HomeMy WebLinkAbout2172 CHESTNUT AVE; ; 75-1916; PermitPjMBING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA
Applicant to complete numbered spaces only.Rermit No.
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ADDRESS f ^H**? PHONE LICENSE NO.
ADDRESS PHONE LICENSE NO.
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ADDRESS .-•'«.^ BRANCH
5^88 S«^ Di»co ^138 ~~~^
USE OF BU 1 LD1N G , . '
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8 Class of Work: D NEW D
f] Describe work: wMNiF lM
ADDITION
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D ALTERATION D REPAIR
AU£«(Ott%
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SPECIAL
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CONDITIONS:
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APPLICATION ACCEPTED BY t
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PLANS CHECKED BY 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 $N;Y TIME AFTERMENCED. :,..,. , Ji|;;
1 HEREBY CERTIFY THAT 1 IfAVE READ AND E
APPLICATION AND KNOW THESS.AME TO BE TRUE
ALL PROVISIONS OF LAWS ANESORDI NANCES GC
TYPE OF Wd-BiK-dW-U-L BEvCOMPLlED WITH WHET
HEREIN OR •NEHT; THE GRANTING OF A PERISPRESUME TO GliVE AUTHORITY TO VIOLATE O
PROVISIONS OF ANY OTHER STATE OR LOCAL LA\
CONSTRUCTION OR THE PERFORMANCE OF C
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SIGNATURE OF CONTRACTOR OR AUTHOR/Si
SIGNATURE OF OWNER (IF
'G2on
•DAGENT
It!
OWNER BU ILDER)
OR CONSTRUC-
50 DAYS, OR IF
MDONED FOR A
i/VORK IS COM-
XAMINED THIS
AND CORRECT.
JVERNING THIS
HER SPECIFIED/1IT DOES NOT
R CANCEL THE
N REGULATING
ONSTRUCTION.
>W?5
(DATEI
(DATE)
>_i-«A,v ---.. '-••;.;-":.".^. ^^pgRMIT FEES * ? : * ; ..'.•...
No.
,
. ... .:•».-
Type of Fixture or Item v
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 4-?'
SEPTIC TANK & PIT
ROOF DRAINS
PERMIT $
TOTAL FEE $
Fee
$
£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
INSPECTION REPORTS
DATE ITEM REMARKS INSPECTOR
USE SPACE BELOW FOR NOTES, FOLLOW-UP, ETC.