HomeMy WebLinkAbout1710 EVERGREEN CIR; ; 75-324; Permit1l32 0
PLUMBING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA
Applicant to complete numbered spaces only. Permit No.
JOB ADOR E5S
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L.OT NO, I 9LK I Tft .. CT
LWL I 1 0£5CO, /!
OWNEII' MAIL ADDA£.SS ZI p PHONE
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CON T!IIAC TOI\ \ MAIL ADDRESS PHONC L ICENSE NO. STATE CITY
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AACHITECT Oflt D[SIC.Ntfl MAIL AOOA ESS ,. PHONE L.1CENS£ NO.
4
[NG IN EC flt MAIL ADDA CSS PHON E LICENSE NO,
5
COMPENSATION (NS. CARRIER MAI L AODRE55 s_ lfltANCH
6 /: iJ /I.I I°) Dct..?10 .s,...,. i11t.. C. 0 ( -'_:_ .,, -. ~ 1(11/NO
use OF BUILDING
7
8 Class of work: t:) NEW 0 ADDIT ION 0 ALTER ATION 0 REPAI R
q Describe work:
PERMIT FEES
No. Type of i:ixture or Item Fee
SPECIAL CONDITIONS: ·3 WATER CLOSET (TOILET) $ ,• .,
..., BATHTUB
i LAVATORY (WASH BASIN) ·/
SHOWER
I KITCHEN SINK & OISP. / 'J
I DISHWASHER ,,
APPLICATION ACCEPTED BY PLANS CHECKED llY APPROVED FOR ISSUANCE BY ' ) ' LAUNDRY TRAY
f ./ DATE 3//ljl7~. CLOTHES WASHER ' 1~-,1
'-./J I WATER HEATER
,,_
/ .~ /')
NOTICE URINAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC· DRINKING FOUNTAIN
TION AUTHORIZED IS NOT COMMENCED WITHIN 60 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. , GASSYSTEMS:NO.OUTLETS .. ':J J, ' , I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS
APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT. WATER PIPING &. TREATING EQUIP.
ALL PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED WASTE INTERCEPTOR
HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PRESUME TO 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
I SEWER "!:5 n,)
~ CESSPOOL
C.\. SEPTIC TANK & PIT
L ./ ;·LJ~ 3,.n.,s-ROOF DRAINS
.SIGNATUrtC 0,. CONTRACTOllll Oft AUTHOlllll?tO AGENT (OAT£) --PERMIT $ ,.1' 5-0
S1GNATllllll£ OP' OWNEllll IIP' OWHEllll BUILDLR) (OATEJ TOTAL FEE $ -..: '-I' ('jt)
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
INSPECTOR