HomeMy Public PortalAbout9915 GARIBALDI AVE_Sewer__ DEPARTMENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER BUILDING
ADDRESS 16('
FOR APPLI T TO FILL IN LOCALITY T C
BUILDING NEAREST /
ADDRESS CROSS ST. J(f /
LOCALI DISTRICT NO. SERIAL NO. PERMIT NO.
NEAREST A 1 LSC 7 c
CROSS ST.
RECEIVED BY Ready for Inspection DATE ISSUED
OWNER [^' ` J
MAIL USE ZONE OCCUPANCY •7 � /MAP
ADDRESS I BK PG
� i
CITY TEL.NO. � '
CONTRACTOR J
CO.IMP.NO. J -�
ADDRESS � JOB NO.
CI TEL,N TRUNK PERMIT NO.
Q fl�� STATE
REGISTRATION N0. a o d ❑ COUNTY ROAD PERMIT NO.LEGAL
2 3 9
DESCRIPTION LOT N0. ar Q i STATE ENCROACHMENT
PERMIT N0.
BLOCK a TRACT INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT NO.BF BLDGS.
NOW ON LOT CHARGES
USE OF
BUILDINGS ��� �/ CONNECTION CHARGE FEE
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TOREIMBURSEMENT FEE
`
PUBLIC SEWER @ $ 3.50 o RECEIPT NO. I DATE I BY
HOUSE SEWER CONNECTING TO
_ PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED
WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING NO. I DATE BY
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 2.00 STATION / DEPTH
CESSPOOL—D RY W ELL
SPECIAL CONDITIONS ONLY 2.00 ! q .� n j MANHOLE REFERENCE 1
UPPER <t' t0WER
TYPE OF CtINNECTION LENGTH FROM
OWNERS PERMIT $ 1 00 Y. CURB • P.L. M.L.TO P.L.
AUTHORIZATION I TOTAL FEE !ys 0
1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING
DWELLING TO THEPUBLIC SEWER APPROVALS INSPECTOR'S SIGNATURE DATE
/
SIGNED THIS.....Z1.. DAY OF------ __ _..........I9� 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 1 HAVE READ THIS APPLI- CESSPOOL❑ DRYWELL
CAT
IMON AND STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COPLY 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 DISCONNECT D
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOPLUG PLUGAND
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDENTIAL P PERTY. BACKFILL SEPTIC TANKS
SIGNATURE SEEP.PIT(S)C] CESSPOOLS
OF PERMITTE ------.. � 1-.
76A642D 663 1/53
DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER BUILDING
I ADDRESS f f 1
FOR APPL NT TP FILL IN LOCALITY .y)
BUILDING ' NEAREST
ADDRESS CROSS ST. I t f
LOCALIT DISTRICT NO. SERIAL NO. PERMIT NO.
NEAREST A �{�6. it /A S
CROSS T.
RECEIVED Y/ Ready for Inspection DATE ISSUED
OWNER t
MAIL USE 70NE OCCUPANCY MAP
ADDRESS BK PG
CIT TEL.NO.
CONTRACTO 1
CO.IMP.NO.
ADORE
JOB N0.
CIT EL.NO.� I TRUNK PERMIT N0.
STATE
REGISTRATION N0. ❑
3 ❑ COUNTY ROAD PERMIT N0. � 3 � ' 8
LEGAL STATE ENCROACHMENT
DESCRIPTION LOT N0.
PERMIT NO.
BLOCK TRACT INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT NO.OF BLDGS.
USE OF
NOW ON OT CHARGES
'
BUILDINGS CONNECTION CHARGE FEE
NO. I DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE
PUBLIC SEWER 0 $ 3.50 RECEIPT NO. DATE I BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED
WORK TO HOUSE SEWER 1.00 C
ALTER OR REPAIR EXISTING NO. I DATE I BY
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 2.00 STATION DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE
UPPER LOWER
TYPE OF CONNECTIONLENGTH FROM
OWNERS PERMIT $ I 00 Y. CURB P.L. M.L.TO P.L.
AUTHORIZATION TOTAL FEE s". !4 �l
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING
DWELLING TO THE PUBLIC SEWER APPROVALS INSPECTOR'S SIGNATURE DATE
SIGNED THIS...IS..... DAY OF-.-- -- ---- _.......190 NEW HOUSE SEWER
OWNER OR CONNECT ADDITIONAL �-
OWNERS AGENT -... ---- .--_. ........ . ... _ BUILDING OR WORK
R
SEPTIC TANK.
