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Home My Public Portal About9550 GIDLEY ST_Sewer__ 7° tr"p f t.ae APPLICATION FOR PERMIT 1 r i-e DIVISION OF BURDMG AND SAMY SEWER-SEWAGE DISPOSAL lle�t d Co—t7 Enghm r Cofmt7 of Los Awe F".R'IN L? Jr-JOHN A. LAMBIE. CouNY ENGINEERCA SA'FT D. GRIFFIN, SUP"T OF BUILDIHe I_ITT FOR APPUrAM TO IN C o>iB ST. C4 L LEGAL / OV - D CR I PTl Al 4 E w Lf l6a_ BLOCK MAIL ADDRESS 3 Zfi•OF t0T N0X .OF0 BL CITY TEL. NO. USE OF BUILDINGS JV DISTRICT GROUP -MAP CONTHA97`OR ON� ADDRESS DATA L rATION DEPTH CITY TEL. X0. MANHOLE REFERENCE .- UPPOZ 94JLI-ATE LOWER REGISTRAT10n NO. y 0 COUNTY ..� 13 / - no. DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM HOUSE SEWER CONNEEiikr.to Y. PUBLIC BER 3.50 CURB P.L. Y.L.TO P.L. SEPTIC TANK.SEEPAGE PIT OR PITS AND/OR DRAINFIELD 3.00 OYER FLOW DEEPAGE PIT,DRAIN FIELD P. C. NO. EZTN., E.5 OL, R ELL NAXHOLE i 2.00 CO. IIP. 0. JOB O. HOVE 8 ER CONNECTING TO PRIVATE bISPOSAL SYSTEM e j 1.00 TRUNK PERMIT X ROAD PERMIT Na. CONNECT ADDITIONAL BLDG.OR �+ aa STATE ENCROACHMENT . WORK TO HOUSE SI:WER ® $1.00 >i. PERMIT X0. - - ALTER, AIR OR ABANDON HOUSE INDUSTRIAL SEWER OR DISP0 SYSTEM 0 1.00 WAM APPROVAL - CHARGES COXXECTTDX CHARGE FEE - OWNE s PmlmT f 1 00 ` AUTHORIZATION TOTAL. FEE :7-- 0-0 REIMBURSEMENT FEE I NAVE AT THIS DATE A CONTRACT WITW THE HEREIN HAYED CON- APISROYAIS DATA IXSPECTOR'SSIGXATURE TRACTOR TO CONNECT THE ABOYE DESCRIBED EX1•$TING DIKUL NG TO THE PUBLIC SEER, NEVE HOUSE 0EW9R _ SIGNED THIS SAY OF 19- CONNECT ADDITIONAL OWNER OR BUILDING OR VIORX - OVXERB AGENT SEPTIC TANK,BEEP,PIT(3) ADDRESS AND/OR DRAINFIELD - 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELLa- AND STATE THAT THE ABOVE-15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND SPATE LAWS REGULATING ALTER,REPAIR,BEV-ER OR PLUM131NG AND SEWERS. SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT ( AY PROPERLY REGISMED AND/OR D18COXNHCT PLUG AND LICENSED AS REQUIRED BY LOB ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AN THE LEGAL OWNER OF THE ABOVY A DON HODS _DESCFHBED R"IDEIIT L PROTIERTY. BACKFILL;EFTIC TAhKB SIGNATURqq S$EP.PIT_(.) ❑ CESSPOOLS El _ bF PEAYITTEE _ JOHN A. E.COUNTY ENGIN �AI.YDAnON ROBERT A.WOOD, CHASE PLBG. IN8PSCT0R R.0. CAU ,0 6 5 a fR JAN 24 4 A 2.0.0 � r 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 ADDRESS FOR APPLICANT TO FILL IN LOCALITY BUILDING ✓ NEAREST ADDRESS �S( jj CROSS ST. LOCALITY 7Za yy: 6, DISTRICT NO. SERIAL NO. PERMIT NO. NEAREST A S CROSS ST. RECEIVED BY Ready for Inspection DATE ISSUED OWNER MAIL ADDRESS USE ZONE I OCCUPANCY'<' BK MAP PG CITY+�l l�us L' /YI/ &A TEL.NO.C 0_L0z a CONTRACTOR CO.IMP.NO. ADDRESS O w k' / JOB.NO. - CITY D TEL.NO. TRUNK PERMIT NO. ❑ STATE REGISTRATION NO. ROAD PERMIT N0. � LEGAL STATE ENCROACHMENT DESCRIPTION LOT NO. PERMIT NO. BLOCK TRACT INDUSTRIAL DO SIZE OF LOT �1 WASTE APPROVAL my DATE.? '7-5.3 '� / i / J N0.OF BLOBS.NOW ON LOT CHARGES USE OF BUILDINGS CONNECTION CHARGE FEE NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER Q : 3.50 RECEIPT NO. I DATE I BY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 CDNNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED WORK TO HOUSE SEWER 1.00 I ALTER OR REPAIR EXISTING NO' _.