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Home My Public Portal About6051 GOLDEN WEST AVE_Sewer__ G 5a E-669 I1•E5- APPLICATION FOR PERMIT _ 1 S&E-8 • DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL Deparx meat of County Engineer County of Los Angeles BUILDING f �_ QQa_1 �� f14 JOHN,A LAMBIE, COUNTY ENGINEER ADDRESS (�(/ pew" 3�r ® CA SSATT D GRIFFIN, SOP T OF Bu1Lo1NG LOCALITY FOR APPLICANT TO FILL IN CROSS ST. z �� LEGALp✓�. - -A DESCRIPTION LOT NO % OWNER MAIL BLOCK TRACT - 1 ADDRESS NO OF BLDGSr'•7, CITY TEL. NO SIZE OF LOT NOW ON LOT 1a'C/ -USE OF BUILDINGS L��- DISTRICT NO GROUP ' MAP � BK - PG ' CONTRACTOR _ t�� 37 ADDRESS �� D 'tj �` CONNECTION DATA CITY A- TEL. NO./— �O g STATION f Z,- DEPTH 6 MANHOLE REFERENCE _ U PER ❑ STATE REGISTRATION'NO. ( ❑ COUNTY NO DESCRIPTION OFMORK FEE TYPE OF CTION LENGTH FROM �. HOUSE SEWER CONNECTING TO � Y. C RB P L M L TO P.L: - PUBLIC SEWER @ $3 50 SEPTIC TANK,SEEPAGE PIT OR / - PITS AND%OR DRAINFIELD @ $3 00 , OVERFLOW SEEPAGE PIT,DRAINFIELD P C. NO. EXTN ,CESSPOOL,DRYWELL,MANHOLE @ $2 00 CO. IMP NO. _ 10B NO, HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $1 00 TRUNK PERMIT NO. - - ROAD PERMIT NO. zj CONNECT ADDITIONAL BLDG OR STATE ENCROACHMENT WORK TO HOUSE SEWER @ $100 PERMIT NO ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL - - SEWER OR DISPOSAL SYSTEM •@ $1 00 WASTE APPROVAL ` CHARGES CONNECTION CHARGE FEE OWNER'S PERMIT - $ 1 00 /a AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE („I t/dUfe%A�d OZP lZ- L' IHAVE.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[I DRYWELL[IAND 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 SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER CALIFORNIA_ OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE - DESCRIBED RESIDENTI L P OPERTY BACKFILL SEPTIC TANKS 0 - ' SIGNATURE SEEP PIT(S) [ICESSPOOLS❑ - ._. • OF PERMITTEE , JOHN A LAMBIE. COUNTY ENGINEER VALIDATIONCFAROBERT A WOOD, CHIEF PLBG. INSPECTOR ' CK EI 0. y:) - Lrslc07 7 3 4, MAY 1 4, -- 4 .5 0 m 0�,� COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 1404220003 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT ILEGAL ID. ISEWER / SEPTIC SEWER BUILDING ADDRESS ITR 6561 LT 90 UN .002 (EXIST OCC GRP 6051 GOLDEN WEST AV I IBLDGS NOW ON LOT TEMP CA 917801755 I (ASSESSOR INFORMATION NUMBER ICONNECTION TYPE I NEAREST CROSS STREET 15385-019-003 (ORIGINATION• I THOMAS PAGE 597 GRID A2 LOCALITY TEMPLE CITY CAI I ILENGTH ML TO PL STATION DEPTH I I ITENANT IMANHOLE REFERENCE UPPER/LOWER 11SSUED ON PROCESSED BY 1 I 104/22/14 SR I ICOUNTY IMPROVEMENT NUMBER I (OWNER TEL. NO. IPLAN CHECK NUMBER IF AL DATE FINAL BY CODE IWILSON CYNTHIA M (626) 287-2839- IJOB NUMBER I I - 16051 GOLDEN WEST AV (TRUNK PERMIT NUMBER: I I ITEMP 917801755 IROAD PERMIT NUMBER ID Ot OF WORK I IAFFADAVIT NO (INSTALL SEWER CLEANOUT AND SEWER LINER !WAIVER NO (APPLICANT. TEL NO (EASEMENT NO (DOBBINS, KEVIN (310) 835-0408- 1 13801 LENAWEE AVE IRECORD