HomeMy WebLinkAboutN/A76A667A ICE 6178) - 11/76fr.
APPLICATION I I®T
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE)
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET
BATH TUB
SHOWER
LAVATORY
SINK
DISHWASHER
CLOTHES WASHER
SWIMMING POOL RECEPTOR
LAWN SPRINKLER SYSTEM 3 00
WATER HEATER
GAS SYSTEM OUTLETS
OUTLETS OVER
5 PER SYSTEM
Plan check fee
PLUMBING PERMIT ISSUING FEE $ 6 00
TOTAL FEE 9 00
Plan check applicant
Name
Address
City Tel. No.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECTAND 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�jTATE OF CALIFOR OR THAT I AM THE
LEGAL OWNER OF, AND INTEND TO RE$1 E N THE OVE D S RIBED RESIDENTIAL
PROPERTY, jjjj
SIGNATURE /,
OFPERMITTEE �1�
IiBBIBBB
PLAN CHECK VALIDATION CK. M.O. CASH
LDING
ADDRESS 21488 Cold Spring Lane
LOCALITY Diamond Bar, California
NEAREST
CROSS ST. Diamond Bar Blvd.
OWNER Diamond Rl d7P AJT Venture
MAIL
ADDRESS 2130 E . 4 th St. -Suite 110
CITY Santa Ana, Ca. TEL.NO.547-3987
CONTRACTOR Industrial Turf, Inc �714)
ADDRESS P.O. BOX 2247
CITY Laguna Hills,C+aTEL.NO. 837-1231
is NSENO. 204588 c ASS C-27 A
DISTRICT NO GROUP ZONE ROCESS BY
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All
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INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
ROUGH PLUMBING
GAS PIPING
GAS VENT
HOT WATER HEATER
PLUMBING FIXTURES
GAS TEST
UTILITY CO. NOTIFIED
FINAL
PERMIT VALIDATION CK. M.O. CASH
