HomeMy WebLinkAbout2411 LA PLUMA LN; ; 76-3155; PermitMODEL N0.__,_ ,
BUILDING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spaces on/y. PhOfie 729"1181 PermitNo.
JOB ADDH ESS
2411 La Flwm hmm, Cath^lad, Qu
ASSESSOR'S
PARCEL NUIMBER
, LEGAL
1DESCR. 13S Itaadbo del VmtSmmM. Ill ([3]SEE ATTACHED SHEET)
PAGE
OH I
,^A1 L ADDRESS
ZFtxideim mmm, 140 SiisiBB Ate., «104, StOmm Beach, 9ms (7SS-97S6)
CON TRAC TOR MAIL ADDRESS STATE LIC. NO.
LICENSE NO.
A CITY LIC. NO.
ARCHITECT OR DESIGNER MAI L ADDRESS
^Mtm, BcMiaa « mxrOn, 1601 Tkm St,, f275» ^nipm 'Bmdk, Oi. C7S2)«924) 0395
ENGINEER HAIL ADDRESS LICENSE NO.
Rick Bisiamxii^. sm Pzicrs &d.» Sm m^, Ca. 92118 (291-0797} iSX9415
COMPENSATION INS. CARRIER MAIL ADDRESS
S'Xlie B^eywrs Self 40S0 MlsMm Mmi., lm fm^lm. Cm. I^Sl
USE OF BUILOING
7 Single finify w/gan^ NO. BDRtVIS.
8 Classofwork: DD NEW •ADDITION • ALTERATION • REPAIR • MOVE • REMOVE
9 Describe work; RMiidttttui - mm. 274 m
10 Change of use from
Change of use to
11 Valuation of work: $ :±9 ^:7y
SPECIAL CONDITIONS:
PLAN CHECK FEE S
Type o
Const il
PERMIT FEE $
Occupancy
Group £ — I
MICRO Fi LM FEE
Size of BIdg.
{Total) Sq. Ft •MA22f No. of
Stories
Max.
Occ. Load
APPLICATION ACCEPTED BY PLANS CHECKED BY
Fire
Zone
Use
Zone / Fire Sprinklers
Required Qve
No. of
Dwelling Units /
OFFSTREET PARKING SPACES:
Sq. Ft.
NOTICE
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-
ING, HEATING, VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED.
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
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT
Special Approvals
PLANNING DEPT.
HEALTH DEPT.
FIRE DEPT.
SOIL REPORT
OTHER (Specify)
ENGINEERING DEPT.
WATER DEPT.
SIGNATURE OF OWNER (IF OWNER BUILDER)
No.
Covered
Required Received Not Required
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.o. CASH PERMIT VALIDATION CK. M.O. CASH
TOTAL FEES $.
5^
INSPECTOR
LOT JS'S" .
' ' I. .1
BUILDING
FOOTINGS
FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
SHEATHING ^^-^
FRAT^E ?/Y/77
INSULATION \jlll?l VJJL
EXTERIOR LATH
INTERIOR LATH & DRYWALL
PLUMBING
SEWER AND PL/CO / p/V/^/WATER ^1^/"-
PLUMBING UNDERGROUND y/ ' '' ' • •
f-.f-yi • < •
COPPER i^/^Jjf^
TOP OUT \Z^j^1^^ MjJa
TUB AND SHOWER l/j/r? hUjL \
GAS TEST IZ/^/'^^
ELECTRICAL
UNDERGROUND
ROUGH /
CEILING HEAT
BONDING
MECHANICAL
DUCT & PLEM, REF.
HEAT—AIR
VENTILATING SYSTEMS
FINAL
Applicant to complete numbered spaces only.
PLUMBING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Phone 729-1181 Permit No. - y ••} -ycf
JOB ADOR ESS
24.11 X* Tlvmm, Imn, Carlsbatd^ C4
- LEGAL
1DESCR. 135
MAI L ADDRESS
fmmSBk BOm - 140 MftriJM Ti«v, Solosa 6wcb» CA
PHONE
755-7877
CON TRAC TOR MAIL ADDRESS STATE LiC. NO.
3 BC«TH (JOraW ¥imsm a»rEfUCTC^1050 W. WMhingt^m, l»c. 743-6193 297-967
CITY LIC. NO.
111J21
ARCHITECT OR DESIGNER MAI L ADDR ESS LICENSE NO-
MAIL ADDRESS LICENSE NO.
COMPENSATION fNS. CARRIER MAIL ADDRESS
USE OF BUILDING
8 Classofwork; '''5 NEW •ADDITION • ALTERATION • REPAIR
9 Describe work:
PERMIT FEES
No. Type of Fixture or Item Fee
SPECIAL CONDITIONS: 3 WATER CLOSET (TOILET) $ ^
1 BATHTUB 1
4 LAVATORY (WASH BASIN) i 2 SHOWER
1 KITCHEN SINK & DISP 1
DISHWASHER
APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY.
DATE
LAUNDRY TRAY APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY.
DATE
1 CLOTHES WASHER 1 ,50
APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY.
DATE 1 WATER HEATER i .50
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF
CONSTRUCTION OR WORK ISSUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED.
1 HEREBY CERTIFY THAT 1 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
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
URINAL NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF
CONSTRUCTION OR WORK ISSUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED.
1 HEREBY CERTIFY THAT 1 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
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
DRINKING FOUNTAIN
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF
CONSTRUCTION OR WORK ISSUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED.
1 HEREBY CERTIFY THAT 1 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
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
FLOOR—SINK OR DRAIN
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF
CONSTRUCTION OR WORK ISSUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED.
1 HEREBY CERTIFY THAT 1 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
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
SLOP SINK
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF
CONSTRUCTION OR WORK ISSUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED.
