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HomeMy WebLinkAboutN/A (1225)76A667A ICE 8178) - 11/76 `s APPLICATION I I, w� BUILDING AND FOR APPLICANT TO FILL IN (PRINT OR TYPE) SAFETY DIVISION BUILDING ADDRESS 21474 Cold Spring Lane NUMBER FIXTURE OR ITEM @ FEE LOCALITY Diamond Bar California WATER CLOSET BATHTUB NEAREST CROSS E. Di amonj Bar Blvd. SHOWER OWNER Diamond Ridge AJT Venture LAVATORY MAIL ADDRESS 21 30 E - Ath--'St- SINK CITY Santa An Ca. TEL.NO. 547-3987 DISHWASHER CONTRACTOR Industrial Turf, In�714) CLOTHES WASHER ADDRESS P.O. BOX 2247 SWIMMING POOL RECEPTOR CITY Laguna Hills TEL. NO. 237-1231. LAWN SPRINKLER SYSTEM OO STATE LIC. LICENSE NO. 204588 CLASS C-2 7 11 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 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 RESIDE, THE AB DES C RID RESIDENTIAL PROPERTY. 1111 SIGNATURE jJ'ny OF PERM ITTEE GAS VENT HOT WATER HEATER PLUMBING FIXTURES GAS TEST UTILITY CO. NOTIFIED PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH ©s