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Home My Public Portal About5612 MCCULLOCH AVE_Plumbing__ 76A667•-CE#817 2.62 APPLICATION FOR PLUMBING - PERMIT - COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDINGZ !OG JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS WILLIAM A.JENSEN. SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST:' f NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET $1.25 MAIL BATH TUB- 1.25 ADDRESS - SHOWER 1.25 CITY TEL. NO. LAVATORY J 1.25. CONTRACTOR teluts +•. SINS 1.25 ADDRESS / M, DISHWASHER 1.25 CITY • j 4i.'4 TEL. NO. C-,o / O CONTCTOR'S STATE LAUNDRY TUB 1.25 EGISTRAT ON NO. COUNTY 'p CLOTHES WASHER '1.25 DIST ICT NO.. GROUP ZONE PROCES BY WATER HEATER 1.50 T Q ] V GAS SYSTEM OUTLETS 1.50 INDUSTRIAL WASTE APPROVAL OUTLETS OVER PER SYSTEM .30 I INSPECTION RECORD LU :fin z " r- - -.A o�rf "•�` '�P M � r�,ems. APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT 5 2 00 UNDER SLAB WORK ,Z- ROUGH PLUMBING TOTAL FEE s` GAS PIPING I D HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION H ANSTATE THAT THE ABOVE I8 CORRECT GAS VENT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING' HOT WATER HEATER ! ,S ,,rW IV PLUMBING. X / .. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR .PLUMBING FIXTURES IPA"' LICENSED AS REQUIRED BY LOS ANGELES-COUNTY AND STATEOF 4 ��•,. CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF.-AND INTEND TO GAS TEST RESIDE IN,THE ABOVE DESCRIBEDRESID NTI PROPERTY. UTILITY CO.NOTIFIEp �,.. SIGNATURE A OF PERMITTEEMMOMod FINAL )FAIA I jV ALIDATION ROBERT A%W60D cK. M.o. CASHSUPERVISING MECHANICAL ENG'R Lj..If 0 8 0 4 6,U DEC 7 5 0 1 3.7 5r 76A667-CE#817 2-62 J ` APPLICATION FOR, PLUMBI PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER ,BUILDING AND SAFETY DIVISION BUILDIING ADDRESS ��/� P JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN, SUP'T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE WATER CLOSET $1.25 OWNER MA BATH TUB 1.25 DRESS c6-0 SHOWER 1.25 . CITY '7' 4ZL. NO. LAVATORY 1,2 CONTRACTOR 4F 117)le SINK . 1.25 ADDRESS DISHWASHER 1.25 CITY TEL. NO. LAUNDRY TUB 1.25 CONTRACTOR'S STATE [I REGISTRATION NO. COUNTY ❑ CLOTHES WASHER 1.25 DISTRICT NO. GROUP :TN P70CEP&D 5Y WATER HEATER GAS SYSTEM OUTLETS 1.50 INDUSTRIAL WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .90 v �- 1 INSPECTION RECORD � r � 1u e. U7 APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT S 2 00 UNDER SLAB WORK 3 ROUGH PLUMBING \ f* 1 TOTAL FEE GAS PIPING ¢ I HEREBY,ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT I AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH UMB NGALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER f i I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR' PLUMBING FIXTURES 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 PROPERTY. UTILITY CO.NOTIFIED SIGNATURE OF PERMITTEE FINAL ALIDATION ROBERT Ar WOOD CK. 'M..O. CASH SUPERVISING MECHANICAL ENG'R LjGo 8 0 6 4 DEC 7 5 D 3.5 0� v 76A.667 (CE-817)-4/72 / / I\� I APPLICAT N. OR , LUMBIVG PERMIT COUNTY OF LOS ANGELES ` DEPARTMENT OF COUNTY ENGINEER Al- BUILDING AND SAFETY DIVISION '. MAKE CHECKS PAYABLE TO: BUILDING �—� 1 An e ADDRESS .J HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE). NEAREST /1 CROSS ST. CJ NUMBER FIXTURE OR ITEM @ FEE WAJ. TER CLOSET 1,75 OWNER AIL BATH TUB ;1,75 ADDRES. j „ JW q— SHOWER 1,75 ITY TEL. NO. f� LAVATORY 1,75 dONTRACT SINK 1.75 ADDRESS DISHWASHER 1.75 CITY TEL. N0. p�'� CLOTHES WASHER 1,75 STATE LIC NO. SWIMMING POOL RECEPTOR 1.,75 LICENSE CLASS DISTRICT N4. GROUP NE PR CESSE BY LAWN SPRINKLER SYSTEM 1,75 CJ(J � WATER HEATER 1,75 INDUSTRIAL WASTE.APPROVAL GAS SYSTEM OUTLETS 1.75 INSPECTION RE RD v OUTLETS OVER 5 PER SYSTEM •30 y� A) CD Nuv r I - >4 a h Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE - . APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant S _ UNDER LA'B•W(:F Name ROUGH PLUMBING Address GAS PIPING City Tel. NO. GAS VENT I HEREBY ACKNOWLEDGE THAT t HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THEABOVE 13 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED ED LICENSA3 REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. all- S1 FINAL ' /7j SIGNATURE OF PERMITTEE PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH CQ 1 7 9 273. JUM 21 5 D 4.75- 76A667-CE#617 5/63 City of Temple City H3246 APPLICATION FOR PLUMPING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY EMSION ADDRESS 5612 McCulloch Ave. JOHN A. LAMBIE. COUNTY ENGINEER WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY Temple Cit FOR APPLICANT TO FILL IN ciOgg ST. Live Oak & Double Road NUMBER FIXTURE OR ITEM EACH FEE OWNER J.B. Johnson WATER CLOSET $1.25 MAu BATH TUB 1.2,5 ADDRESS snmp SHOWER 1.25 CITY TEL. NO. LAVATORY 1,25 CONTRACTOR General Installation Co SINK 1.25 ADDRESS 655R West Blvd, DISHWASHER Lu Com' Los Angeles TEL. NO. PL 3-2541 LAUNDRY TUB 1.25 CONTRACTOR'S STATE REGISTRATION NO. 01-36 151839 787 COUNTY CLOTHES WASHER 1.25 DISTRICT N GROUP ZONECESSED.BY WATER HEATER 1.50 -,.G7 . INDUSTRfAIC o_ GAS SYSTEM OUTLETS 1.50 WASTE APPROVAL 0 OUTLETS OVER 5 PER SYSTEM .