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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