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LOT NO. LEGAL 1 DESCR.
# PLUMBING PERMIT APPLICATION
ILK TRACT (OSEE ATTACHED SHEET)
f City of CARLSBAD, CALIFORNIA ,- I .J-
1 .Jplicant to complete numbered spaces only.
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SPECIAL CONDITIONS:
I r
~...
No. I Type of Fixture or Item I Fee
I WATER CLOSET (TOILET1 IS I
I I I
OWNER MAIL ADDRESS PHONE
2 Shield@,& Tm 2070 Barpwa9d
3 Bab's Plumbbg 2.91 St&%@ Ca~l8Wd 729-2055 245707
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CONTRACTOR MAIL ADDRESS PHDNE LICENSE NO.
ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO.
14
ENGINEER MAIL ADDRESS PHONE LICENSE NO.
5 &' c
6
7
LENDER MAIL ADDRESS BRANCH
USE OF BUILDING
18 Class of work: 0 NEW 0 ADDITION 0 ALTERATION 0 REPAIR I 1
I PERMIT FEES
I I BATHTUB I I
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT CQMMENCED WITHIN 60 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR' ABYDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK tS COM- MENCED. i ~
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS" APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT THE GRANTING OF A PERMIT DOES NOT
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PRESUME TO GIV'E AUTHORITY TO VIOLATE OR CANCEL THE
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GAS SYSTEMS: NO. OUTLETS
WATER PIPING & TREATING EQUIP.
WASTE INTERCEPTOR
I I VACUUM BREAKERS II
I I LAWN SPRINKLER SYSTEM II
I I SEWER II
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CESSPOOL
SEPTIC TANK 61 PIT 7/17/73
I I I I I SIGNATURL OF CONTRACTOR OR AUTHORIZED AGENT (DATE) I
SIGNATURE or OWNER iir OWNER BUILDER) (OATE) ~ ~~
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERM IT VALIDATION CK. M.O. CASH
Form 100.2 9-69
AUDIT
REORDER FROM: INTERNATIONAL CONFERENCE OF BUILDING OFFICIALS e 50 so. LOS ROBLES PASADENA. CALIFORNIA 91 101