CONTRACTOR MAIL ADDRESS PHONE L CENSE NO J$SL*#j4 3 Vic Stein Elec.,Inc. -312 S. Melrose,Placentia 528-21^1 /^7/ ^2_ ARCHITECT OR DESIGNER MAIL ADDRESS PHONE 4 ENGINEER ' MAIL ADDRESS PHONE 5 LENDER MAIL ADDRESS 6 LICENSE NO _i**^™ L CENSE NO f BRANCH USE OF BUILDING 7 Service Station /^ 8 Classofwork Q NEW DADDITION [^ALTERATION D REPAIR 9 Describe work /, , L, j,h /* DMft.l , 1 i ,, il?i i ty yi£ «£^ ^M^OI J> r <P^<. Gu- iii. J B^tli^f «''>lt be ve&.\c>e»litJL a*.. Lof * SPECIAL CONDITIONS XxX/ APPLICATION ACeufED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY1 / A^ r ?! ^ NOTICE THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECTALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOTPRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION sicmrune OF CONTRACTOR OR AUTHORIZED AGENT (DATE) SIGNATURE Or OWNER (IF OWNER BUILDER) (DATE) tuJl,-J/tt, tjr Ifi / o Z 71 k** > -^ o *!HI ^/Al/«B ^«* 1 PERMIT FEES RECEPTACLE LIGHT SWITCH LIGHTING FIXTURES Totat Outlets */? V? Total Fixtures W3 RANGES CLO DRYER WTR HTR GARBAGE DISP STA COOK TOP DISH WASH SPACE HTR CLOTHES WASH STA APPL ¥2 H MOTORS SIGNS NO TRANS P MAX H P NO LAMPS TEMP POWER DPOLE DUNDGD SERVICE D NEW D CHANGE 0 200A 201-400A 401-600A OVER 600A PERMIT ISSUING FEE TOTAL FEE No Each $ Fee H - If /# ?* -s2/ vc , *& — ~- &-C 00 (• '> ' I%c V S X WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK M O CASH Form 100 3 9 69 INSPECTOR REORDER FROM INTERNATIONAL CONFERENCE OF BUILDING OFFICIALS • so )*IA 91101