Loading...
HomeMy WebLinkAboutN/A (1027)"s 76A667A ICE 817EI) - 11/76 AIL APPLICATION FOR PLUMBING PERMIT BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN (PRINT OR TYPE I ADILDING DRESS 21454 Cold S ring Lane NUMBER FIXTURE OR ITEM @ FEE LOCALITY Diamond Bar, California WATER CLOSET BATHTUB NEAREST CROSS ST. Diamond Bar Blvd. SHOWER OWNER Diamond Ridge AJT Venture LAVATORY MAIL ADDRESS 2130 E. 4th St. ® Suite 110 SINK CITY Santa Ana Ca. TEL.NO. 547-3987 DISHWASHER CONTRACTOR Industrial Turf, Inc. CLOTHES WASHER ADDRESS P.O. Box 2247 SWIMMING POOL RECEPTOR CITY Laguna Hills CaIEL NO 837-1231 LAWN SPRINKLER SYSTEM 3 00 STATE LIC. LICENSE NO. 204588 CLASS C-2 7, A DISTRICT NO. GROUP ZONE PROCESSED BY + )� > 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 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 THATTHE 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 ATE OF GALIF0RNI R THAT I AM THE LEGAL OWNER OF, AND INTEND TO RES I, E IN THE OVE DES RI ED RESIDENTIAL PROPERTY. SIGNATURE %I OF PERMITTEE / ! GAS VENT HOT WATER HEATER PLUMBING FIXTURES GAS TEST UTILITY CO, NOTMED FINAL PLAN CHECK VALIDATION CK, M.O. CASH PERMIT VALIDATION CK. M.O. CASH ©s