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Home My WebLink About1173 OAK AVE; MULTI-PERMIT FILE; CB143189; PermitIA/K 4.0 ayr ti fio A" LA/I) Id City of Carlsbad 1635 FaradayAv Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 11-17-2014 Permit No: CB 143189 Building Inspection Request Line (760) 602-2725 Job Address: 1173 OAK AV CBAD Permit Type: PME Status: ISSUED Parcel No: 2050205100 Lot #: 0 Applied:' 11/17/2014 Entered By: JMA Reference #: Plan Approved: 11/17/2014 PC #: Issued: 11/17/2014 Inspect Area: Project Title: PEREZ: REPLACE FURNACE/LIKE FOR LIKE/ FLOOR FURNACE Applicant: ' Owner: ESPINOZAS HEATING & AIR PEREZ MAX P 4607 ALLENDE AVE 16271 AMALFI DR OCEANSIDE CA 92057-6147 PERRIS CA 92570 760-908-5576 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES $0.00 $0.00 $160.00 $0.00 $160.00 Total Fees: $160.00 Total Payments To Date: $160.00 Balance Due: $0.00 EX 1 P RED PERMIT. PERMIT HAS EXPIRED IN ACCORDANCE WITH C.B.C. SECTION 10 AS A1EWDED B M .18.04 030 .4A DATE SIGNATURE _)14i___. FINAL APPROVAL Inspector: Date: Clearance: NOTICE: Please take NOTICE that approval of your project includes the Imposition of fees, dedications, reservations, or other exactions hereafter collectively referred to as fees/exactions. You have 90 days 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 Carlsbad 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/exactions DOES NOT APPLY to water and sewer connection fees 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 /[THEFOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: F-1 PLANNINGDENGINEERING DBUILDING []FIRE DHEALTH DHAZMAT/APCDI Building Permit Application •' ' G'( Plan Check No. -31 of : 1635 Faraday Ave., Carlsbad, CA 92008 City Est. Value ,- 1 1 1 Ph: 760-602-2719 Fax: 760-602-8558 if --ci Plan Ck.Deposut email: buildingcarlsbadca.gov Date ( (- ( L( swppp wwwcarlsbadca.gov. JOB ADDRESS • . SUITE#/SPACE#/UNIT# APN II 73 CT/PROJECT B LOT PHASE B UNITS B OF UNITS B BEDROOMS B BATH OMS TENANT BUSINESS NAME . CONSTR. TYPE 0CC. GROUP .7. DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) Zeic oi/ R1o( !JQtAJ k)/ EXISTING USE PROPOSED USE •. GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS c17S : •' . . . . YESD# NOIJ YES [:]NOQ4 YESE:] NOEl APPLICANT NAME PrtnaryContact i4'l K PROPERTY OWNER NAMED 14'? 'f'eJe . ADDRESS 1173 ADDRESS C):-.,4k' 4Jc- &.-Jf CITY . STATE ZIP (cr/St3z,(. (• . CITY STATE ZIP - 9v côr . PHONE. . i?q FAX . .. PHONE . . •. FAX ,.. . EMAIL. • . . . . EMAIL DESIGN PROFESSIONAL . . . S CONTRACTOR BUS. NAME P13 2S /-4-I. '• ADDRESS . . . . . . , . • ADDRESS •. 46d V e- CITY '. STATE . ZIP CITY STATE . zip : C. PHONE . -. FAX . PHONE . FAX go EMAIL . . . . -. . . EMAIL . •• cOy H-- STATE LIC B CS CITY BUS. L 4f the to a - I OJ 1( , Workpensation Declaration: (hereby affirm under penally of pe4u1y one of the following declarations: . and will maintain a certificate of Consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Cede, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation, as required by Section 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: InsuranceCo. _t/iy L-.9 I .t¼.f Policy No. Al W/.- £ rW-9(, Expiration Date This This section need net be completed if the permit is for one hundred dollars ($100) or less: []Certificate of Exemption: I certify that in the performance of the work for which this permit i 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 secur rn compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation arnage s provid d for in ection 3706 of the Labor code, interest and attorney's fees, S. CONTRACTOR SIGNATURE • AGENT DATE - . Li4'€ I hereby affirm that lam exempt from Contractor's License Low for the following rason (J 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). 'El I, as owner of the property, am exclusively contracting with licensed contractors to construct theprojecl (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) E1 l 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 IIYes IINo . • • 2. ((have I have not) signed an application for a building permit for the proposed work. . • . • . • 3.1 have contracted with the following person (firm) to provide the proposed construction (include name address/phone/contractors' license number): - 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 / address / phone / contractors' license number): - (will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): - - ,.PROPERTY OWNER SIGNATURE • • • • • • • . . .