HomeMy WebLinkAbout2012 CIMA CT; ; 78-4912; PermitPLUMBING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spaces only Phone 729-1181 Permit No
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CONTRAC TOR
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ENGINEER
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COMPENSATION fNS CARRIER
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MAIL
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ADDRESS PHONE STATE LIC NO CITY L1C NO
ADDRESS PHONE LICENSE NO
ADDRESS PHONE LICENSE NO
ADDRESS BRANCH
USE OF BUILDING
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ADDITION
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D ALTERATION D REPAIR
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SPECIAL CONDITIONS
APPLICATION ACCEPTED BY
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PLANS CHECKED BY
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APPROVED FOR ISSUANCE BY
DATE
! NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK
TION AUTHORIZED IS NOT COMMENCED WITHIN
CONSTRUCTION OR WORK IS SUSPENDED OR ABA
PERIOD OF 120 DAYS AT ANY TIME AFTER
MENCED
1 HEREBY CERTIFY THAT 1 HAVE READ AND E
APPLICATION AND KNOW THE SAME TO BE TRUE
ALL PROVISIONS OF LAWS AND ORDINANCES GCTYPE OF WORK WILL BE COMPLIED WITH WHETHEREIN OR NOT THE GRANTING OF A PERI\PRESUME TO GIVE AUTHORITY TO VIOLATE O
PROVISIONS OF ANY OTHER STATE OR LOCAL LAI
CONSTRUCTION OR THE PERFORMANCE OF C
SI GNATU
SI GNATU
RE OF CONTRACTOR OR AuTHORIZ
(E OF OWNER (1 F OWNER BUTtDEF
ED AGENT
£^
)
WHEN PROPERLY
OR CONSTRUC
20 DAYS OR IFMDONED FOR A
WORK IS COM
AND CORRECT
)VERNING THIS
HER SPECIFIED/I IT DOES NOTR CANCEL THEA/ REGULATINGONSTRUCTION
(DATEI
(DATE)
PERMIT FEES
No
/
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 & TREATING EQUIP
WASTE INTERCEPTOR
VACUUM BREAKERS
LAWN SPRINKLER SYSTEM
SEWER NUMBER rLFANDMTS
CESSPOOL
SEPTIC TANK & PIT
ROOF DRAINS
ISSUANCE FEE S
TOTAL FEES $
Fee
S
cy
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VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK M O CASH
INSPECTOR