$0 INSPECTION RECORD water softener Ready for Inspection Now V w a t� Z :n APPROVALS DATE INSPECTOR'S,SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK 'y ROUGH PLUMBING ` TOTAL FEE 3 50 GAS PIPING , I HEREBY ACKNOWLEDGE THAT I 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 PLUMBING. .. HOT WATER HEATER 1 , I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES 1 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF y GAS TEST RESIDE IN,THE ABOVE DESCRIBED RESI:rCALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED RESID ALy�Os/6 .. UTILITY CO.NOTIFIED SIGNATURE OF PERMITTEE FINAL N/Mb + /,y/ //}VALIDATION ROBERT AA/ Ob[) /CIS./ M.O. CASH SUPERVISING MECHANICAL ENG'R LAAO 2 2 0 3 Q01 NOV' 4 5' D . .__.._.. .5 r WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereb affirm that I have a certificate of consent to self 76A667A or c, ur a certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) (� or a certified copy thereof(Sec. 3800, Lab. C:) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy JWC70028aMpl CNA Certified copy is hereby furnishe ® FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING 5 612 N McCulloch Certified copy is filed with o ty buil ng inspec- ADDRESS tion department. NUMBER FIXTURE OR ITEM @ FEE M Locaurr Temple Cit WATER CLOSET Date3/2/87Appligant NEAREST CERTIFICATE OF EXEMPTIQ FROM WO ERS' BATH TUB CROSS ST. COMPENSATION I SURANCE OWNER (This section need not be comple ed If the work Involved by SHOWER MAIL the permit is for one hundred dollars($100)or less.) LAVATORY 4DDRESS 5612 N. McCulloch Ave. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY Tem le City TEL.NO. 79-637 so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTORVerCO Plumbing, Inc. Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of SWI.MMINGPOOLRECEPTOR 501 W. Maple Ave. Suite F Exemption, you should, become subject to the Workers' CITY TEL. NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM Orange 771-7533 with comply with such provisions or this permit shall be STATE 484333LIC' C36 deemed revoked. 1 WATER HEATER .00 6. 0 LICENSE NO. CLASS ),I,CENSED CONTRACTORS DECLARATION DISTRICTS P CE ED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Sect' 7000)of Division 3 of the Business OUTLETS OVER and Profession ode, my license is in full force and effect. 5 PER SYSTEM FINAL VALI TION } DATE License Nu er 8 3 Lic. Class C36 C 3/2/87 FIN c Contracto Date B. ❑ C I am empt un er Sec. �/ B.BP. , for this reason ®�/„J `�l a Plan check fee u Date: PLUMBING PERMIT ISSUING FEE$ 6 8 8 4 A z _H16 . 50 0. 50 �� ! , � Signature TOTAL FEE 16 . 5 0 G'� , # 0 0 0 0 0 5 SINGLE FAMILY Plan check applicant I HOME OWNER-BUILDER DECLARATION Name A ,-,0 o l 630 1 hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and o 0,01 6,3 O v Professions Code): City Tel. No. ❑ I, as owner of the property, will do the work and the 4,l J a 8 7 structure is not intended or offered for sale (Section ® 0 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I 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 Lender's Address I certify that I hav ead this application and state that the above informatio i correct. I agree to comply with all County ordina s ndFte lawsregulating Plumbing, and hereby aut rize r preatives of this County to enter upon the ab a-me onroperty for inspection purposes. � SEE REVERSE]FOR EXPLANATORY LANGUAGE o 3/2/87 gnature of P mittee Date i WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT heby affirm that I have a certificate of consent to self 76A667A insure, or a certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) or a certified copy thereof(Sec. 3800, Lab..C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY 0 CA fAC✓a S Company, rl Lr fL/Y 1A(. l� Certified copy is hereby furnished. CF/'/7r/ f BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) ,,/ r Certified