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HomeMy WebLinkAboutN/AAPPLICATION FOR PLUMBING PERMIT BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN (PRINT OR TYPEI BUILDING ADDRESS 21481 Cold Spring Lane Diamond Bar California NUMBER FIXTURE OR ITEM @ FEE LOCALITY WATER CLOSET NEAREST ST. Diamond Bar Blvd. CROSS BATHTUB OWNER Diamond Rid SHOWER MAIL E 4th St. ® Suite 110 LAVATORY ADDRESS2130 . SINK CITY Santa TEL. NO. r, s DISHWASHER CONTRACTOR Industrial Turf Inc�714) CLOTHES WASHER ADDRESS P.O. Box 2247 SWIMMING POOL RECEPTOR CITY Laguna Hills CaTEL. No. 8 37-12 31 STATE LIC. LICENSE NO. 204588 CLASS C ®2 7, A LAWN SPRINKLER SYSTEM WATER HEATER DISTRICT NO GROUP ZONE ROCESSED BY GAS SYSTEM OUTLETS r INDUSTRIAL WASTE APPROVAL INSPECTION RECORD OUTLETS OVER 5 PER SYSTEM Plan check fee PLUMBING PERMIT ISSUING FEE $ Ann TOTAL FEE Plan check applicant Name Address City Tel, No. 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 TATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RES IN THE 1,jkOVE DES)RIBED RESIDENTIAL PROPERTY. SIGNATURE OF PERMITTEE PLAN CHECK VALIDATION CK. M.O. CASH APPROVALS UNDER SLAB WORK ROUGH PLUMBING GAS PIPING GAS VENT HOT WATER HEATER PLUMBING FIXTURES GAS TEST UTILITY CO. NOTIFIED FINAL PERMIT VALIDATION DATE INSPECTOR'S SIGNATURE CK. M.O. CASH ©s