__DATE I BY SEWER OR DISPOSAL SYSTEM 1.00 DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 1.00 I CONNECTION DATA SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD 2.00 I STATION DEPTH CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 2.00 I MANHOLE REFERENCE UPPER LOWER TYPE OF CONNECTION LENGTH FROM OWNERS PERMIT $ I Il 00 Y. CURB P.L. M.L.TO P.L. AUTHORIZATION I TOTAL FEE I 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 SEPTIC TANK,SEEP.PIT(S) ADDRESS---..............•-----...... ---_-----•-------•- - - AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI. CESSPOOL F] 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 DISCONNECT PLUG AND AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER AND STATE OF CALIFORNIA OR THAT I AM ITH LEGAL.OWN- ER OF THE ABOVE DES D RESIDENTIAL OPER BACKFILL SEPTIC TANKS (� SIGNATURE �/ SEEP.PIT(S)E] CESSPOOLS `-( /� OF PERMITTEE.....-............ ------------ { --•-_-•-----------......--•----••--- 76A642D 663 1/53 WaRKERS'COMPENSATION DECLARATION CE 808(4-80) APPLICATION FOR PERMIT I herdby affirm that I have a certlticate of courant to self SEWER—SEWAGE DISPOSAL insure, or a certificate of Workers'Compensation Insuragce,or a certifled copy thereof(Sec.3800,Lab.C.) COUNTY OF LOS ANGELES BUILDING` ANDSAFETY, Policy N any Ge fled copy L he y furnished. FOR APPLICANT TO FILL IN CONNECTION DATA aIUILDIHO {a STATION D[PTH rtined copy Is filed with the county building Inspection ADDR[SS 0 G /w/ � J� YPPIR deplrtment. LOCALITY ' MANHOL[ R[F!RKNC! LOW[R 4Data- Applicaht NKAR**T /+ TYP! O CONKZCTION L[NOTI-I PROM CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST. G t Q" 4- Y. qvism r,L. M,L. TO P.L. COMPENSATION INSURANCEP.C. N0. O"KR _ r l CO. IMP. NO. j00 NO. /�r�{,�� ,,„y MAIL d 7�.,+,6 pKdQn Il� not b0 LCOm�1Pl�EtW irf��th6 work 1IIvolved ADDP#KS■ TRUNK PK NO. ROAD PKMMIT NO, /1 OJ the perni t is for one Lundiel dollm ($100) or Imo.) AP PIOAVIT RANG CORD.IN■TR.NO. OAT. TU{ CITY TZ L. NO. I certify that In the perfbrmance of the work for which this L[gwL permlt IS issued.I shall not employ any person in any manner DUNCRIPnON LOT NO. O H1/Y, OR ST. YID[NIN6 hU- so as to become subject to the Workers' Compensation Lawn. ■LOCK TRACT STAT! ZNCROACHMKNT LLl Date Applicant" NO.OP ■LD6S. P[RMIT NO. NOTICE TO APPLICANT: If, after mAiking this Certlflcate of ■II! OF LOT NOW ON LOT Exemption, you should become subject to the Workers' ! va! OP Compensatlon provisions of the Labor Code, you must forth- BUILDINGS CHA1406S with comply with such provisions or this permit sball be CONTRACTOR Cyn J n CONN[CTION CHARGit F!¢ deemed revoked. LICENSED CQNTRACTORS DECLARATION ADDR[SS � � � rh A RQIMMURS[MRNT Pis: I hereby affirm that I aril Licensed under provisions OfC siptel DISTRNO. .R ■ MAP PRocE■■ED■Y 9 (commencing with Section 7000) of Division 3 of the Busi- ness and Professiops Code, and my license is in full force and ■TAT! L c. LIC No. CLAS■ effect. D[ CRI ON OF WORK P!! _ ''�p ��sS OUS.SEWER CDNNEOTINO TD PHNAL / p, VA. DATION License NU Sri LIC.CLas Fu■uc sEWER DATI< —�CO aL M ` ■E c TARR,■SSPA [PIT OR