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HomeMy WebLinkAboutN/A (10)t 76A667A ICE 81713) - 11/76 ' BUILDING AND FOR APPLICANT TO FILL IN (PRINT OR TYPE) SAFETY DIVISION BUILDING ADDRESS 21415 Cold Spring Lane NUMBER FIXTUREORITEM @ FEE LOCALITY Diamond Bar, California WATER CLOSET BATH TUB NEAREST CROSS ST. SHOWER OWNER DlaIaond Ridge AJT Venture LAVATORY MAIL ADDRESS2130 E. 4th St. ®Suite 110 SINK CITY Santa Ana a. TEL. NO. 5 4 9 8 DISHWASHER CONTRACTOR r � % 1 4 Industrial .Purf, Inc. CLOTHES WASHER ADDRESS P.O.2 SWIMMING POOL RECEPTOR CITY q Ca TEL, NO. To clun a LAWN SPRINKLER SYSTEM STATE LICENSE NO. 204588 CLASS C-2 % A DISTRICT NO. GROUP ZONE PRQCESSED BY r.. . WATER HEATER GAS SYSTEM OUTLETS OUTLETS OVER S PER SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD Plan check fee PLUMBING PERMIT ISSUING FEE $ ( 00 TOTAL FEE 9 00 Plan check applicant Name APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK Address ROUGH PLUMBING City Tel. No. GAS PIPING 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 TE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RE 51 E THE AB. VE DESCRI E RESIDENTIAL PROPERTY. g > SIGNATURE OFPERMITTEE V 1. GAS VENT HOT WATER HEATER PLUMBING FIXTURES GAS TEST UTILITY CO. NOTIFIED FINAL PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH ©s