HomeMy WebLinkAbout2893 BRENTWOOD CT; ; 81-106; PermitUSE BALL POINT PEN AND PRESS FIRMLY
ELK. LOT NO. I ;E:::. TRACT (OSEE ATTACHED SHEET1
ENGINEER MAIL ADDRESS PHONE LICENSE NO. 5
COMPENSATION INS CARRIER MAIL ADDRESS
6 Northern Assurance Co. 3333 Cmbo del Rio South 92108 &
USE OF BUILDING
1
j Clau of work: aNEW 0 ADDITION 0 ALTERATION 0 REPAIR
Temporary service 1 Describe work:
SPECIAL CONDITIONS:
UPLICATION ACCEPTED BY I CLANS CHECKED BY I APPR~E&O8bSSUWCE BY
, - . . , - . , . , . ,
NOTICE I ! 1.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 120 0AYS.OR IF CONSTRUCTION OR WORK ISSUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM MENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINE0 THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIEO HEREIN OR NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GlVk AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
2/20/81
ACT~R CR UTHORIZED AGENT (DATE)
SIGNATURE OF OWNER [IF OWNER BUILDER) (DATE)
PERMIT FEES
SWIMMING POOL WIRING,
NO INCREASE IN SERVICE
NEW CONSTRUCTION, FOR EACH AMPERES OF MAIN SERVICE, SWITCH, FUSE OR BREAKER
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
I
ISSUANCE FEE
TOTAL FEES
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT ~~
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O.
BLDG DEPT (WHITE) APPLICANT (PINK) TEMP. FILE (GOLD) INSPECTOR ( MANILLA HARD COPY)