HomeMy WebLinkAbout2858 CARLSBAD BLVD; ; 78-4276; PermitPLUMBING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spaces only. Phone 729-1181
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1 DESCR.
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LOT NO.
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BLK
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TRACT
MAI^ ADDRESS IIP f~~ ~\ PI4S£E /" S* /
COMPENSATION fNS. CARRIER
6
USE OF BUILDING
7
8 Classotwork: D NEW D ADDITION
9 Describe work: \ .,4
M*TL AlfbRESS PHONE STATE LIC. NO. CITY LIC. HO.
MAIL ADDRESS PHONE LICENSE NO.
MAIL ADDRESS PHONE LICENSE NO.
MAIL ADDRESS BRANCH
O(ALTERATION D REPAIR
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SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PL***flftmecxED BY.. ,
NOTICE
THIS PERMIT BECOMES NULL AND VOID IFVTION AUTHORIZED IS NOT COMMENCED WlCONSTRUCTION OR WORK IS SUSPENDED OPPERIOD OF 120 DAYS AT ANY TIME AF
MENCED
1 HEREBY CERTIFY THAT 1 HAVE READ f>APPLICATION AND KNOW THE SAME TO BE 'ALL PROVISIONS OF LAWS AND ORDINANCTYPE OF WORK WILL BE COMPLIED WITH \HEREIN OR NOT, THE GRANTING OF APRESUME TO GIVE AUTHORITY TO VIOLAPROVISIONS OF ANY OTHER STATE OR LOCflCONSTRUCTION OR THE PERFORMANCE
SIGNATURE OF CONTRACTOR OIT AVfHOR 1 Z ED A6ENT
SIGNATURE OF OWNER (IF OWNER BUILDER)
APPROVEpi6e"FriSSliANtE BY.
JL ' "' L~^ - ^ ' &
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DATE /"/'/ jr^3>
WORK ORCONSTRUC-
rHIN 120 DAYS, OR IF
ABANDONED FOR A
TER WORK IS COM-
fRUE AND CORRECT.
WHETHER SPECIFIED
TE OR CANCEL THE
OF CONSTRUCTION,
«"1 *•* *~'~
1 *r\ 1 *• / ?X
' (DATE)
(DATE)
PERMIT FEES
No.
/
Type of Fixture or Item
WATER CLOSET (TOILET}
BATHTUB
LAVATORY (WASH BASiN)
SHOWER
KITCHEN SINK & DI5P.
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 MIIMRER CLEANOIITS
CESSPOOL
SEPTIC TANK & PIT
ROOF DRAINS
ISSUANCE FEE $
TOTAL FEES $
Fee
$
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{ £>
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WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK.M.O.CASH PERMIT VALIDATION CK.M.O.CASH
INSPECTOR