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HomeMy WebLinkAboutN/A76A667A ICE 817B) - 11/76 APPLICATION� PLUMBING1 BUILDING AND SAFETY DIVISION FOR APPLICANT T71N(PRINT 7TYPE)LDING ADIDRESS 21496 Cold Springs Lane NUMBER FIXTURE OR WATER CLOSET LOCALITY Diamond Bar California NEAREST BATHTUB CROSSST. Diamond Bar Boulevard SHOWER OWNER Tli �srrin a v] rir A.TrP 17ani 1irP LAVATORY MAIL ADDRESS 2130 L . 4 th S t . - Suite 110 SINK CITY Santa Ana, Ca. TEL.NO. 547®3987 DISHWASHER CLOTHES WASHER SWIMMING POOL RECEPTOR LAWN SPRINKLER SYSTEM WATER HEATER GAS SYSTEM OUTLETS OUTLETS OVER 5 PER SYSTEM Plan check fee PLUMBING PERMIT ISSUING FEE $ 6 00 TOTAL FEE 9 00 CONTRACTOR Industrial Turf, In ADDRESS ADDRESS P.O. Box 2247 CITY Laguna Hills,Ca;ELNO. 837-1231 is iNSE NO. 2 0 45 8 8 CLASS -2 7 A DISTRICT NO GROUP ZONE �POCESSED BY INDUSTRIAL WASTE APPROVAL INSPECTION RECORD Plan check applicant Name PPROVALS UNDER SLAB WORK Address ROUGH PLUMBING City Tel. No.AS PIPING HEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATIOGAS THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY AND STATE LAWS REGULATING PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR BY LOSNGELES COUNT AND STATE OF CALIF RNIA OR TGAS OWNER OF, AND INTEND T;O SIDE IN E ABOV ESCRIBEDPROPERTY. PERMITTEE " 'FINAL VENT HOT WATER HEATER h PLUMBING FIXTURESREQUIRED TESTLEGAL UTILITY CO. NOTIFIEDSIGNATURE%/�OF PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION DATE INSPECTOR'S SIGNATURE CK. M.O. CASH ©s