HomeMy WebLinkAbout187 Hemlock St; ; 73-465; Permit/,
PLUMBING PERMIT APPLICATION /3-/(p 0 ~
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City of CARLSBAD, CALIFORNIA Cl "' > . I :a Q Q :a
Applicant to complete numbered spaces only. .. .. ..
J OB ADD~ ES'i.87 Hemlock '
~I LOT NO. Im I TftACT Q sEE ATTACHED SHE.E.T) LEGAL I 1 DUCft,
"'' OWNE .. MAIL ADDfllE.SS ZIP PHONE.
2 Vierra, • c;. )805 --artield 729-4526 i CONT .. ACTOIII MAI L ADDftESS PHONE. LICENSE. NO. . 3 ob•s lumb1ng 2501 tat• Carlabad 7299• 20.s.s 4856 ~ AfllCHI TECT OR DESIGNE.fll MAIL Aoo,ir.s s PHONE. LICENSE. NO,
4
' ENGINEER MAIL AODJU.SS PHONE LICENSE NO. ' 5
1~'"'· LI.NOCl'I . MAIL A00fllESS • I l ., BRANCH ; 6 r,.
use o,-BUILDING 1r1.. r 7
•NEW 0 ADDITION 0 ALTERATION 0 REPAIR ~ 8 Class of work: \.l
9 Describe work: Replace water heater I ~
~
PERMIT FEES
No. Type of Fixture or Item Fee
SPECIAL CONDITIONS: WATER CLOSET (TOILET) $
BATHTUB
LAVATORY (WASH BASIN)
SHOWER
KITCHEN SINK & DISP,
DISHWASHER
APPLICATION ACCEPTEO eY: PLANS CHECKEO BY: APPROVEO FOR ISSUANCE BY LAUNDRY TRAY
, CLOTHES WASHER
.L WATER HEATER
NOTICE URINAL
THIS PERMIT BECOMES NULL AND VOi DI F 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 AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND 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 2/24/73 -~ I L , I ' ,A~
SI C.NATURE. o, C0NTftACT0ft 0 .. AUTHV'JZED AGE.NT (DATE)
PERMIT $ --
TOTAL FEE $ ;) Vv
!IIGNAT Uftl: o, OWNE.ft 1, OWNEft IIUILDUI) (DATE.)
WHEN PROPERLY VALIDATED (IN THIS SPACEI THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.0 , CASH PERMIT VALIDATION CK. M.O. CASH
AUDIT
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