HomeMy WebLinkAbout1790 BASSWOOD AVE; ; 77-615; Permit:Tt;p i*l* dbj.' 0. PLUMBING PERMIT APPLICATION
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$
TOTAL FEE $
PERMIT
City of CARLSBAD, CALIFORNIA
Applicant to complete numbered spaces only. Permit NO. '?
JOB ADOR ESS 17 20 ?fJq iJ(U0Ud
LOT NO. OLK TRACT
LEGAL I OESCR.
OWNER MAIL ADORESS PHONE z ELEMOR DAYIS 17'90 Bassrvaad 92& 729-6381
CITY LICENSE NO. STATE CONTRACTOR MAIL AOORESS PHONE
3 BOB'S F3,UEBXNc SWXCE, 291 State,Carlsbael 729-2055 245307 11473
PHONE LICENSE NO. ARCHITECT OR DESIGNER MAIL AODRE55
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EN GIN EER MAIL AOORZSZ 7 PHONE LICENSE NO. :. *t d' 3 -3
COMPENSATION INS. CARRIER MAIL AOORESS BRANCH
; STATE COIP. INS. FUND Po 00 BOX 80488 Saur f)iWo, CI. 92138
USE OF BUlLOlNG
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I Class of work: c] NEW 0 ADDITION 0 ALTERATION 0 REPAIR
I Describe work: -
I PERMIT FEES
No. Type of Fixture or Item Fee
PECIAL CONDITIONS: WATER CLOSET (TOILET) $
BATHTUB
LAVATORY (WASH BASIN)
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iPPLlCATlON ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY .---
'-. * DATE "- * "L ~ I- *
NOTICE
TlON AUTHORIZED IS NOT COMMENCED WITHtN 60 DAYS,>OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
MENCED
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTAUC..
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
SIGNATURE OF OWHER (IF OWNER BUlCOERI (DATE1
I SHOWER Ill
KITCHEN SINK &
DLSHWASHER
LAUNDRY TRAY I *
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CLOTHES WASHER, - t au A 1 WATERHEATER Fy
1 URINAL -1 I I . DRINKING, FOUNTAIN I 1 FLOOR -SINK OR DRAIN I
1 SLOPSINK Ill I GAS SYSTEMS NO. OUTLETS Ill
I WATER PIPING L T-ATING EQUIP. .I I I
WASTE INTERCEPTO~
VACUUMBREAKERS~
LAWN SPRINKLER $STEM
SEWER
I CESSPOOL Ill
I SEPTIC TANK I PIT Ill
ROOF DRAINS I I I
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
INSPECTOR