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HomeMy Public PortalAbout5824 ENCINITA AVE_Sewer__ DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL SIVISIGN OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER BUILDING ryC�/1 J ADDRESS FOR APPLICAy�s���T TO F�LL W LOCALITY BUILDING NEAREST ADDRESS .CROSS ST. V � /�o/j LOCALITY 1 4 �f / DISTRICT NO. SERIALJ�{`0 PERMIT NO. NEAREST ^^ T�L l T� C /� ap- Y- S CROSS ST. j / L(iyt�pl�e `J 7L BC EDB Ready for Inspection DATE ISSUED OWNER a _LS MAIL �^� USEZONE OCCUPANCY IMP ADDRESS iyJ(� XqNCJ/✓I //./��, BK PG CITY_ YYY`TEEL.NO. / V`I'OL/ L I CONTRACTOR CO.IMP.NO. AD SS r �' B NO. CIT TEL.NO TRUNK PERMIT i0. STATE REGISTRA / N NO. �v n �/OU NT ROAD PERMIT NO. DESCRIPTION LOT NO. S. 5LEGL 'b- / 7S" STATE NOENCROACHMENT BLOCK TRACT rn S� I INDUSTRIAL ^ /] WASTE APPROVAL SIZE OF LOT ,5-Z XA 6 7 NOW ON LOTS a CHA ES USE OF //'J/� � BUILDINGS UCrC¢- a CONNECTION CHARGE FE NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO PUBLICSEWER Q $ 3.50 RECEIPT NO. DATE IBY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG.OR XCEPTIO RECORDED WORK TO HOUSE SEWER 1.00 TE ALTER OR REPAIR EXISTING I I IBY _SEWER OR DISPOSAL SYSTEM 1.00 DISCONNECT AND ABANDON SEWER _ AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA SEP IC TANK,SEEPAGE PIT OR PITS AND/OR GRAINFIELD 2.00 STATION EPTH CESSPOOL-DRYWELI SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERS CE UPPER LOWER TYP OF CONNECTION LENG FROM OWNERS PERMIT $ I DD Y. CUR P.L,. M.L.T P.L. AUTHORIZATION I TOTAL FEE zim 1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOA DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE DWELLING TO BLIC SEWER / SIGNED THIS.. .._._ ._. DAY OF...._.. ....._....__....... .KA - NEW HOUSE SEWER OWNER OR �1 'G � � CONNECT ADDITIONAL OV/HERS A _ BUILDING OR WORK SEPTIC TANK,SEEP.PIT(S) ADDRESS. .... _ .. _. . ............._.._......._...._:._......_..____._. AND/OR GRAINFIELD I HEREBY ACKNO LEDGE THAT 1 HAVE READ THIS APPLI- CESSPOOL E3 DRYWELL I] CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR.SEWER OR REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED DISCONNECT PLUG AND AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN- ER OF THEABOVE DESCRI REBID TIAL PROPERTY. BACKFILL SEPTIC TANKS SEEP.PIT(S)0 CESSPOOLS[] SIGNATURE OFPERMITTE ... _ _ _.........._.._.._.._......_.._......_.._... T6A642A 663 i/5 CE800 5-65 APPLICATION FOR PERMI {� ]6A fi42D LJ COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION SUILO No ��.,p.2�/ W. JOAN' A. LAAI ISIS, Courcy E-11Deer ADDRESS �+ U T COLEMAN lT'. JENKINS,Sulf%. o[ If uild ing LOCq L'iTY NEAREST f �• /(/� C AL FOR APPLICANT TO FILL IN y/y RQ55 5T V J DESCRIPTION LOT NO. / / OWNER 4eIt4 A/14 1- MAIL L // MAIL BLOCK TRACT /�, l / ADDRESS NO OF CLOGS. SIZE OF LOT NOW ON LOT CITY TEL. NO. USE OF // y,/ ' BUILDINGS r(�� a,,X� DISTRICT NO. GfRfIIP MAP PROCEs pp a p r •I�� BK PG CONTRACTOR 0.610/�✓ pw .0 �v9 ADDRESS �Q�}py.3 .0 /A(.04 S/-tT h/ CONNECTION DATA 'Iy^ {// ,/ /�v J�bj 7 J STATION !