HomeMy WebLinkAbout2168 CHESTNUT AVE; ; 75-758; PermitPLUMBING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA
Applicant to complete numbered spaces only.Permit No..
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CONTRACTOR ^/
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ARCHITECT OR DESIGNER
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ENGINEER
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MAIL ADDRESS PHONE LICENSE NO. STATE C TY
MAIL ADDRESS PHONE LICENSE NO.
MAIL ADDRESS PHONE LICENSE NO.
MAIL ADDRESS BRANCH
USE OF BUI LD1N G
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8 Class of work: j£
S"9 Describe work: vv-J
£NEW n ADDITION
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D ALTERATION D REPAIR
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SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLANS CHECKED BY
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF V
TION AUTHORIZED IS NOT COMMENCED WrCONSTRUCTION OR WORK IS SUSPENDED OR
PERIOD OF 120 DAYS AT ANY TIME AFMENCED.
I HEREBY CERTIFY THAT I HAVE READ ftAPPLICATION AND KNOW THE SAME TO BE 'ALL PROVISIONS OF LAWS AND ORDINANCTYPE OF WORK WILL BE COMPLIED WITH \
HEREIN OR NOT, THE GRANTING OF A
PRESUME TO GIVE AUTHORITY TO VIOLA
PROVISIONS OF ANY OTHER STATE OR LOCP
CONSTRUCTION OR THE PERFORMANCE
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT
SIGNATURE OF OWNER II F OWNER BUILDER)
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APPRO^E/fftlR ISSUANCE BY
DATE f-f
YORK OR CONSTRUC-
fHIN 60 DAYS, OR IFABANDONED FOR A
TER WORK IS COM-
ND EXAMINED THISFRUE AND CORRECT.ES GOVERNING THISWHETHER SPECIFIEDPERMIT DOES NOT
TE OR CANCEL THEL LAW REGULATING
OF CONSTRUCTION.
(DATE)
(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
CESSPOOL
SEPTIC TANK & PIT
ROOF DRAINS
PERMIT $
TOTAL FEE %
Fee
$
5"
"7
'•52.
Cf'*f
% <s
<T£>
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK.M.O.CASH PERMIT VALIDATION CK.M.O.CASH
INSPECTOR