HomeMy WebLinkAboutN/A76A667A ICE 8171B) - 11/76
i
)
APPLICATION FOR PI I
BUILDING AND SAFETY DIVISION
3
FOR APPLICANT TO FILL IN (PRINT OR TYPE(
BUILDING
2925 South . Diamond . Ri_ dge
NUMBER FIXTUREORITEM @
ADDRESS
FEE
WATERCLOSET
LOCALITY Diamond Ba _Cal.-.fornla.
BATH TUB
NEAREST
CROSS ST. Diamond Bar Blvd.., --
SHOWER
OWNERDiamond Ridcle AT venture
LAVATORY
MAIL
ADDRESS 2130 E. 4th St. -Suite 110
SINK
CITYSanta Ana Ca. TEL.NO, 547-3987
714 )
DISHWASHER
CONTRACTOR
CLOTHES WASHER
ADDRESS
P.O. Box 2247
SWIMMING POOL RECEPTOR
a
clrvLa una Hills, Ca. TEL.No. 837-1231
STATE LIC, F
LICENSE NO. 204588 CLASS C.> 27' , A
DISTRICT NO. GROUP ZONE'' ROCESSEDBY
LAWN SPRINKLER SYSTEM
3
0
WATER HEATER
GAS SYSTEM OUTLETS)
OUTLETS OVER
5 PER SYSTEM
INDUSTRIAL
WASTE APPROVAL
x ,
Plan check fee
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE 9 00
Plan check applicant
APPROVALS DATE INSPECTOR'S SIGNATURE
Name
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel. No. GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES
REQUIRED BY LOSL/)
GELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST
LEGAL OWNER OF/R� E IN THE ABOVE SCRIBED RESIDENTIAL
PROPERTY.! �(( - - / UTILITY CO. NOTIFIED
SIGNATURE.FINAL
OFPERMITTE"6r'
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
r,
l -
@S