� / DEPTH CITY (J �t TEL. NO. T /tom LICE N � q LICENSE -�' Q MANHOLE REFERENC / G R ND. _7 V/ CLA 55 N°. DESCRIPTION OF WORK FEE TYPE OF CONNE TION LE TH FROM HOUSE SEWER CONNECTING TO Y. CURB P.L. M.L.TO P.L. PUBLIC SEWER $ 5.00 } SEPTIC IANI St 111.1 PIT OR ♦ P.C.NO. a PITS AND/OR GRAINFIELD C $10.00 CO.IMP. NO. I UOB NO. O HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERMIT NO. V PRIVATE DISPOSAL SYSTEM C $ 3.00 w CONNECT ADDITIONAL BLUG, OR _ l AFFI°AVIT AIV AII"- RECORD,INSTR,NO, DATE O WORN TO HOUSE SEWER C S 3.00 /JSLMV r 'ATTEk-RTP' R ABANDON 04 USE SEWER OR DISPOSAL SYSTEM 9 $ 3.00 W LTEPA ECO HVIY.OR ST.WIDENING a E%T N.,CESCESSPOOL, MANHOLE l' S 5 DO In r STATE ENCROACHMENT z Z I PERCOLATION TEST C $ 5.0G PEFMIT NO, IN DUSTRIAI WASTE APPROVAL OWCHARGESNER S PERMIT S 2 00 AUTHORIZATION I TOTAL FEE n ON NECTION CHARGE FEE 'I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. APPROVALS DATE INSPECTORS S I.NATURE SIGNED THIS DAYOF 19- OWNER OR NEW HOUSE SEWER OWNERS AGENT CONNECT ADDITIONAL Vr BUILDINGTOR WORK ADDRESS SEPTIC ANK,SEE P.lITI.I 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS, CESSPOOL ❑ DRYWELL ❑ IHEREBY CERTIFY THAT I AM PROPERLY REGjSWlD7O PND/OR ALTER.REPAIR,SEWER OR LICENSED AS REQUIRED BY L 5 ANGLES CO Y D STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THA AM E LEGAL OW R O ANO INTEND TO RESIDE IN, THE A ED RE ENTI PROPERTY. DISCONNECT PLUG AND ABANDON HOUSE SEWER SIGNATURE > OF PERMITTEE BACKFILL SEPTIC TANKS ❑ SEEP,PIT(S) ❑ CESSPOOLS ❑ OVALIDATION CN. M.O. CASH LACp 5 6 8 7 m Nov 4 1 0 0 8.00- Q DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL DIVISIQN OF BUILDING AND SAFETY PERMIT APPLICATION +' COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER BUORILDIESSNG AO ✓ /�6b�r•• / FORKLDING APPLICANT TO FILL IN /� LOCALITY G' C EAREST [ABDDRESS 6 A CREST OSS ST. f-L/S 7EAREST ' ( DIST�CT N0. SEfl IA /P�MIT N0. Cf DA OSS ST. / ./1 AREC/E��IIVVEEJD,/BBY Ready I I}n6oaction D E IISSSUEDDJWNER _ w/sA -[RECEIVED w7 A;spe AOORESS _ USE ZONE 0 U/ I MAPAl -AQoO / BK PG CITY TEL.NO. CONTRACTORS A CO.IMP.N0. ADDRESS JOB.NO. CITY TEL.NO. / TRUNK PERMIT NO. p( REGISTRATION N0. [] STATE ROAD PERMIT NO. LEGAL /O DESCRIPTION �LUTN STATE ENCROACHMENT PERMIT NO. BLOCK TRACT (. INDUSTRIAL WASTE APPROVAL NO-OF SIZE OF LOT SB Y -,7- 7 NO W/ON LOTS// CHARGES USE OF ( BUILDINGS GJ / ( CONNECTION CHARGE FEE NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER ® f 3.50 RECEIPT NO. I DATE BY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG.OREXCEPTION RECORDED WORK TO HOUSE SEWER 1.00 /OO ALTER OR REPAIR EXISTING NO' I DATE I BY 'SEWER'Oft DISPOSAL SYSTEM 1100 ' DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA SEPTIC.TANK,SEEPAGE PIT OR PITS AND/OR GRAINFIELD 2.00 STATION DEPTH CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE UPPER LOWER TYPE OF CONNECTION LENGTH FROM OWNERS PERMIT = 1 11 00 V. CURB P.L. M.L.TO P.L. AUTHORIZATION I TOTAL FEE �I OC} S 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.................._..... IY.._... NEW HOUSE SEWER OW N ER ORJ ,/ CONNECT ADDITIONAL / d OWNERS AGENF'v..... .._ (� ._i ... 1 ..,,.._.... „ ,.._ BUILDING OR WORK �? T J1 i SEPTIC TANK,SEEP.PIT(S) ADDRESS... .167I.F.S ...T.I}�{.,�JLyy,L4�-L`I l`.�'JG�y� AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APP CESSPOOL Q DRYWELL� CATION AND STATE THAT THE ABOVE IS CORRECT AND AGR TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER, REPAIR,SEWER OR REGULATING PLUMBING AND SEWERS. C SEWAGE DISPOSAL SYSTEM 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY DISCONNECT PLUG AND AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL.OWN. ABANDON HOUSE SEWER ER OF THE ABOVE DESCRIBED RESIOENTIAL PROPERTY. BACKFILL SEPTIC TANKS ' SEEP.PIT(S)Q CESSPOOLS , SIGNATURE I� - OFPERMITTEE.......... ._..... _......... 76AG42D 663