HomeMy WebLinkAbout1707 CATALPA RD; ; 78-3167; Permit-•• -v • •)
ELECTRICAL PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spaces only Phone 729-1181 Permit No ~?4
JOB ADDRESS
LEGAL
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OWNER
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TRACT (LJSEE ATTACHED SHEET)
MAIL ADDRESS ZIP PHONE
CONTRACTOR -
ARCHITECT OR DESIGNER
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ENGINEER
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* MAIL ADDRESS PHONE * LICENSE NO
MAIL ADDRESS PHONE LICENSE NO
COMPENSATION INS CARRIER MAIL ADDRESS BRANCH
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USE OF BUILDING^
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8 Class of work D NEW STADDITIONs\
9 Describe work f & -
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D ALTERATION D REPAIR
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SPECIAL CONDITIONS
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APPLICATION ACCENTED BV
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PLANSCHECKED8V AP
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PROVED FOR ISSUANCE BV
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NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC
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
MENCED
1 HERESY CERTIFY THAT 1 HAVE READ AND EXAMINED THISAPPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECTALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THISTYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIEDHEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT_PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE J
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATINGCONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION
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SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT /
SIGNATt RE OF OWNER (IF OWNER BUILDER)
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"(DATE)''
(DATE)
PERMlfF'eESi «^.v ^^p**^**
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**««. ,^NEW CONSTRUCTION, FOR EACH-
FUSE OR BREAKER T';
NEW SERVICE ON EXISTING BLDG
FOR EA AMPERE OF, INCREASE
IN MAIN SERVICE, SWITCH, FUSE
OR BREAKER
REMODEL, ALTERATION, NO CHANGE
IN SERVICE, FOR EA AMPERE OF
INCREASE
TEMP SERVICE UP TO AND INCLUD-
ING 200 AMP
TEMP SERVICE OVER 200 AMP
„ P^EJR^ 100 - _ -,
ISSUANCE FEE
TOTAL FEES
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Each
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WHEN PROPERLY VALIDATED UN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK.M O CASH PERMIT VALIDATION CK MO CASH
INSPECTOR