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HomeMy WebLinkAbout1051 Palm Ave; ; 78-20; PermitPLUMBING PERMIT APPLICATION City of CARLSBAD, CALIFORNIA 92008 Applicant to complete numbered spaces only. Phone 729-1181 JOB ADOllt £$5 ~. //)<;"/ I .:oT NO, -OLK I T•Ac T LC GAL 1 Dtsc•. owl),, Y} / / J ,k7 /)\/ ;;;;;••~nPM ZIP PHONC 2 CON l'1fAC TO iii• V'" . ;)/~ MA IL ADDRESS ,.,,,,,-4, PHON t STATE LIC. NO, 3 A .l1 _/OA7/'l71 'JL.p / e-;: I_:_._< C "7-'1? !,/-7/✓ ::;c./f? 296 ... AfllCHltt"'cT Ollf'9'ESrcNCR . , (7 ~t L ADDlltCSS , -P'40NC I L,..ICCNSC .to. 4 [HCINCCIIJ MAIL A0Dlll[55 PHONC LICENSE NO. 5 COMPENSATION (NS. CA,RRIER MAIL .&0011£55 llfltANCH 6 /, , --~ US£ or e ulLOIHC -· -7 8 Class of work: □NEW 0 ADDITION 0 ALTERATION 0 REPAIR 9 Describe work : /1/4/M(; ,\,, C' 0 PERMIT FEES No. Type of Fixture or Item SPECIAL CONDITIONS: WATER CLOSET (TOILET) BATHTUB LAVATORY (WASH BASIN) SHOWER KITCHEN SINK & DISP. DISHWASHER APPLICATION AC,EO BY PLANS Cl-<EC~E0 BY APPROVE 0 FOR ISSUANCE BY . LAUNDRY TRAY C L OTHES WASHER I ,/ DATE WATER HEATER J NOTICE URINAL THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUC· DRINKING FOUNTAIN TION AUTHORIZED IS NOT COMMENCED WITHIN 120 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. I GAS SYSTEMS: NO.OUTLETS ~ I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO Bf TRUE AND CORRECT. WATER PIPING & TREATING EQUIP. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLI ED WITH WHETHER SPECIFIED WASTE INTERCEPTOR HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME T O 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 NUMBER CLEANOUTS 7/~i2J - CESSPOOL -..__? /L.-!~1~~ *179 SEPTIC TANK a. PIT ROOF DRAINS s1yNATU .. C 0,-CONTlltACTOllt Ollt AUTHO .. IZ.ED AGCMT I IO,,;oty • - ISSUANCE FEE SIGNATlllltlr 01" OWN( .. 1, OWJt4CR &UILOCRJ (DATE) TOTAL FEES WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION ' CK. M.O. CASH PERMIT VALIDATION CK. INSPECTOR M.O. ✓ .I I ~ CITY LIC, NO, / l t::'0< , - Fee $ / s $ 7 • $ ~·A I".: ·- CASH 1/- INSPECTION REPORTS DATE ITEM REMARKS INSPECTOR ~ ---. .... ' A ~ (0 l c) ~ , • USE SPACE I --l -7?