I ►ITV ANO/OR DRAINFIELO Contract ate FINAL HOUSE■EWER COrINSCTINO TO fix i P TV DI■■O■AL■Y■YZM I and exempt from the llceaA fng raquirelnents as I am a a oN R.cr wngrTIP NAL OLDS.OR licensed architect or a redsteled profeadonal engineer WORK To Ho ■■ ■■,raR acting In my professional capacity (9-tion 7051, $us- OVERFLOW■<.PA.. FIT,DRAINFIELD Iness and Professions Code). uTN..c.uPooL,DwTWEu,MANHOLE ALT=R, REPAIR OR w.wNDQry HOUSE + ■EWER ON DISPOSAL SY STUY Llc,or Reg.No. Date HOME OWNER-BUILDER DECLARATION 50, 1 A I hereby affirm that I am exempt from the Contractor OWNER'S Permit s 5Contractor's License Law for the following reason (Section 7031.5, Susi UTHOR17ATION TOTAL FEE, #'O'OiO D 1 0 nese and ProfessfogA Code): 1 O - I HAVE AT THIP DATE A CON1+TTRA FT WITH THE HWRE NAMED CON- ' , I, l3 Owner Of the i0 TRACTOR TO CONNSLr THS A�ovE OESCRIEEO AXISTINa OWaLLINV property, will do the work and the TO THE Pu■LIC Sr Kn. 2 O ° 5 0 structure is not intended or offered for saleSection ( SI¢N!❑THIS DAY Of b 7044, Business and Professions Code). OWNER OR ;° 5 0 , CONSTRUCTION LENDING AGENCY OWNER■AGENT ofl'09-821 1 hereby afth-m that there L a construction lending agency ADDRESS � for the performance of the work for which this permit is Issued (Sec, 3097,Ch.C.). Lender's Name Lender's Address I ¢artlfy that I have. read this application and state that the above Information L correct.I agree to comply with all County ordinances and State laws regulating Plumbing and Sewers, " and hereby authorize representatives of this County to enter upon the above-mentioned property for inspectlon,purpol% SEE REVERSE FOR EXPLANATORY LANGUAGE ofPermitt Date �5 a •� n COUNT( OF LOS ANGELES TEMPLE CITY 0508 I SEWER PERMIT DEPARTM"T OF PUBLIC 6MKS 9701 LAS TUNAS SE 0508 000606DO01 s BUILDING AND SAFETY / LAND DEV5LOPMENT TEMPLE CITY CA 917BO PHONE: (626) 285-0488 EXT: LEGAL 10: SEWER Y BUILDING ADDRESS: ON PILE EXIST OCC GRP:: 9550 GIDLEY ST BLDGS. NOW ON LOT: TEMP CA 917804213 ASSESSOR INFORMATION NUMBER: NECTIOM TYPE: NEAREST CROSS STREET: TEMPLE CITY BLVD 8592-004-039 ORIGINATION: THOMAS PAGE: 597 GRID; A5 LOCALITY: TEMPLE CITY LENGTH ML TO PL: STATION: DEPTH: T MANHOLE REFERENCE: UPPER/LOWER: T9990-M-- PROCESSM BY: EXPIRES ON: 06/06/00 UT 12/03/-00 COMITY IMPROVEMENT NUMBER: 06INER: TEL. NO: PLAIT CHECK NUMBER: KIM JEMIAN (714) 680-5028- 1 JOB NUMBER: 9556 GIDLEY ST TRUNK PERMIT NUiBER: RED TEP 917804-213 ROAD PWIT NUMBER: DEZS61PTIONMOF WOU, AFFADAVIT: NO ABANDON CLARIFIER WAIVER: NO APPLICANT: TEL. NO- EASEMENT: NO SAME AS OWNER - RECORD INSTRUMENT N RECORD DATE:. SPECIAL CONDITINS: HIGHWAY/STR ET-9 STATEB SCONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR .SIGkATURE AME AS 06INER LIC. ND i E�DES TLON:./� QUANTITY' � AMOMIINT: 01 IT E F i `\ 27.75 29 I RN C 1.00 SY 30.45 BUILDING OR WORK ARCHITECT OR ENGINEER-- TEL. NO: T At FEES f-- 58.20 SEPTIC SEEPAGE PIT LIC. I rlYYll AND/OR BRAIN FIELD DRTWELL SEVER MAP BOQK: PAGE: /(� 6� REPAIR SEWER OR I I I� n�U C �§I`{ J�A n' ,�� SEWAGE DISCONNECT PLUG AND DISPOSAL SYSTEM ABANDON HOUSE SEDER RA I CKFILL SEPTIC Lf ❑ �� SEF-P. PIT _ CESSPOOL _ Service Tha r_ REPORT ID: DPR266 ROUTE TO SS0508