HomeMy Public PortalAbout6203 GOLDEN WEST AVE_Sewer__ DEPAIVrAIENT OF'COUNTY ENGINEER SEWER-SEWAGE DISPOSAL 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENt3INEER BUILDING
I ADDRESS �(/.3 IV, f� &//17�
BUILDINGNEAREST
FOR APPLICANT TO FILL IN LOCALITY -7_l A.t-A9,1(1
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ADDRESS Q _ / /�` / /� CROSS ST. 1 V 6,
TT// /Y V(l
LOCALITY nt z /I •-�- DISTRICT N0. tAERIAL NO. PERMIT/N 0. c
NEAREST ��jA ��� V b S
CROSS ST.
/ �, � RECEIVED
BY Ready for Inspection DATE ISSUED _
OWNER J
_ `.".._7
MAIL
ADDRESS USE ZONE OCC PU ANCY EMAP
��_ �� /
CITY' 4. �f TEL.NO, .-
CONTRACTOR �'^ ( �. �y,.�/
CO.IMP.N0. I'��j 2.--
ADDRESS 10B NO.,---__
CITY TEL'--.NU. 77 V'/ TRUNK PERMIT N0.
STATE
REGISTRATION NO. y j'9 �� � 8 COUNTY ROAD PERMIT NO. '' _`�� ►e,w
LEGAL ,llI
DESCRIPTION LOT NO. O V LP?A,1 STATE ENCROACITMENT
PERMIT NQ'
BLOCK TRACT ftl 11 fj7,�¢1 51 INDUSTRIAL U
NO.OF BLDGS. WASTE APPROVAL
SIZE OF LOT 0 O �/��(� NOW ON LOT CHARGES
USE OF
BUILDINGS /% ""� L� �--" CONNECTION CHARGE FE\
N0. DESCRIPTION OF WORK FEE
• HOUSE SEWER CONNECTING TO - REIMBURSEMENT FEE
PUBLIC SEWER C2 $ 3.50 RECEIPT N9../� DATE _I BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR % EXCEPTION RECORDED
WORK TO HOUSE SEWER 1.00 0 In
ALTER OR REPAIR EXISTING NO- DATE BY
SEWER OR DISPOSAL SYSTEM 1.00 �A—.. moo- Rf"^"4""="� `
DISCONNECT AND-ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1 00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 2.00
STATION DEPdT
CESSPOOL—DRYWELL ;
SPECIAL CONDITIONS ONLY 2.00 MANHOLE P&_ERENCE
UPPER LOWER
TYPE OF CONNFLCMONLENGTH FROM
OWNERS PERMIT $ 1 00 Y. C P.L. M.L.TO P.L.
AUTHORIZATION I TOTAL FEE 2 D
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............_...._............__._19_. 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[:j DRYWELL
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS; ALTER,REPAIR,SEWER OR i
REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIF�Y"THAT I AM PROPERLY REGISTERED DISCONNECT PLUG AND
AND/OR LICENSED AS REQUIRED BY LOS ANGELES,COUNTY ABANDON HOUSE SEWER
AND STATE OF CA IFORNIA R THAT I AM TH!E LEGAL OWN
ER OF THE AB OV
DESCRIB D RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKSEl
SIGNATURE SEEP.PIT(S)E] CESSPOOLS E]
OF PERMITTEE - - - - �'�- - _............----------•--
76A642D 663 1/53
DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION 1
COUNTY OF LOS ANGELES
WILLIAM J. FOX. COUNTY ENGINEER I BUILDING
CASSATT D. GRIFFIN, SUPT DF BUILDING ADDRESS
FOR APPLICANT TO FILL IN LOCALITY
BUILDING NEAREST
ADDRESS/�')�/ � �� � _—_ CROSS ST.
LOCALITY ;' DISTRICT NO. SERIAL NO. PERMIT NO.
NEAREST _
CROSS ST. ol,` RECEIVED BY Ready for Inspection DATE ISSUED
OWNER
MAIL `,� �� _, _� USEZQNE OCCUPANCY M
ADDRESS B PG���>_
TEL.NO.A 1+ ;z:-7,3 2. /
CONTRACTOR F CHARGES REIMBURSEMENT FEE
ADDRESS REQUIRED
NOT 9EQ ED
CITY TEL.NO. JOB N0. CONNECTION CHARGE FEE
STATE CO. IMP. N0.
