HomeMy WebLinkAbout1680 COSTA DEL MAR RD; ; 73-3395; PermitPLUMBING PERMIT APPLICATION
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CONTRACTOR / ' ™ MAIL ADDRESS PHONE LICENSE NO
ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO
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ENGINEER MAIL ADDRESS PHONE LICENSE NO
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LENDER
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MAIL ADDRESS SRANCH
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USE OF BUILDING , . VsA
8 Class of work D NEW D ADDITION D ALTERATION D REPAIR P
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SPECIAL CONDITIONS
APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED F0R ISSUANCE BY
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THIS PE
TION A
CONST
PERIOC
MENCE
1 HEREAPPLICALL PFTYPE CHEREICPRESUIPROVISCONST
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NOTICE V
•RMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
UTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IFAUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
» OF 120 \pAYS AT ANY TIME AFTER WORK IS COM-
D
BY CERTIFY THAT 1 HAVE READ AND EXAMINED THISATION AND KNOW THE SAME TO BE TRUE AND CORRECTIOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS)F WORK WILL BE COMPLIED WITH WHETHER SPECIFIED4 OR NOT. THE GRANTING OF A PERMIT DOES NOT*E TO GIVE AUTHORITY TO VIOLATE OR CANCEL THEIONS OF ANY OTHER STATE OR LOCAL LAW REGULATINGRUCTION OR THE PERFORMANCE OF CONSTRUCTION
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
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PERMIT FEES \
No
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Type of Fixture or Item
WATER CLOSET (TOILET)
BATHTUB
LAVATORY (WASH BASIN)
SHOWER
KITCHEN SINK & DISP
DISHWASHER
LAUNDRY TRAY
CLOTHES WASHER
WATER HEATER
URINAL
DRINKING FOUNTAIN
FLOOR— SINK OR DRAIN
SLOP SINK
GAS SYSTEMS NO OUTLETS
WATER PIPING 4. TREATING EQUIP
WASTE INTERCEPTOR
VACUUM BREAKERS
LAWN SPRINKLER SYSTEM
SEWER
CESSPOOL
SEPTIC TANK * PIT
PERMIT S
' TOTAL FEE S
Fee
$
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5"£
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WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK.MO CASH PERMIT VALIDATION CK MO CASH
INSPECTOR
79-359.5
INSPECTION REPORTS
DATE ITEM REMARKS INSPECTOR
•
USE SPACE BELOW FOR NOTES, FOLLOW-UP, ETC