INSTRUMENT NBR RECORD DATE ISPECIAL CONDITIONS I ICULVER CITY CA 90232 (HIGHWAY/STREET WIDENING: I I ISTATE ENCROACHMENT PERMIT NUMBER I ICONTRACTOR TEL NO- FEES PAID (APPROVALS DATE INSPECTOR SIGNATURE 1 IMIKE DIAMOND PLUMBING (310) 838-0408- I 1 1 13801 LENAWEE AVE LIC. NO IFEE DESCRIPTION QUANTITY UOM AMOUNT INEW HOUSE SEWER I I 1 ICULVER CITY CA 90232 765436 C36 *: I I 1 101 PERMIT ISSUANCE FEE 27 80 ICONNECT ADDITIONAL I I i I 115 ALT/REP HOUSE SEWER 1 00 EAC 30 50 IBUILDING OR WORK I I I (ARCHITECT OR ENGINEER TEL NO 1 TOTAL FEES 58 30 1 1 1 1 1 - ISEPTIC TANK, SEEPAGE PITI I 1 1 LIC NO 1 (AND/Ok DRAIN FIELD IDRYWELL _ I I I I 1 ( ' I - I 1 SEWER MAP BOOK PAGE I 1ALTER REPAIR EWER OR ISEWAGE DISPOSAL SYSTEM I IDISCONNECT PLUG AND (ABANDON HOUSE SEWER II I I I I { { I IBACKFILL SEPTIC TANKS _I 1 1 ISEEP PIT _ CESSPOOL I I I I I I IGRAYWATER 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 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 I I I I I I 1* ADDITIONAL DATA ON FILE I 1 1 I I I I I I I I I I I I IREPORT ID DPR266 ROUTE TO BS0508 I I I I I I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 1111090002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT ILEGAL ID ISEWER / SEPTIC SEWER 1' BUILDING ADDRESS: 1 ITR 6561 LT 90 UN- 002 IEXIST OCC GRP 1 6051 GOLDEN WEST AV 1 I IBLDGS NOW ON LOT- TEMP CA 917601755 I (ASSESSOR INFORMATION NUMBER ICONNECTION TYPE NEAREST CROSS STREET 1 15385-019-003 !ORIGINATION I THOMAS PAGE 597 GRID A2 LOCALITY TEMPLE CITY, Cl I ILENGTH ML TO PL STATION DEPTH I I ITENANT IMANHOLE REFERENCE UPPER/LOWER 11SSUED ON PROCESSED BY 1 I I I11/09/11 SR 1 I ICOUNTY IMPROVEMENT NUMBER I (OWNER- TEL NO IPLAN CHECK NUMBER IFINAL DATE FIN CODE• 1 IWILSON CYNTHIA M (626) 287-2839- IJOB NUMBER I (_�`' 16051 GOLDEN WEST AV ITRUNK PERMIT NUMBER I �` ` ITEMP 917801755 !ROAD PERMIT NUMBER IDE R PTION F WORK I IAFFADAVIT NO (INSTALL SEWER CLEAN OUT 1 IWAIVER NO ! ! 1APPLICANT TEL NO (EASEMENT NO - I IRESCUE ROOTER (626) 858-9284- i I 1475 E ARROW HWY RECORD INSTRUMENT NBR RECORD DATE ISPECIAL CONDITIONS: IAZUSA 1HIGHWAY/STREET WIDENING 1 1 ;STATE ENCROACHMENT PERMIT NUMBER ICONTRACTOR TEL NO FEES PAID (APPROVALS DATE INSPECTOR SIGNATURE IRESCUE ROOTER (626) 858-9284- 1 1475 E ARROW HWY LIC NO IFEE DESCRIPTION QUANTITY UOM AMOUNT INEW HOUSE SEWER I I I IAZUSA CA 91702 765155 C42 *j I I I I 101 PERMIT ISSUANCE FEE 27 80 ICONNECT ADDITIONAL I I I 1 115 ALT/REP HOUSE SEWER 1 00 EAC 30 40 IBUILDING OR WORK I I I 1ARCHITECT OR ENGINEER TEL NO TOTAL FEES 58 20 -1-1 1 I - I ISEFiIC TANK, SEEPAGE PITI I I 1 LIC NO ! (AND%OR DRAIN FIELD 1, 1 I ! IDRYWELL 1 SEWER MAP BOOK PAGE (ALTER, REPAIR, SEWER OR I ! I ISEWAGE DISPOSAL SYSTEM ! I ! I I I I (DISCONNECT PLUG AND ! (ABANDON HOUSE SEWER I I 1 I IBACKFILL SEPTIC TANKS ISEEP PIT _ CESSPOOL IGRAYWATER 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* ADDITIONAL DATA ON FILE ! I ! I I I I I I I I I IREPORT ID DPR266 - ROUTE TO BSO508 1 I I I I I I