HomeMy WebLinkAbout1065 PALM AVE; ; 79-1159; PermitELECTRICAL PERMIT APPLICAIIO~ /11119
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City of CARLSBAD CALIFORNIA 92008 ' Jttj-//.:,-Y Applicant to complete numbered spaces only. Phone 729-1181 Permit No.
JOB ADDRESS /-t v € JI' (. # .:::. PA-Lt' i I LOT NO. I BLK, l TRACT <OsEE ATTACHED SHEET) LEGAL 1 DESCR,
OWNER
51'101.Y.;'~M-~'
MAIL ADDRESS ZIP PHONE
2 -72/\(17 I 7l.,, \I .J ~r-Mt:
CONTRACTOR MAIL ADDRESS PHONE ST ATE LIC, NO. CITY LIC, NO,
3 i: LF'C~T ~ )J ,~-; ~I 11~7'1~/ -;: // ,., 'tJt/ ' • ARCHITECT OR DESIGNER MAIL ADDRESS PHONE ; LICENSE NO,
4
ENGINEER MAIL ADDRESS PHONE LICENSE NO,
5
COMPENSATION 11' CARRIER MAIL ADDRESS BRANCH
6 ,y-ytl ' L,J,, . L1 ~
USE or BU llDING -I",,,
7
8 Class of work: 0 NEW 0 ADDITION ~ALTERATION 0 REPAIR
..
9 Describe work: '.I// 6£/11)£ €L-Ecr S-,3_-pJ/Jc~
PERMIT FEES
No. Each Fee
SPECIAL CONDITIONS: SWIMMING POOL WIRING,
NO INCREASE IN SERVICE
NEW CONSTRUCTION, FOR EACH
APl'LICATION ACC£,TEO IY ,LANS CHECKED 8Y APPROVED FOR ISSUANCE 8V AMPERES OF MAIN SERVICE, SWITCH ,
FUSE OR BREAKER
DATE NEW SERVICE ON EXISTING BLDG.
NOTICE FOR EA. AMPERE OF INCREASE 3~ f.
IN MAIN SERVICE, SWITCH, FUSE ,,~ 7 --...
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-OR BREAKER
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS,OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM REMODEL, ALTERATION, NO CHANGE
MENCED. IN SERVICE, FOR EA. AMPERE OF
I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS INCREASE Vr APPLICATION ANO KNOW THE SAME TO BE TRUE ANO CORRECT. h ). ALL PROVISIONS OF LAWS ANO ORDINANCE~ GOVERNING THIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
TEMP. SERVICE UP T6 ~ D INCLUD· l v (\ \ HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVIS)ONS OF ANY OTHER STATE OR LOCAL LAW REGULATING ING 200 AMP. /1 / CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ~
tJ/IW/ /2t !.,,~1-f 4 (41 ,ityt 0 \ TEMP. SERVICE O\J v J PER 100 /\
) -SIGNATURE or CONTRACTOR OR AUTHORIZED AGEi{!j ' (DATE) I ' ;-i _J .., :I-'() ISSUANCE FEE ~
TOTAL FEES I 7 .St
s 1GNA.TURE nF WNER IF OWNER BUILDER! DATE
WHEN PROPERLY VALIDATED (IN THIS SPACE I TH'$ IS v.huR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALffiKrlON CK. M.O. CASH
INSPECTOR