copy is filed with the county building inspec- ADDRESS -5 ',Z /Y, � i./ C / tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date 3U-SS Applir<anf ' ' u• WATER CLOSET NEAREST �1� ,y '`� e I I! L v CROSS ST. /i i•� ti j• `� ��f}yy rC CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB COMPENSATION INSURANCE OWNER (This section need not be completed If the work Involved by SHOWER "y the permit is for one hundred dollars $100 or less. I MAIL P ( � � LAVATORY ADDRESS I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK 6 CITY TEL.NO. so as to become subject to the Workers'Compensation Laws. I DISHWASHER 67 CONTRACTOI!! Date Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR ADDRESS&J+ � � � � j�_1 1— Exemption, you should become subject to the Workers' uUy Compensation provisions of the Labor Code, you must forth- CITY `v T �fJ�. with comply with such provisions or this permit .shall be LAWN SPRINKLER SYSTEM 0 O P Y P P STATE LIC. deemed revoked. WATER HEATER LICENSE NO Z-� 3 CLASS e" 3 LICENSED CONTRACTORS DECLARATION DISTRICT NO. P ESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 5 PER SYSTEM IL FINADATEL Or— VAL ATION V License Number 3`V,"1 3 '7 Lic. Clak'�'U25—I C �. / FIN. O Contractor' u•�'t Date ? 3y' t� BY ' ❑ 1 am exempt under Sec. IL B.&P.C: for this reason Plan check fee Date: i PLUMBING PERMIT ISSUING FEE$ Signature LO— TOTAL TOTAL FEE S(} Plan check applicant -22568A SINGLE FAMILY # 0 0 0 0 0 5 HOME OWNER-BUILDER DECLARATION Name 1 2250 I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5; Business and o 0 - 2250c'; . Professions Code): City Tel. No. ❑ I, as owner of the property, will do the work and the 07.30-85 structure is not intended or offered for sale (Section 7044, Business and Professions Code). Poo CONSTRUCTION LENDING AGENCY I hereby offirm•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 Lender's Address I certify that I have read this application and state that the ► above information is correct. I agree to comply with all County 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 u_ P 11U ?--5v--?f S- Signature of Permittee Date �� t '?/i-y WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby, offirm.,that I have a certificate of consent to self in- 26A667 DPW 4/87 f� sure,or a certificate of Workers'Compensation Insurance,or 76A667A "Dull P CE 817(REV.8/86) certifierfcop thereof/ Sec. 3800, Lob. C.) COUNTY OF LOS ANGELES Policy No. 43 0` Company 4 DEPT. OF PUBLIC WORKS ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspection ADDRESS / department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date d 49 Applicant WATER CLOSET(TOILET) PP NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. 0 e COMPENSATION INSURANCE SHOWER OWNER /�Y4 (This section need not be completed if the work involved by the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS J �l�- dl/. �L° I certify that in the performance of the work for which this per SINK '_ mit is issued, I shall not employ any person in any manner so CITY / TEL. NO. as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS �yQ. NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- CITY _ TEL. NO. ��Q sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM /o ly with such provisions or this permit shall.be deemed revok- STATE ed. �.�?c� CLASS 1 ZA WATER HEATER 6 LICENSE NO. LICENSED CONTRACTORS DECLARATION v DISTRICT NO. PRO 95ED BY 1 hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER fed Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALID ION C . DATE License Number IIA�7o Lic. Class 6-2,o0 FINAL Contractor i Date (0- Z4-.9O BY ' f O I am exempt under Sec. 1 0 2 0 A LU CL B.&P.C. for this reason Plan check fee # o o a 0 0 5, � Date: PLUMBING PERMIT ISSUING FEE$ o JeT ( - - 2250 Signature TOTAL FEE SINGLE FAMILY o 0 0 2 2 5 0 xo HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and II (127t-88 Professions Code): Address ❑ I, as owner of the property, will do the work and the City Tel. No. structure is not intended or offered for sale(Section 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I.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 Lender's Address I certify that I have read this application and state that the above information is correct. I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby utho 'ze repr entatives of this County to enter -upon the abov m r do d proper r inspec7ton purposes. VIMT (�, r SEE REVERSE FOR EXPLANATORY LANGUAGE Su Future of Permittee Date