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HomeMy WebLinkAboutN/A76A667A ICE 817B) - 11/76 APPLICATION ' BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN (PRINT OR TYPE( BUILDING ADDRESS 21490 Cold Springs LOCALITY Diamond Bar , Californi NUMBER FIXTUREORITEM @ FEE WATER CLOSET NEAREST cRosssT. Diamond Bar B BATHTUB OWNER Diamond Ridge AJT Ventu SHOWER LAVATORY MAIL ADDRESS 2130 E. 4 SINK CITY Santa Ana Ca . TEL, NO. 5 4 7 — 9 (714) DISHWASHER CONTRACTOR Industrial Turf Inc ADDRESS P.O. BOX 2247 CLOTHES WASHER SWIMMING POOL RECEPTOR CITY Laguna Hills Ca ;EL. NO. 8 37 --12 31 LAWN SPRINKLER SYSTEM 3 00 STATE 204588 c C. C —2 7, A LICENSE NO. WATER HEATER 71 DISTRICT NO. GROUP ZONE PROCESSED BY GAS SYSTEM OUTLETS `,,;,- �, (�, INDUSTRIAL WASTE APPROVAL INSPECTION RECORD Plan check fee PLUMBING PERMIT ISSUING FEE $ 1 C 100 TOTAL FEE 9100 Plan check applicant APPROVALS DATE INSPECTOR'S SIGNATURE Name UNDER SLAB WORK Address ROUGH PLUMBING Tel. No. GAS PIPING City I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES HOT WATER HEATER AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES 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 GAS TEST LEGAL OWNER OF, AND INTEND TOR E IN THE BOVE DE RIBED RESIDENTIAL UTILITY CO. NOTIFIED PROPERTY. SIGNATURE `Al, FINAL OF PERMITTEE PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIDATION cK. n+.o. cnsH ©s