1 HEREBY CERTIFY THAT 1 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
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
GAS SYSTEMS: NO. OUTLETS 5 1 .50
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF
CONSTRUCTION OR WORK ISSUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED.
1 HEREBY CERTIFY THAT 1 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
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
WATER PIPING & TREATING EQUIP.
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF
CONSTRUCTION OR WORK ISSUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED.
1 HEREBY CERTIFY THAT 1 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
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
WASTE INTERCEPTOR
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF
CONSTRUCTION OR WORK ISSUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED.
1 HEREBY CERTIFY THAT 1 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
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
VACUUM BREAKERS
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF
CONSTRUCTION OR WORK ISSUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED.
1 HEREBY CERTIFY THAT 1 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
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. LAWN SPRINKLER SYSTEM
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF
CONSTRUCTION OR WORK ISSUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED.
1 HEREBY CERTIFY THAT 1 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
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
9
SEWER NUMBER CLEANOUT.=; 5 .00
CESSPOOL
SEPTIC TANK & PIT
ROOF DRAINS
SI GNATURE <^F fON TRAC TOR OR AUTHORIZED AGENT
SIGNATURE OF OWNER (IF OWNER BUILDER)
(DATE) SI GNATURE <^F fON TRAC TOR OR AUTHORIZED AGENT
SIGNATURE OF OWNER (IF OWNER BUILDER)
ISSUANCE FEE $ .5C
SI GNATURE <^F fON TRAC TOR OR AUTHORIZED AGENT
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) TOTAL FEES $ 3J .50
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.o. CASH PERMIT VALIDATION CK. M.O. CASH
INSPECTOR
Applicant to complete numbered spaces only.
ELECTRICAL PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Phone 729-1181 Permit No ^ ' ^
JOB ADDRESS
,LEGAL
IDESCR.
LOT NO.
135 73-18 (•SEE ATTACHED SHEET)
MAIL ADDRESS
2 ^taaimom VSmm 140 ^miao D»*.« sto 104t Beadit Ca« 1-^55-9756
CONTRACTOR MAIL ADDRESS
3 dnigar^ Kleetsrie« 143 Iiolii8>8« ^ do^te, Ca» 49S-dl63
STATE LIC. NO. CITY LIC. NO.
1054^ 10720
ARCHITECT OR DESIGNER MAIL ADDRESS LICENSE NO.
MAIL ADDRESS LICENSE NO.
COIVIPENSATION INS CARRIER MAIL ADDRESS
USE OF BUILDING
7 Wm imiiSmMj^
8 Class of work: [?NEW • ADDITION • ALTERATION • REPAIR
9 Describe work: west mcSj^m^uas^
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLANS CHECKEO BY APPROVED FOR ISSUANCE BY
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM
MENCED.
1 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 PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTROCTION OR THE PERFORMANCE OF CONSTRUCTION.
SIGNATURE OF CONTRACTOR OR AUT »I^J4D
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATEI
PERMIT FEES
No. Each Fee
SWIMMING POOL WIRING,
NO INCREASE IN SERVICE
NEW CONSTRUCTION, FOR EACH
AMPERES OF MAIN SERVICE, SWITCH,
FUSE OR BREAKER
100 25 00
NEW SERVICE ON EXISTING BLDG.
FOR EA. AMPERE OF INCREASE
IN MAIN SERVICE, SWITCH, FUSE
OR BREAKER
REMODEL, ALTERATION, NO CHANGE
IN SERVICE, FOR EA. AMPERE OF
INCREASE
TEMP. SERVICE UP TO AND INCLUD-
ING 200 AMP.
TEMP. SERVICE OVER 200 AMP.
PER 100
ISSUANCE FEE 1 ) 2
TOTAL FEES 27 00
WHEN PROPERLY VALIDATED IIN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
INSPECTOR
|Pj|r-^!!7>»...Ji,H,.|pj l!J.UpiHi.. i#)IP',l - .'.l".L
MECHANICAL PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spaces only. Phone 729-1181 Perm
-A-m9******l^M
JOB ADDR ESS
2411 tm PluM Umm, ^srim^, CA
LEGAL
1DESCR.
(QSEE ATTACHED SHEET)
MAI L ADDRESS
m HmtiM Hm mm. mUm Jtmmlh, CA mf% tfUiMSt
CONTRAC TOR
3 Ommmf Mr 1:^3 u.
MAIL ADDRESS STATE LIC. NO. CITY LIC. NO.
11176
ARCHITECT OR DESIGNER MAI L ADDR ES S LICENSE NO.
MAIL ADDRESS LICENSE NO.
MAIL ADDRESS
im Nttriw vtM am. §tm $m%mm
BRANCH
CA nsfs
USE OF BUILDING
8 Classofwork: BNEW • ADDITION • ALTERATION • REPAIR
9 Describe work:
Type of Fuel: Oil • ^^^^^ Nat. Gas
PERMIT FEES
LPG. •
SPECIAL CONDITIONS: No. Type of Equipment Fee
Air Cond. Units-H.P. Ea.
Refrigeration Units-H.P. Ea.
Boilers-H.P. Ea.
Gas Fired A.C. Units-Tonnage Ea.
Forced Air Systems-B.T.U. M Ea. 4,00
APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY Gravity Systems-B.T.U. M Ea.
Floor Furnaces—B.T.U. M
Wall Heaters.-B.T.U. M
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED.
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
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
Unit Heiters-B.T.U. M
Evaporative Coolers
Clothes Dryers
Ventilation Fan
Range Hood
Air Handling Unit-C.F.M.
Incinerator
SIGNATURE OF CONTRACTOR QR AUTHORIZED AGENT f ISSUANCE FEE
SICNAT(JWE or OWNER (IF OWNER BUILDEH) TOTAL FEES 44,
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
INSPECTOR