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HomeMy WebLinkAboutN/A (1200)APPLICATION Pam,:AT '.. O PLUMBING PERMIT BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN(PRINT ORTYPE) ADILDING DRESS 2901 South Diamond Ridge NUMBER FIXTURE OR ITEM @ FEE LOCALITYDiamond Bar., foNEAREST WATER CLOSET CROSSST. Diamond Bar Blvd. BATHTUB SHOWER OWNER Diamond Ridge AJT Ventur LAVATORY MAIL ADDRESS2130 E , 4th St, - Suite 110 SINK CITY Santa Ana a . TEL. "°. 5 4 - 39 8 DISHWASHER CONTRACTOR Industrial Turf I�4) CLOTHES WASHER ADDRESS P.O. BOX 2247 SWIMMING POOL RECEPTOR CITY Laguna TEL. NO. LAWN SPRINKLER SYSTEM 3 00 STATE LIC. LICENSE NO. 204588 CLASS C,- 2 7, A DISTRICT NO..j GROUP ZONE PROCESSED BY 0 f` v WATER HEATER GAS SYSTEM OUTLETS OUTLETS OVER 5 PER SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD Plan check fee PLUMBING PERMIT ISSUING FEE $ ( 00 TOTAL FEE 9 Plan check applicant Name Address City Tel, No. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING, I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND ;rpEIN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. J (. SIGNATURE OF PERMITTE T ')LAN CHECK VALIDATION CK. M,O. CASH APPROVALS UNDER SLAB WORK ROUGH PLUMBING GAS PIPING GAS VENT HOT WATER HEATER PLUMBING FIXTURES GAS TEST UTILITY CO. NOTIFIED FINAL PERMIT VALIDATION DATE INSPECTOR'S SIGNATURE CK. M.O. CASH ©s