HomeMy WebLinkAbout155 CHESTNUT AVE; ; 74-1269; PermitPermit No.
PLUMBING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA
Applicant to complete numbered spaces only. ~ . . ' ' ~ '':?•.'
JOB ADDRESS . , - . . ^ • • •
155 «li6S^I51l1b
LOT NO. '- LEGAL1 DESCR.
OWNER
2 Moravee
BLK TRACT . '([_ JS E E ATTACHED SHEET)
MAIL ADDRESS ZIP • PHONE
, tfary A* 155 Chestnut 729-2023
CONTRACTOR • MAIL ADDRESS ' PHONE .' LICENSE NO.
3 Bofe'is Pltaablrig 2501 State • Cferlsfead 729-2055 245707
. ARCHITECT OR DESIGNER^
ENGINEER
5
LENDER
6
^.siC-^'-f-'H'N:--"-1'" -'• - .;/.. MAIL; ADDRESS " ;. ^ , ^PHONE . ^LICENSE NO.'~i" ' - ;
' - MAIL ADDRESS "' . ' PHONE . LICENSE NO.
. •"• , MAIL ADDRESS . - BRANCH
/USE OF BUILDING.. . ' ... . • , •
7 - , .' ,: ••••. .' ' •.-. ";-! ' ' '' . i ,:;
8 Classofwork: D NEW DADDITION DALTERATION D REPAIR
9 Describe work:water feeater changeowt
SPECIAL CONDITIONS:
' >. '. : '-' '
' • " ' ! •' ' ' \
APPLICATION ACCEPTED BY:
THIS PERMIT BEC'OM
TION AUTHORIZED 1
CONSTRUCTION OR V
PERIOD OF 120 DA
MENCED.
I HEREBY CERTIFYAPPLICATION AND KALL PROVISIONS OFTYPE OF WORK WILHEREIN OR NOT, TPRESUME TO GIVE ;PROVISIONS OF ANYCONSTRUCTION OR
S7)^? & &
PLANS CHECKED BY: APPROVED FOR ISSUANCE BY:
3;c NOTICE . ' *
ES NULL AND' VOID IT- WORK OR CONSTRUC-
S NOT COMMENCED WITHIN 60 DAYS, OR IF
VORK IS SUSPENDED OR ABANDONED FOR AYS AT ANY TIME AFTER WORK IS COM-
THAT 1 HAVE READ AND EXAMINED THIS
NOW THE SAME TO BE TRUE AND CORRECT.
LAWS AND ORDINANCES GOVERNING THIS
L BE COMPLIED WITH WHETHER SPECIFIED
HE GRANTING OF A PERMIT DOES NOT
AUTHORITY TO VIOLATE OR CANCEL THE
OTHER STATE OR LOCAL LAW REGULATING
THE PERFORMANCE OF CONSTRUCTION.
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SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
SIGNATURE OF OWNER'UF OWNER BUILDER) • (DATE)
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PERMIT FEES
No.
\
HV:
% -.
-
*.
Type of Fixture or Item
WATER CLOSET (TOILET)
BATHTUB
LAVATORY (WASH BASIN)
SHOWER •
KITCHEN SINK & DISP. .
DISHWASHER
LAUNDRY TRAY
CLOTHES WASHER" ': '
WATER HEATER j.
Y URINAL, '? '• .." "v. /- , . .: .'' -'-,'.•' ' •''
DRINKING FOUNTAIN
FLOOR— SINK OR DRAIN
SLOP SINK
GAS SYSTEMS: NO. OUTLETS
WATER PIPING & TREATING EQUIP.
WASTE INTERCEPTOR
VACUUM BREAKERS ;. *T|
LAWN SPRINKLER SYSTEM
SEWER
CESSPOOL '..---
SEPTIC TANK & PIT
PERMIT $
TOTAL FEE $
Fee
$
.,.
- ' -
*»OQ
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
UCD
3
o
PLAN CHECK VALIDATION CK.M.O.CASH PERMIT VALIDATION CK.M.O.CASH
INSPECTOR