- EIAGENT DATE - -• • - • S • -, - 'I . • .5 • . (Sec. (031.b business and Proressions Code: Any City or County which requires a permit to Construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, commending with Section 7000 of Division 3 of Business and Professions Code) or that he is 1 exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a,perg-ijsu . ' cts th .1 e a plicant civil penalty of not more than five hundred dollars ($500)). . - — S ,Zi I / • ... :- ) Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 Yes 0 No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 Yes 0 No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? . 0 Yes 0 No .• . IF 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 EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. . 1.hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name . Lender's Address icerlify that i have read the application and state thatthe above information is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned property for inspection purpeses: I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST SAID CITY INCONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA An OSHApermtiis required hr excavations over 50' deep and demolition or construction of stn.ictuiresover3 stories,in height. EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void tithe building or work authorized by such permit is not commenced within 180 clays from the dale of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a penod 01180 days (Section 10644 Uniform Building Code) Inspection List . 0 Permit#: CB143189 Type: PME PEREZ: REPLACE FURNACE/LIKE' I . FOR LIKE! FLOOR FURNACE Date Inspection Item Inspector Act. Comments 12/09/2014 43 AirCond/Furnace Set PD CO 0 S '5 5' Wednesday, November 18, 2015 0 Page 1 of 1 ' (City of Carlsbad September 29, 2015 Permit Number: 11ä7 Issue Date: November 17, 2014 PEREZ MAX P ESPINOZA'S HEATING & AIR 16271 AMALFI DR 4607 ALLENDE AVE PERRIS CA 92570 OCEANSIDE CA 92057-6147 RE: BUILDING PERMIT EXPIRATION ADDRESS: 1-7OAK-AJ PERMIT TYPE: PLUMB/MECH/ELECT PERMIT PLEASE CALL FOR AN INSPECTION IF WORK IS COMPLETE Our records indicate that your building permit will expire by limitation of time on November 17, 2015 The provisions of CBC, Section 105.5 as amended by the Carlsbad Municipal Code state: EXPIRATION." Every permit issued by the Building Official under the provisions of this code shall expire by limitation and- become null and void if the building or work authorized by such permit is not commenced within one hundred eighty calendar days from the date of such permit, or if the building or work authorized by such permit is stopped at any time after the work is commenced for a period of one hundred eighty calendar days, or if the building or work authorized by such permit exceeds three calendar years from the, issuance date of the permit. Work shall be presumed to have commenced if the permittee has obtained a. required inspection approval of work authorized by the permit by the Building Official within one hundred eighty calendar days of the date of permit issuance. Work shall be presumed to be stopped if the permittee has not obtained a required inspection approval of work by the Building Official within each one hundred eighty day period upon the initial commencement of.work authorized by such permit. Before such work can be recommenced, a new permit shall be obtained to do so, and the fee therefore shall be one half the amount required for a new permit for such work, and provided that no changes have been made or will be made in the original plans and specifications for such work, and provided further that such suspension or abandonment has not exceeded one year. In order to renew action on a permit after expiration, the permittee shall pay a new permit fee. Any permittee holding an unexpired permit may apply for an extension of time within which work may commence under that permit when the permittee is unable to commence work within the time period required by this section for good and satisfactory reasons. Please check below indicating