ADDRESS - - - - �".` AND/OR DRSEEP.PIT(S)
AINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL[:] DRYWELL❑
CA
TIONAND 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 THE ABOVE DESCRIBE ESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS
SIGNATURE �� SEEP.PIT(S)E] CESSPOOLS
OF PERM ITTEE.(y4(�-•-_ -.-------
76A642D 663 1/53
DEPAWrMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER BUILDING
ADDRESS
FOR APPLIC TO F LL IN LOCALITY
BUILDING NEAREST
ADDRESS CROSS ST.
LOCALITY DISTRICT N0. SERIAL NO. PERMIT NO.
NEAREST S
CROSS ST.
RECEIVE Ready for Inspection DATE ISSUED
OWNER
MAIL
ADDRESS USE ZONE OCCUPANCY MAP
BK PG
CIT ELAO.
CONTRACT p
CO.IMP.NO.
ADDRESS elo
JOB N0.
CI TEL. 0 j� TRUNK PERMIT NO.
lool STATE
REGISTRATION NO.
COUNTY ROAD PERMIT N0.
LEGAL
DESCRIPTION LOT N0. STATE ENCROACHMENT -!
- Q PERMIT NO.
BLOCK Q TRACT INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT NO,
OF BLDGS.
NOW ON LOT CHARGES
USE OF �
BUILDINGS CJi�GylTi;/� CONNECTION CHARGE FEE
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE
PUBLIC SEWER S 3.50 RECEIPT NO. I DATE I BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR EXCEPTION ECORDED
WORK TO HOUSE SEWER 1.00 6 (j
ALTER OR REPAIR EXISTING NO- I DATE BY
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM I.00 CQNNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 2.00 STATION ` DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE
UPPER LOWER
TYPE OF CONNECTIONLENGTH FROM
OWNERS PERMIT $ 1 00 Y. CURB P.L. M.L.TO P.L.
AUTHORIZATION I TOTAL FEE `� 00
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING
DWELLING TO THE PUBLIC SEWER APPROVALS INSPECTOR'S SIGNATURE DATE
/�
SIGNED THIS_-___� DAY OF_�✓ ........I NEW HOUSE SEWER
OWNER OR CONNECT ADDITIONAL c�!
OWNERS AGENT .... -------____ -.
BUILDING OR WORK
ADDRESS._- �L ..- _ /.Gl:.._.__._.-.-- SEPTIC TANK.SEEP.PIT(S)
AND/OR DRAINFIELD
t HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI. CESSPOOL E] DRYWELL E]
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
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED DISCONNECT PLUG AND
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSESEWERAND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE ESCRIB RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS E]
SIGNATURESEEP.PIT(S)[] CESSPOOLS
- -
OF PERMITTEE--
76A642D 663 1/53
DEPAKTM-ENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER BUILDING ./
ADDRESS
FOR APPLICAN TO FILL IN LOCALITY
BUILDING NEAREST /
ADDRESS CROSS ST.
LOCALITY
DISTRICT NO. SERIAL NO. PERMIT NO.
NEAREST A J e ...r -° S
CROSS ST.
RECEIVED Y Ready for Inspection DATE ISSUED
OWNER
MAIL
MAILUSE ZONE OCCUPANCY MAP
-ADDRESBK PG
CITEL.NO. Q
CONTRACTO
CO.IMP.N0.
ADDRESS
JOB N0.
ClT m TEL.
TRUNK PERMIT N0.
REGISTRATION NO. ��� ❑ COUNTY
ROAD PERMIT N0.
LEGALs y�
DESCRIPTION LOT N0. ! �j STATE ENCROACHMENT '
PERMIT NO.
BLOCK TRACT �eioegv INDUSTRIAL
SIZE OF LOT N0.8F BLDGS. WASTE APPROVAL
NOW ON LOT CHARGES
USE OF
BUILDINGS 4f CONNECTION CHARGE FEE
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE
PUBLICSEWER Q $ 3.50 RECEIPT NO. DATE I BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED
WORK TO HOUSE SEWER 1.00 Q
ALTER(R REPAIR EXISTING NO- I DATE I BY
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/ORDRAINFIELD 2.00 STATION DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE
UPPER LOWER
TYPE OF CONNECTION LENGTH FROM
OWNERS PERMIT $ 1 00 Y. CURB P.L. M.L.TO P.L.
AUTHORIZATION TOTAL FEE 0 0
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 SEW
SIGNED THIS-.Z/ _DAY OF.._..- -----------------19.4-1.. 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❑ DRYWELL
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
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY D
DISCONNECT ABANDON HOPLUG PLUGAND
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROP TY. BACKFILL SEPTIC TANKS
SIGURE SEEP.PIT(S)❑ CESSPOOLS[:]
OF
OF PERM ....
.-
76A642D 663 1/53