HomeMy WebLinkAbout2631 ROOSEVELT ST; ; 71-223; Permit2 u B 0 ~ :e 0
z .. PL M ING PERMIT APPLICATION
#1/-:?d3 City of CARLSBAD, CALIFORNIA 5PAIO _,.,. "' >
PERMIT HAR 23-71 ., .; 6.0 -cc1096 ~ .., Applicant to complete numbered spaces only. .. .. 0
JOB ADOR ESS ... i ' 2631 Roosevelt Street t ~:
LOT NO. I 8LK I T"ACT QSEE ATTACHED SHEET) ' ~ 5 LEGAL I l>-> 1 DESC"• ...... ~ OWNEfll MAIL ADDftESS ZIP PHONC ~ 2 Nancy Johnson 2631 Roosevelt St. 92008 729-.5201 I
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CONTftAC TOR MAIL AODfllESS PHONE City,!tsJO~ ~ (lJ 3 Bob's Plumbing Service 2501 State st. 729-2055 Cont. 2 57 7 UJ
AfttHITECT OR DESIGNER MAIL AODftESS PHONE. LICENSE NO. ' ~ ~ 4 I ~ ~ ENGINEER MAIL ADDRESS PHONE LICENSE NO,
5 I ' ~ LENDER MAIL ADDIIESS I BfllANCH ~ 6 ~ I -
USE OF BUILDING I ~
7
8 Class of work: □NEW □ ADDITION □ ALTERATION □ REPAIR
9 Describe work: Install Water Heater
I
PERMIT FEES
No. Type of Fixture or Item Fee
SPECIAL CONDITIONS: WATER CLOSET (TOILET) $
BATHTUB
LAVATORY (WASH BASIN)
SHOWER
KITCHEN SINK & OISP.
DISHWASHER
APPLICATION ACCEPTEO BY: PLANS CHECKEO BY: APPROVEO FOR ISSUANCE BY: LAUNDRY TRAY
CLOTHES WASHER
1 WATER HEATER 1 50
NOTICE URINAL
THIS PERMIT BECOMES NULL AND VOID I F WORK OR CONSTRUC-DRINKING FOUNTAIN
TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF FLOOR-SINK OR DRAIN CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-SLOP SINK
MENCED. GASSYSTEMS:NO.OUTLETS I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. WATER PIPING & TREATING EQUIP. ALL PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED WASTE INTERCEPTOR H EREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE V ACUUM BREAKERS PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. LAWN SPRINKLER SYSTEM
SEWER
2tL 1r{IJ(/4~ CESSPOOL
--1 ,.,I I ,.,. ,_,.l',4'.,.. MM ., -;971 SEPTIC TANK & PIT ~;/" • f/ /r' I
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SIGNATURE. OP' CONTRACTOfl OR AUTHORf~~ ~Gt.NT (DATE)
PERMIT $ 3 )0
91GNATIIR£ OP' OWNEft IP' OWNER BUIL0£R DATE) TOTAL FEE $ 5 0
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
INSPECTOR
Form 100.2 9·69 REORDER FROM: INTERNAT IONAL CONFERE N C E O F B U ILOING OFFICIALS e 50 90. LO S ROBLES e PASADENA, CALI P'ORNIA 91101