your intentions and return this letter to us. Project abandoned. A new permit will be obtained prior to commencing work. No fee extension requested for 180 days. (must attach a letter of explanation) Renewal permit requested. If the project has been completed and only a final inspection is needed, please call the inspection request line at 760- 602-2725. If you have any questions, please contact the Building Inspection Division at 760-602-2700. Maria Emery Senior Office Specialist Community & Economic Development Building Division 11635 Faraday Avenue Carlsbad CA 92008-7314 760-602-2700 1 760-602-8560f I www.carlsbadca.gov LZ 7735 1 City of Carlsbad )C,, 1635 Faraday Av Carlsbad, CA 92008 11-15-2001 Plumbing Permit Permit No:C13013571 Building Inspection Request Line (760) 602-2725 Job Address: 1173 OAK AV CBAD Permit Type: PLUM Status: ISSUED Parcel No: 2050205100 Lot #: 0 Applied: 11/15/2001 Construction Type: NEW Entered By: RMA Reference #: Plan Approved: 11/15/2001 Issued: 11/15/2001 Project Title: DOLKAS RES-REPLACE GAS LINE Inspect Area: FROM METER TO KITCHEN .Applicant: - Owner: .LAYLAND DOUGLAS E&DOLKAS MARY C LAYLAND DOUGLAS E&DOLKAS MARY C ..I173 OAK AVE / 1i73 OAK AVE, 4684 11/15/01 0002 01 o CARLSBAD CA 92008 CARLSBAD CA 92008 / CGF 27-00 / 7 Total Fees $27.00 , Total Payments To Date $0 00 Balance Due:,$27.00 - V Plumbing Issue Fee "$20.00 Fixture or Trap k\0 / / $0.00 Building. Sewer \0 ..) /7 j 5 $0.00 Roof Drain o - - ,/7 -' - $0.00 Install/Repair Water Line / / 0 I 1 $0.00 Water Heater and/or Vent 0 1 1 / $0.00 Gas Piping System N. , j. V $7.00 Vacuum Breaker $0.00 Other Plumbing Fees \\ 7 / $0.00 Master Drainage Fee\ - OHPA/1CD ,/ $0.00 Sewer Fee " $0.00 Additional Fees /_( / - J' $0.00 \ / TOTAL PERMIT FEES , . 7 $27.00 FINAL APPROVAL Inspector: Date: __________ Clearance: NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days 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 Carlsbad 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/exactions DOES NOT APPLY to water and sewer connection fees and capactiy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. 'C' C. ' , . . '•t' '• . '- . . , FOROFFICE USE ONJY' PERMIT APPLICATION PLAN CHECK NO CITY OF CARLSBAD BUILDING DEPARThIENT, EST. VAL. Plan Ck. Deposit /71 1635 Faraday Ave.,..Carlsbad, CA 92008 • - Validated By -. Date 1/ //.r—/e' / Mp ........ ..................:.:.... . . k F /773 99 .' .. '., Address (include Bldg/Suite #) . ' Business Name (at this address) . Legal Description Lot No., Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # ,' Existing Use ' Proposed Use . . VDescription of Work ., - SQ. FT. - #of Stories - # of Bedrooms # of Bathrooms * ' (45 4(4/a:5 ,:ie,f,v i2 i'J L/DE J4r?d .. 9y ç VF 2 CONTACT PERSON (if different from applicant) Name' . - - Address - . City . State/Zip Telephone # Fax #' 3 CQntççr fl D'Orer Name ' - ' ,, 'Address .• ' ' ' City State/Zip Telephone # .. ', "r. 4 PROPERTY OWNER tu .A'jI'.b45 1/73 . , . . qzeb6, Name . . - . .. Address . . ' City. . State/Zip Telephone # 5 CONTRACTOR COMPANY NAME (Sec'7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its .-issuarce, also requires the applicant for such permit to file a signed statement that he is licensed 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 is exempt therefrom, and-the basis for the alleged exemption Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$ 5001). ' '• Name '.'' , . . ' Address . ' , City '-. State/Zip ' Telephone # ' State License # License Class City Business License # ' Designer Name -_- " Address , - . ' . City ' - State/Zip Telephone ,St ate License #. 6 - ERS COMPENSATION Workers' Compensation Declaration: I. hereby affirm under penalty of perjury one of the following declarations: C3. 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 S El i have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued My worker s compensation insurance carrier and policy number are Insurance Company ' ' , , . Policy No. ' ' ' " Expiration Date ., " •. (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) . • , '• . ' - 0 - CERTIFICATE OF EXEMPTION: I ertify that in the performance of 'the work for which this permit is issued, I shall not employ any prson 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 employer to criminal penalties and civil fines up to one hundred 'thous'fld dollars ($100,000), in. addition to the cost of compensation, damages as provided for in Section 3706 of the Labor coda, interest and attorney's fees. -SIGNATURE...