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HomeMy WebLinkAbout2687 ROOSEVELT ST; ; 77-401; Permity G) ** 9.00 PLUMBING PERMIT APPLICATION City of CARLSBAD, CALIFORNIA Applicant to complete numbered spaces only Perm it No 7 /f 0 / JOB AOOR E.55 (~ •~-.- -< / r' 1 I(<,(,~ JC • -t ~ LOT NO, l ■LK I T~AC T - LEGAL I t DESC~. 2 Dit-!~10 V,, },MAIL A;:l:s y Zl P PHOHC ,I_ ~e ~t f'/N(j t . l,ay c-r ) ,,;1 '/ r-/ ., ... CON TRAC TO .. /_/ I MAIL ADOACSS PHONE LICENSE. NO. ST ATE CITY 3 --ARCHITECT OR DESIGNER MAIL ADDA CSS PHONE LICENSE NO. 4 ENG IN CCR MAIL AOOR £55 PHONE LICENSE NO. 5 COMPENSATION (NS. CARRIER MAIL ADDRESS BRANCH 6 use OF BUILDING 7 8 Class of work : □NEW □ ADDITION □ ALTERATION ffiEPAIR q 0 escribe work: N c..u 6 A,::. l IN c.._ PERMIT FEES No. Type of Fixture or Item Fee SPECIAL CONDITIONS: WATER CLOSET (TOILET) $ BATHTUB LAVATORY (WASH BASIN) SHOWER KITCHEN SINK & DISP. DISHWASHER APPLICATION ACCEPTE.r BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY LAUNDRY TRAY .,. CLOTHES WASHER /,,l / CATE WATER HEATER NOTICE URINAL THIS PERMIT BECOMES NULL AND VOID IF 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. t--GAS SYSTEMS: NO.OUTLETS I 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 AND ORDINANCES GOVERNING THIS TYPE OF WO RK WILL BE COMPLIED WITH WHETHER SPECIFIED WASTE INTERCEPTOR HEREIN OR NOT, THE GRANTING O F A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE VACUUM BREAKERS PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. LAWN SPRINKLER SYSTEM SEWER CESSPOOL SEPTIC TANK & PIT ROOF D R AI NS SIGNATU"E o, CONTRACTOR OR AU THO .. I ZEO AGENT (DATE) ;, ~-: c' //' ?/77 PERMIT $ J I) TOTAL FEE $ ':/ 4' ....... 51 GNATU Nt OP' OWN!.N t,' OW,IUI I U ILOtAJ CAT E) WHEN PROPERLY VALIDATED (IN THIS SPACEI THIS IS YOUR PERMIT , PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH INSPECTOR