HomeMy WebLinkAbout1826 Forest Ave; ; 71-1010; Permit2
~~ ... 0
7 I -IO I D City
..
of CARLSBAD, CALIFORNIA ~~
~ Applicant to complete numbered spaces only. I~
PLUMBING PERMIT APPLICATION
JOB ADDA ESS ~ ~-r l~. ~ I {l,. (,., p lll'lll , n-"11 5P~ (~S..'th"t.1t1 ~~ 00 , -LOT NO. I BLK I T",\CT QsEE ,\TT,\CHED SHEET) 1 ~i~~~-~ C
2 ow~i,v J'? -0 e {'c__P MAIL ADOftESS 11P PHONE ~"/1 7;; 9 -%<15 9 r,. ,..;..
Yn\o -Jc)
CONTPIACTOR MAIL ADDPIESS PHON£ LICENSE NO. ):, 3 JOHN HOLDERER & SON, INC. 3470 ADAMS AVE 281-6615 203684
MAIL AODPIESS PHONE LICENSE NO. -. ~ ARCHITECT OR DESIGNER 0
4 ~
ENGINEEIII MAIL ADDRESS PHONE LICENSE NO, 0 5 (0
LEND EA MAIL AOOli':ESS 8111:ANCH
6
USE OF BUILDING ·~ 7 ~
8 Class of work: D NEW ~ ADDITION D ALTERATION D REPAIR \
~
Describe work: Gas Light 9 I"--
C)
PERMIT FEES
No. Type of Fixture or Item Fee
SPECIAL CONDITIONS: WATER CLOSET (TOILET) $
BATHTUB
LAVATORY (WASH BASIN)
SHOWER
KITCHEN SINK & OISP. . DISHWASHER ... 7 ~CCEPTEO BY. PLANS CHECKED BY . -~~ ~UANCE BY: LAUNDRY TRAY
CLOTHES WASHER
WATER HEATER -URINAL NOTICE " THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-DRINKING FOUNTAIN
TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF FLOOR-SINK OR DRAIN CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-SLOP SINK
MENCED. GASSYSTEMS:NO.OUTLETS
I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS 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
~ /I .A~ 0 -j "-"' //fn.9/7 I
SEPTIC TANK & PIT
C"Tl/l>.E Ol' CONTIUCTO" OR AUTH'f>R?;)"AG'CNT /IDATE)/ ~ .
PERMIT $
S IGNATU .. E OP' OWNE .. {I,-OWNE" &UIL0£1'1 (OAT£) TOTAL FEE $ 5 00
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
INSPECTOR
.......... R ... l""C'I .,..,,,...~. lldT~Ct,.tA,"l t"\"'-IAI f"'t"l"'-1~~~~1'.lf'.I=' nl=' RIii! n1N('; CFFICI ALS • so 80, LOS ROBLES e PASAOENA. CALIFORNIA 0 110 1
PLUMBING PERMIT APPLICATION
-'i'~ .., /
Permit No. I City of CARLSBAD, CALIFORNIA
Applicant to complete numbered spaces only.
.JO& ACOR £SS 0 L -0
f""'2 _A ,),..J)
:I: 0 Cl)
:.,£ > z Ill~ P~-3 ,,,, Ill )>;:::;.:
LOT NO. I 8 LK
-I T"ACT '-., ll 02
LE~AL I QsEE ATTACHf.D SHE.ET) 00 1 OESC~. ll,
-,'' Ill ... OWII£" // (Y1~/A MAIL AOD .. ESS ZIP PHONE u,
2 ,,I r 1'1 I .A -A ~
.~
COJ"TI ... CTO" ' -----MAIL AD0A£SS PHONE LICENSE NO,
3 ~ _A.
ARCHITECT DA DESIGN£,. MAIL ADOAESS PHONE LICENSE HO, iJ 4 -~~ '-...J _,_
:~ ENGINE£", MAIL ADD .. IESS PHOM!: LICENSE HO. ~. 5 _;a.-z .A >-i---,
---L ~ \. LE.N0£11t MAIL AOD .. ESS BllltANCH ~ 6 ~~ --~
USE OF BUILDING -
j i\ 7
(~
8 Class of work: ONEW 0 ADDITION 0 ALTERATION ,fotREPAIR ;~ s
~
J
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.
"""'1 . DISHWASHER
APPLICATION ACCEPTEI'.) SY'' PLANS CHECKED SY -'·"~"" LAUNDRY TRAY
/X;' JI/, CLOTHES WASHER
~ WATER HEATER J -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 -SINK OR DRAIN CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-SLOP SINK
MENCED. GAS SYSTEMS: NO. OUTLETS I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS APPLICATION ANO KNOW THE SAME TO BE TRUE ANO CORRECT. WATER PIPING & TREATING EQUIP. ALL PROVISIONS OF LAWS AND 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
SIGNATURE OP' CONT,.ACTO,. O" AUTHO"IZEO AGENT (OATE)
PERMIT $
,; . ,J
.$1G,NATLIRE. OP' 0WN£fll IP' OWNER BUILD£" DATE) TOTAL FEE $ -
WHEN PROPERLY VALIDATED (IN THIS SPACEI ,:HIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
INSPECTOR