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Home My Public Portal About9105 EMPEROR AVE_Sewer__ DEPAWrNMVT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER BUILDING JO� ADDRESS OR APPLICANT T FILL IN LOCALITY BUILDING v NEAREST ADDRESS CROSS ST LOCALITY DISTRICT NO SERIAL NO PERMIT NO NEAREST _6— A -, lfs2l S CROSS ST a eA y RE IV Ready for Inspection D TE I SSQE D OWNER MAIL ` USE Z OCCUPANCY AP ADDRESS g PG CITY TELFO CONTRACTOR CO.IMP NO ADDRESS JOB NO CITY TEL NO 40a I TRUNK PERMIT NO REGISTRATION NO /�� COUNTY1 ROAD PERMIT NO LEGAL DESCRIPTION LOT NO _3 STATE ENCROACHMENT PERMIT NO BLOCK TRACT /�� INDUSTRIAL ! WASTE APPROVAL SIZE OF LOTNO 3F BLDGS O O NOW ON LOT CHARGES USE OF �^ BUILDINGS ��`, CONNECTION CHARGE FEE NO DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE PUBLIC SEWER @ $ 350 RECEIPT NO DAdE I BY HOUSE SEWER CONNECTING TO /]/) PRIVATE DISPOSAL SYSTEM 100 V(d CONNECT ADDITIONAL BLDG OR EXCEPTI N F ECORDED WORK TO HOUSE SEWER 1 00 ALTER OR REPAIR EXISTING NO I D E I BY SEWER OR DISPOSAL SYSTEM 1 00 DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 1 00 CONN TIO D to SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD - 200 STATION DEPTH CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 200 MANHOLE R ERENCE UPPE LOWER TYPE OF CONNECTION LENGTH FROM OWNERS PERMiT $ 1 00 Y CURB P ML TOP L - AUTHORIZATION TOTAL FEE 1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING , APPROVALS INSPECTOR'S SIGNATURE DATE DWELLING TO THE PUBLIC SEWER SIGNED THIS _ __ __DAY OF _ .19_... NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERS AGENT _ BUILDING OR WORK ADDRESS _ _ _ _ _ SEPTIC TANK,SEEP PIT(S) AND/OR DRAINFIELD I_HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL IS DRYWELL E-] � I �y /7 CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE Y � _ iN TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER REPAIR,SEWER OR REGULATING PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY DISCONNECT PLUG AND AND STATE OF CALIFORNIA 0 THAT I AM THE L AL OWN. ABANDON HOUSE SEWER ER OF THE ABOVE R E R NTI PRO RTY BACKFILL SEPTIC TANKS Ej SIGNATURE SEEP PIT(S)[-] CESSPOOLS❑ OF PERMITTEE _. 76A642D 663 1/53 D S&E-689 I1 'S9 APPLICATION FOR PERMIT 8&E-8 DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL Deportment of County Engmeer QA County of Los Angeles !BUILDING //IJLS JOHN A LAMBIE COUNTY ENGINEER ADDRESS /L0 ® CASSATT D GRIFFIN SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN, CROSS ST 0 LEGAL DESCRIPTION LOT NO OWNERMAIL BLOCK TRACT ff% y a ADDRESS NO OF BLCITY P EL SIZE OF LOT NOW ON LOTT USE OF DISTRICT NO GROUP I MAP BUILDINGS .- --- --- BK PG CONTRACTOR S ��.33/�❖ � ADDRESS (3, '' CONNECTION DATA ^ �e STATION 'J DEPTH CITY L NO r.41. 