HomeMy WebLinkAbout2712 JACARANDA AVE; ; 78-2128; Permit..
MODEL NO. _________ _
City of CARLSBAD, CALIFORNIA 92008 -, ¥ ·:JJ;JJ
Applicant to complete numbered spaces only Phone 7 29-1181 Permit No
Joe ADD" rss S A--C.. I+ t<. '4 IV D A
ASSESSOR'S
~ 71d. '41/£ II. r PARCEL NUMBER
LOl NO, I I LK , T•ACT BOOK PAGE I PAR.
LEGAL I I 10sec ATTAC!o1E0 SH[ETi 1 DtSCR, I ,:. L
0WN[A MAIL A00"t55 \ ZIP PMONE. 8'f&a 2 r: , I ,. t{\ 753 . { ' 't1
CON TRAC TOIi MAIL A0D At5S PHON [ STATE LIC, NO. CITY L IC. HO.
3 I r \_
,U~:CHITCCT Oflt OCSIGNCft MAIL A 00R£S5 PHONE LIC[NSE NO.
4
[HGINttlll MAIL .t.OOR(S5 PM ONE t.lCCNSC. NO.
5
COMPENSATION INS._ CARRI ER MAIL ADOIICSS &IIIIANCH
6 ~ __,
ust 0,. BUil.DiNG
7 ~ ----......,_ NO. BDRMS NO. BATHS
8 Class of work: 0 NEW ( 0 ADDITION ~ ALTERATION 0 REPAIR 0 MOVE 0 REMOVE
9 Describe work: fr+no Co V(3-(2_ /J X ;/ti
,,, ?I~ g-)
10 Change of use from
Change of use to '
11 Valuation of work. $ I h' • -9 . ( <,)
/ -PLAN CHECK FEES . PERMIT FEE $
SPECIAL CONDITIONS MICRO FILM FEE
Type of Occupancy
Const Group
Sile of Bldg. No. of Max.
(Total) Sq Ft Stories 0cc. Load
I Fire use I Fire Sprinklers
APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED Fi ISSUANCE BY Zone Zone ifequ~d 0Yes □No
OFFSTREET PARH l~G ~S· ~ 4 '/" N o. of I ) No, ~ . ~ r Dwelling Units No. S,. Ft. I open CATE Covered
NOTICE Special Approvals Required i R,ceiv, ~ Not Required
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB· PLANNING DEPT. ~ / l A
ING. HEATING. VENTILATING OR AIR CONDITIONING. HEALTH OEPT. I\J /1 THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC· l\ /I j ' v I TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF FIRE DEPT
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A SOIL REPORT ' I [7 I (
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM· I Y' JI jV \ MENCED. OTHER (Specify)
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS ENGINEERING DEPT. \ 7 1 r" -\ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. I (_l I ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS WATER DEPT. , TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED ~ .. / p \, V HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO V IOLATE OR CANCEL THE \ \,] 7, V PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING -' CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. I ' V I u--c -I -\ _/'\
51GMATU,i[ o, CONTIIIA.CTOIII OJ!t AUTH09'1Zl.0 AGCNT (DAT[) I / ,I\''/ ..I
J 17!1 ...,. -. I '1/1 t/ fi. '1'-' ,rll-/ \ I (OAT[) ~ICHATUIII[ 0' OWN[III II,-OWN['I IUILDEIII)
WHEN PROPERLY VALIDATED ON THIS SPACE) THIS IS vou'i<PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION
INSPECTOR
CK. M.O.
.,) (
TOTAL FEES $ __ ..,.l __ (o __ --_
CASH
...
PLUMBING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Phone 729-1181 Applicant to complete numbered spaces only
-r "];., y;. .. .--:, ?, I~
Permit No ~ ·
JOB AOl)llll [$5
) l ,~ ' LOT NO. I OLK I TUCT LtGAL I \ \ 1 ocsc•. ,.. I \ \
O~NEllt hAAI L AO0fll[95 ZIP PMONC
2 \ \( ) ' r -CONT ... ACTOIII MAIL A00A:ES5 PHONE STATE LIC. NO. CITY LIC, NO.
3 ' l \ A
,. . / .). r ~ 'I. .
AflllCHI TEC T 011 OESIGNUI MAIL A0Ollt[55 PHONE 1..IC[NSE NO,
4 l \ t I\
[NGIHEE.flt MAIL AOOAtSS PHON[ LICENSE NO.
5
COMPENSATION (NS . .CARRI ER cL. MAIL A0091![S.5 IIIIIANCM
6
-• ,....J' ,,\
U5C OF IIUlt.OING l 7
8 Class of work: 0 NEW 0 ADDITION □ALTERATION 0 REPAIR .
9 Describe work:
PERMIT FEES
No. Type of Fixture or Item Fee
SPECIAL CONOITIONS WATER CLOSET (TOILET> $
BATHTUB
LAVATORY (WASH BASIN)
SHOWER
K ITCHEN SINK & OISP.
DISHWASHER
APPLIC.A TIO"" ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY LAUNDRY TRAY
'J CLOTHES WASHER Ci,,. 1-, DATE WATER HEATER
NOTICE URINAL
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUC DRINKING FOUNTAIN
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANOONE D FOR A FLOOR-SINK OR DRAIN
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-SLOP SINK
MENCEO. GAS SYSTEMS NO. OUTLETS I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS APPLICATION ANO KNOW THE SAME TO BE Tt=lUE ANO CORRECT. WATER PIPING & TREATING EQUIP. ALL PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED WASTE INTERCEPTOR HEREIN OR N OT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE t\ VACUUM BREAKERS ... C 1 PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. LAWN SPRINKLER SYSTEM _, .~
SEWER NUMBER CLEANOUTS
CESSPOOL
SEPTIC TANK & PIT
J ) 'Y ROOF DRAINS
SIGNATU111£ OF CONT,tA(TOJI 0 .. AUTHOllllllED AGENT (DA TE J
' ISSUANCE FEE $ , (
S"NATUllU: Of' OWN[fl Ir OWNtfl 8UILOtft) OATt> TOTAL FEES $ (.
WHEN PROPERLY VALIDATED (IN THIS SPACEt THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M .O. CASH
INSPECTOR
•
•
CITY OF CARLSBAD
BUILDING DEPARTMENT
(714) 729-1181
CERTIFICATION
I certify that in the performance of the work for which this permit is issued I shall not
employ any person in any manner so as to become subject to the workers' compensation
laws of California.
If, after making this certificate, I become subject to the workers' compensation pro-
visions of the California Labor Code, I will forthwith comply with Section 3700 of the
Labor Code.
I understand that if I fail to comply with the workers' compensation laws, this permit
shall be deemed revoked.
I further certify that if I should contract or subcontract with any person, including any
firm or company, to do all or part of the work for which this permit is issued, I shall assure
~~~:liance by that contractor or subcontractor~with Section 38; o~f the California Labor
SIGNED: C ·
PRINT NAME AND TITLE:~ + ~/?..,Of'i
(OuJ/UIE
JOB ADDRESS: d:7/d--04o--A/2.J1,IJ})f!-AUE, 611R..L5f, . 7 ~
DATED: 0/,½L ~ l17Y '