-,.'.. _.''.. . DATE .. . .. -. 7 NEW BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: . - 0 ,:,'s 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). ' .1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: 'The Contr'acto'r'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 Con-tractor's License Law) 0 I am exempt under Section _______________ Business and Professions Code for this reason 1 (personally plan to provide the major labor and materials for construction of the proposed property improvement 0 YES DNO "2. "I (have / 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 / phone number /contractors license number): 'VmLAee PlujnAi&6 'O "krIPE 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 / address / phone number / contractors 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 / address / pho'ie number/ type . of work)''- PROPERTY OWNER SIGNATURE ' ___*** LDATE JJ///i_-• ,.'' . !.COMPE-TETHl&SECTIONiFORLrNONRESID(TIAL BUILDING PERMITSONt!.., . ... Is the' applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk m'nagement and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner HazardoUs Substance Account Act? 0 YES 0 NO -* - Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES 0 NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Cl' YES 0. NO . * IF 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 EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.-- 18 CQNSTRVCTION LENDING AGENCY ' I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(i) Civil Code) LENDER'S NAME LENDER S ADDRESS__________________________________________________________ * , - -. I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate,.l agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the Citt' of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY 'IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over 5'0" deep and demolition or construction' of structures over 3 stories in height. EXPIRATION: Every permit issued by the building Off icil under the provisions of this Code shall expire by limitation and become null and''oid if the building or work * authorized by such permit is not commenced within 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned - • at any time after the work is commenced for a period of 180 days' (Section 106.4.4 Uniform Building Code). , )iLICANT S SIGNATURE 12_42QA44-DATE - WHITE: File YELLOW: Applicant ,-' PINK: Finance CO ETS -101 X~ !on DATE t t- 1 oOi iNSPECTOR PERMIT # a&A I PLAN CHECK # - — - — PLUMBING PERMIT APPLICATION City of CARLSBAD, CALIFORNIA — Applicant to complete numbered spaces only. Permit No. JOB ADDRESS 11'7 LEGAL 1. DESCR LOT NO. I I K BL I I TRA I CT I I - OW NE MAIL ADDRESS 24,qg 'eke,'eke,-)/70 ZIP PHONE 9 S CONTRAC1OR I MAIL ADDRESS 4'? PHONE LICENSE NO. STATE CITY -z1-,'/7r ARCHITECT OR DESIGNER MAIL ADDRESS 4 PHONE LICENSE NO. ENGINEER MAIL ADDRESS 5 PHONE LICENSE NO. COMPENSATION INS. CARRIER MAIL ADDRESS 6 BRANCH USE OF BUILDING 7 8 Class of work: Li NEW LI ADDITION $IALTERATtON U REPAIR 9 Describe work: - PERMIT FEES No. Type of Fixture or Item Fee SPECIAL CONDITIONS: WATER CLOSET (TOILET) $ BATHTUB LAVATORY (WASH BASIN) - SHOWER KITCHEN SINK & OISP. DISHWASHER APPLICATION ACCEPTED BY. PLANS CHECKED BY APPROVED FOR ISSUANCE BY DATE LAUNDRY TRAY CLOTHES WASHER WATER HEATER 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. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. URINAL - DRINKING FOUNTAIN I FLOOR--SINK OR DRAIN - SLOP SINK GAS SYSTEMS NO. OUTLETS WATER PIPING & TREATING EQUIP. - HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT WASTE INTERCEPTOR VACUUM BREAKERS LAWN SPRINKLER SYSTEM - SEWER CESSPOOL SEPTIC TANK & PIT . ROOF DRAINS SIGNATUR, , CONTRACTOR OR AUTHORIZED AGENT (DATE) - PERMIT $ . TOTAL FEE $ FV SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) WHEN PROPERLY VALIDATED ON THIS SPACE) THIS IS YOUR PERMIT • PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. • CASH INSPECTOR INSPECTION REPORTS . DATE ITEM REMARKS INSPECTOR - - USE SPACE BELOW FOR NOTES, FOLLOW-UP, ETC. I / - . 1 -