9j,1 l MANHOLE REFERENCE PPE ❑ STATE �r REGISTRATION NO [-COUNTY NO DESCRIPTION OF WORK FEE / HOUSE SEWER CONNECTING TO ` TYPE OF CONNECTION LENGTH FROM f„' PUBLIC SEWER @ $3 50 (� P L MEN L TO P L pJ SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD Q $3 00 OVERFLOW SEEPAGE PIT DRAINFIELD P C NO EXTN ,CESSPOOL,DRYWELL,MANHOLE Q $2 00 CO IMP NO Q JOB NO HOUSE SEWER CONNECTING TO {' PRIVATE DISPOSAL SYSTEM Q $1 00 TRUNK PERMIT NO 4 ROAD PERMIT CONNECT ADDITIONAL BLDG OR STA ACHMENT WORK TO HOUSE SEWER Q $1 00 PERMR NO ALTER REPAIR OR ABANDON HOUSE INDUSTRIAL SEWER OR DISPOSAL SYSTEM cQ $1 00 WASTE APPROVAL CHARGES CONNECTIOHARGE FEE OWNER'S PERMIT $ 1 00 AUTHORIZATION I TOTAL FEE 's'-0 REIMBURSEMENT FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- APPROVALS DATE INSPECTOR SSIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER NEW HOUSE SEWER SIGNED THIS DAY OF 19 CONNECT ADDITIONAL OWNER OR BUILDING OR WORK OWNERS AGENT SEPTIC TANK;SEEP, PIT(S) ADDRESS AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL ElDRYWELL❑ AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER OR PLUMBING AND SEWERS I SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER CALIFORNIA OR THAT I AM THE LE.54L OWNER OF ABOVE DESCRIBED R_ESIDEN PE C BACKFILL SEPTIC TANKS❑ / SIGNATURE SEEP PIT(S) ❑ CESSPOOLS �� rte✓` Q LI OF PERMITTEE.:j�2 _6� JOHN A LAMBIE COUNTY ENGINEER VALIDATION ROBERT A WOOD, CHIEF PLBG INSPECTOR CK !I 0 SH " 1 9 3 E—&cw MV 1 4 4.50 '� by COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 1008230001 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID ISEWER / SEPTIC SEWER BUILDING ADDRESS ITR 11990 LT 3 IEXIST OCC GRP 9105 EMPEROR AV 1BLDGS NOW ON LOT SGAB CA 917752018 (ASSESSOR INFORMATION NUMBER (CONNECTION TYPE I NEAREST CROSS STREET LOMA 15382-012-024 (ORIGINATION I THOMAS PAGE 596 GRID H1 LOCALITY TEMPLE CITY, Cl (LENGTH ML TO PL STATION DEPTH I I TENANT IMANHOLE REFERENCE UPPER/LOWER IISSJED ON PROCESSED BY 1 I 108/23/10 SR 1 (COUNTY IMPROVEMENT NUMBER I 1 10WNER TEL NO IPLAN CHECK NUMBER IFINALDDATE FINAL BY CODE IMARSCHALL, BRUCE (62G) 287-2044- IJOB NUMBER I ! 19105 EMPEROR AV ITRUNK PERMIT NUMBER I ISGAB 917752018 IROAD PERMIT NUMBER IDESCRIPTION OF WORK 1 IAFFADAVIT NO IREPLACE SEWER LINE 1 IWAIVER NO I 1 (APPLICANT TEL NO (EASEMENT NO I I ISAME AS OWNER - I I IRECORD INSTRUMENT NBR RECORD DATE ISPEriAL CONDITIONS I IHIGHWAY/STREET WIDENING 1 ISTATE ENCROACHMENT PERMIT NUMBER I I ICONTRACTOR TEL NO I FEES PAID (APPROVALS DATE INSPECTOR SIGNATURE I ISAME AS OWNER - I I LIC NO IFEE DESCRIPTION QUANTITY UOM AMOUNT INEW HOUSE SEWER I I 01 PERMIT ISSUANCE FEE 27 80 ICONNECT ADDITIONAL I 115 ALT/REP HOUSE SEWER 1 00 EAC 30 40 IBUILDING OR WORK I I I (ARCHITECT OR ENGINEER TEL NO 1 TOTAL FEES 58 20 1 I I 1 1 I ISEPfIC TANK, SEEPAGE PITI I 1 1 LIC NO I IAND"OR DRAIN FIELD I I DRYWELL _ I I I I SEWER MAP BOOK PAGE IALTiR, REPAIR, SEWER OR I I I ISEWAGE DISPOSAL SYSTEM I I IDISCONNECT PLUG AND I (ABANDON HOUSE SEWER I IBACKFILL SEPTIC TANKS ISEEP PIT _ CESSPOOL I I 1GRAYWATER SYSTEM I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I '•� I I 1 IREPORT ID DPR266 ROUTE TO BS0508 I - I