Loading...
HomeMy WebLinkAboutN/A (1202)76A667A ICE 8171B) - 11/76 APPLICATION I1 a�a BUILDING AND FOR APPLICANT TO FILL IN (PRINT OR TYPE) SAFETY DIVISION BUILDING DRESS 21447 Cold SpringLane NUMBER FIXTURE OR ITEM @ FEE LOCALITY Diamond Bar-, California WATER CLOSET NEAREST CROSS ST. Diamond Bar Blvd. BATH TUB SHOWER OWNER Diamond Ride AJT Venture LAVATORY MAIL ADDRESS2130 E . 4th St. -Suitt- 110 SINK CITY Santa Ana, Ca. TEL.NO, 547-3987 DISHWASHER CONTRACTOR Industrial Turf Inc � 714) CLOTHES WASHER ADDRESS P.O. BOX 2247 SWIMMING POOL RECEPTOR L CITY Laguna Hills , Ca:NO. 8 37-� 1231 LAWN SPRINKLER SYSTEM 3 00 STATE LIC LICENSE NO. 204588 CLASS C ®2 7, A WATER HEATER DISTRICT NO GROUP ZONE PROCESSED BY T GAS SYSTEM OUTLETS OUTLETS OVER 5 PER SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD Plan check fee PLUMBING PERMIT ISSUING FEE $ 6 00 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 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 TO REST E IN THE ABOVE DESC D RESIDENTIAL PROPERTY. SIGNATURE OFPERMITTEE / GAS VENT HOT WATER HEATER PLUMBING FIXTURES GAS TEST UTILITY CO. NOTIFIED FINAL PLAN CHECK VALIDATION CK. M.O. CASH I _ PERMIT VALIDATION CK. M.O. CASH ©s