HomeMy WebLinkAbout1785 CHESTNUT AVE; ; 72-1743; Permit/7^A3
PLUMBING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA
Applicant to complete numbered spaces only.
JOB ADDRESS ^^ 1 /(
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OWNER MAIL ADDRESS ZIP PHONE
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CONTRACTOR ' *~ MAIL ADDRESS PHONE LICENSE NO.
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ENGINEER MAIL ADDRESS PHONE ^ LICENSE NO.
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LENDER MAIL ADDRESS BRANCH
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USE OF" BUI LpING /" ';
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8 Class of work: QUtfgW D ADDITION D ALTERATION D REPAIR
f - ' '"' - / „-/ Ot9 Describe work: i * i> .^_ A ':, . ',:/' .. / . /"' ^ .jty /-• ^
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SPECIAL CONDITIONS:
APPLICATION ACCEPTED BV: PLANS CHECKED BY: APPROVED FOR ISSUANCE BY:
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NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 60 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 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS
APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
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SIGNATURE OF CONTRACTOR OR Au THOR IZETB" AGENT (DATE)
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
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PERMIT FEES
No.
/
Type of Fixture or Item
WATER CLOSET (TOILET)
BATHTUB
LAVATORY (WASH BASIN)
SHOWER
KITCHEN SINK & DISP.
DISHWASHER
LAUNDRY TRAY
CLOTHES WASHER
WATER HEATER
URINAL
DRINKING FOUNTAIN
FLOOR— SINK OR DRAIN
SLOP SINK
GAS SYSTEMS: NO. OUTLETS
WATER PIPING & TREATING EQUIP.
WASTE INTERCEPTOR
VACUUM BREAKERS
LAWN SPRINKLER SYSTEM
SEWER
CESSPOOL , . - -
SEPTIC TANK & PIT
PERMIT $
TOTAL FEE $
Fee
$
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WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
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PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O.CASH
INSPECTOR