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Home My Public Portal About5544 MCCULLOCH AVE_Plumbing__ -76A667-CE4817 2-66 APPLICATION FOR PLUMBI G PER COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING L9 JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST EEARS ST. r7J NUMBER FIVURE OR ITEM EACH FEE OWNER _. WATER CLOSET $1.25 MAIL y BATH TUB 1.25 ADDRESS SHOWER 1.25 CITY TEL. NO. LAVATORY 1.25 CONTRACTOR SINK 1.25 +� ADDRESS DISHWASHER 1.25 CITY .NO. LAUNDRY TUB 1.25 STAT d-� LIC LICENSE NO. CLASS CLOTHES WASHER 1.25 DISTRICT GR P Z NE PWS 8 BY WATER HEATER 1.50 . � .0 3 GAS SYSTEM�_OUTLETS 1.50 INDUSTRIAL APROVAL OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD v CD • W a / N APPROVALS DATE INSP T 'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK ^� ROUGH PLUMBING ' TOTAL FEE GAS PIPING ® rf2 7,q I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES G LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST ' CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO RESIDE IN.THE ABOVE DESCRIBED RESIDENTIAL•PROPEWY. UTILITY CO.NOTIFIED SIGNATURE ' OF EE,,kd 7f,-AP-e� A FINAL VAIMATIJACK R:-AL E CK. m'0! cases SUPERVISING MECHANICAL ENG'R. 110 9 -9- 3 6% JUL 12 5 D 7 2.5 Q q 76A66.7-CE#617 2-66 /�A APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS.ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY L FOR APPLICANT TO FILL IN AJORSBSS$. e NUMBER. FUNTURE OR ITEM EACH FEE OWNER s. WATER CLOSET $1.25 MAIL Z. BATH TUB 1.25 ADDRESS SHOWER Im �^D CITY TEL. NO. LAVATORY 1.25. CONTRACTOR Ci SINK 1.25. ADDRESS DISHWASHER 1.25 CITY O. LAUNDRY TUB1.25 STAT LIC LICENSE NO. CLASS � CLOTHES WASHER 1.25' DISTRICT N GR U Z NE P O ES BY WATER HEATER 1.500 0l c GAS SYSTEM OUTLETS 1'� WASE APPPPROVAL CD OUTLETS OVER 5'PER SYSTEM• AD v INSPECTION RECORD � C) W - d Z APPROVALS DATE INSPECT NATURE PERMIT 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITHBALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMING. HOT WATER HEATER 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES /' f LICENSED AS OREQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST _ CALIFORNIA R THAT 1 AM THE LEGAL OWNER OF AND INTEND TO .� i RESIDE IN,THE ABOVE DESCRIBED RESID AL PROPERTY. UTILITY CO.NOTIFIED SIGNATURE ' OF PERMITTE. FINAL Lill VAIMATIO�Y'1 JACK R.AL EN CK. M.O. (CASH/) SUPERVISING MECHANICAL ENG'R. JACO 9 5. 3 7r- JUL 12 5 0 5 5.5 0' WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm +*_e have a certificate of consent to self 20-0026 DPW 6/87 insure, or a qp ykcate of Workers'Compensation Insurance, 76A667A or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS Policy No. Company Certified copy is hereby furnished. BUILDING l L' ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS J 7v Certified copy is filed with the county building inspec- tion department. NUMBER FIXTURE OR ITEM ® FEE LOCALITY Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' + BATH TUB CROSS ST. Zlgf COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed If the work involved by MNL the permit is for one hundred dollars(:100)or less.) LAVATORY ADDRESS L� J� LCIS/ I certify that in the performance of the work for which this SINK CITY TEL.NO.i permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR �7 ;7Q1 G Date 9'v Applicant I CLOTHES WASHER ADDRESS � // NOTICE TO APPLICANT: If, after making this Certificate of '00V � icgv Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY TEL.NO. � � LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE 99 LIC. y deemed revoked. WATER HEATER LICENSE NO. C/b�y� CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. JROP BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER O / and Professions Code,and my license is in full force and effect. 5 PER SYSTEM �•j FINAL VALIDA N DATE C License Number Lic. Class FINAL � Contractor 44�& Date —90 BY ❑ I am exempt under Sec. t LIU B.BP.C. for this reason 113, Plan check fee w Date. PLUMBING PERMIT ISSUING FEE$ J Signature TOTAL FEE SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Address �� 4�° :I Professions Code): City Tel. No.❑ ITEMS I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section TI��RLir,5+o � 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY CRECK 41°5I) 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name 13CCO—IND 6i 7/9111, Lender's Address f`s49 1 Al 8.0 17, 1 certify that I have read this application and state that the above information is correct. I agree to comply with all County loop ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE SIgnafture of Permittee Date