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HomeMy WebLinkAbout5676A76A667A CE 81 71REV. 6/78) ©S BUILDING AND SAFETY Lot #10 FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ADDRESS Diamond $ar NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET LOCALITY NEAREST ST. Diamond Ridge BATH TUB CROSS SHOWER OWNER LAVATORY ADDRESS MAIL , N T S t � i-- SINK CITY Santa Ana TEL. NO, 953-093 DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS ? P.O. $ OX 2 2 4 7 SWIMMING POOL RECEPTOR CITY TEL. NO. LAWN SPRINKLER SYSTEM 837 TATE WATER HEATER LICENSE NO, 2 014 5 8 8 CLASS C 2 7 —A APPROVALS DATE INSPECTOR'S SIGNATURE GAS SYSTEM OUTLETS UNDER SLAB WORK OUTLETS OVER 5 PER SYSTEM ROUGH PLUMBING GAS PIPING 2 irrigation GAS VENT HOT WATER HEATER PLUMBING FIXTURES GAS TEST UTILITY CO. NOTIFIED _ Plan check fee 7 00 PLUMBING PERMIT ISSUING FEE $ 13 00 FINAL PLAN CHECK VALIDATION TOTAL FEE Plan check applicant Name Address City Tel. No, 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 CERTIF� 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 IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. 1' SIGNATURE OF PERMITTEE �� t DISTRICT NO < <PR?CESSED,BY INDUSTRIAL WASTE APPROVAL' PERMIT VALIDATION