HomeMy WebLinkAbout1048 CARLSBAD VILLAGE DR; ; 78-4010; PermitPLUMBING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008,
Applicant to complete numbered spaces only PhOHG 729-1181 Permit No
JOB ADDR ESS
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. LEGAL
1 DESCR
OWNER_ ,
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CONTRACTOR ,
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ENGINEER
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COMPENSATION fNS CARRIER
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USE OF BLMLDI Njtf
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8 Classof work D NEW D ADDITION
3 Describe work /fbty
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MAILA.QDRESS ZIP PHONE
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f MAIL ADDRESS . /) PHONE STATE L I C, NO CITY L1C NO
jri&AIL ADDRESS PHONE LICENSE NO
MAIL ADDBESS PHONE LICENSE NO
MAIL AODRESS 8RANCH
D ALTERATION ^&nfpAIR
SPECIAL CONDITIONS
APPLICATION ACCEPTED ev
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PLANS CHECKED BY
'-*]?-7<5
/ NOTICE
THIS PERMIT BECOMES NULL AND VOID IF V
TION AUTHORIZED IS NOT COMMENCED Wl
CONSTRUCTION OR WORK IS SUSPENDED OF
PERIOD OF 120 DAYS AT ANY TIME AF
MENCED
1 HEREBY CERTIFY THAT 1 HAVE READ P
APPLICATION AND KNOW THE SAME TO BE
ALL PROVISIONS OF LAWS AND OROINANC
TYPE OF WORK WILL BE COMPLIED WITH
HEREIN OR NOT, THE GRANTING OF A
PRESUME TO GIVE AUTHORITY TO VIOLA
PROVISIONS OF ANY OTHER STATE OR \-OCf
CONSTRUCTION OR THE PERFORMANCE
/
*SlfcNfcTuflE Of" CONTRACTOR OR AUTHORIZED AGENT *
SIGNATURE OF OWNER IF OWN ER BUILDER)
APPROVED FOR ISSUANCE BY
DATE
WORK OR CONSTRUC
fHIN 120DAYS.OR IF
ABANDONED FOR A
TER WORK IS COM
NO EXAMINED THIS
FRUE AND CORRECT
ES GOVERNING THIS
WHETHER SPECIFIED
PERMIT DOES NOT
TE OR CANCEL THE
^L LAW REGULATING
OF CONSTRUCTION
/- '/""'
(OATE)
PERMIT FEES
No
/
Type of Fixture or Item
WATER CLOSET (TOILET)
BATHTUB
LAVATORY [WASHBASIN)
SHOWER
KITCHEN SINK 8, DISP
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 NUMBER CLEANOUTS
CESSPOOL
SEPTIC TANK & PIT
ROOF DRAINS
ISSUANCE FEE $
TOTAL FEES $
Fee
S
^y
•£$
( tj
>£t)
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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