REGISTRATION NO. COUNTY
LEGAL RECEIPT NO. DATE I BY
DESCRIPTION LOT NO. _
BLOCK r,I TRACT WAIVER FOR RECORDING
SIZE OF LOTIoOp'j,, 9 57:, NOW ON LOTS RECEIPT NO. I DATE BY
USE OF
BUILDINGS TRUNK PERMIT NO.
I� NO. DESCRIPTION OF WORK FEE --
HOUSE SEWER CONNECTING TO ROAD PERMIT NO.
PUBLIC SEWER @ $ 3.50
HOUSE SEWER CONNECTING TO STATE ENCROACHMENT
PRIVATE DISPOSAL SYSTEM 1.00 I ( PERMST N0.
CONNECT ADDITIONAL BLDG.OR (� INDUSTRIAL
WORK TO HOUSE SEWER 1.00 WASTE APPROVAL
ALTER OR REPAIR EXISTING
SEWER OR DISPOSAL SYSTEM 1.00 (� CONNECTION DATA
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 STATION } DEPTH
SEPTIC TANK,SEEPAGE PIT OR -
PITS AND/OR DRAINFIELD 2.00 I MANHOLE REFERENCE
CESSPOOL—DRYWELL UPPER LOWER
SPECIAL CONDITIONS ONLY 2.00 I TYPE OF CONNECTION LENGTH FROM
V. CURB 'isa: M.L.TO P.L.
OWNERS PERMIT $ I 1 00 —
AUTHORIZATION I TOTAL FEE
CO THAVE THIS DATE CONTRACAED RACTOR TO CONNECT THTE
ABOVE D ED SCRIBEDWITH THEIEXIISTING APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED THIS_1.�,..._D Y OF._ ..LYgetc-.__..._....__... 19'tJ. NEW HOUSE SEWER
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT_'_ BUILDING OR WORK
--- -
SEPTIC TANK,SEEP.PIT(S)
ADDRESS_.1�"�f.ljl...... ....
I HEREBY ACKNOWLEDGE THAT 1 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
REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
I DISCONNECT PLUG AND
HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOPLUGAND
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
USE SEWER
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS
SEEP.PIT(S)[-] CESSPOOLS
SIGNATURE
OFPERMITTEE----------------------------------------------------------------------------------
i 6A642D 663 12/52
DEPAW.MENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL 1 '
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER (,AUILDING
DDRESS
FOR APPLICANT TO FILL IN / j� LOCALITYBUILD
NEARES
� ,`✓,f,��j [���
ADD EISS f� �� �yL%. ���N� �7 � r'" �� CROSS ST. A " /
LOCALITY, � � � � DISTRICT NO. SERIAL NO. J PERMIT NO.
NEAREST /� •/J A �� /^ UJ S
CROSS ST.
/ LA
BY Ready for Inspection DATE ISSUED
OWNER '
c =�� O`er ��� <_-�1 )oJ7)
MAIL ��'` /
ADDRESS G� ? / _ ,CZA USE ZONE OCCUPANCY BK MAP PG
CITY TEL.NO. -2 vo"l
CONTRACTOR �_ �4 K
�a CO.IMP.NO.,! �,�L_� ✓ �',
ADDRESS
ry'7'� JOB NO.
CITY _ d 'T/ ✓ TEL
TRUNK PERMIT NO.
STATE
REGISTRATION NO. 9 r 8 COUNTY
ROAD PERMIT N0.
LEGAL
DESCRIPTION LOT NO.y -f /� v ����� STATE ENCROACHMENTS
�I PERMIT NO. / � �V /
BLOCK N TRACT S�e� �q rf INDUSTRIAL 1 U
�
SIZE OF LOT N0.OF BLDGS. WASTE APPROVAL
P�� N��® NOW ON LOT CHARGES
USE OF
BUILDINGS 'k ., Y t.s-�-� CONNECTION CHARGE FEE
N0. DESCRIPTION OF WORK FEE \
HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE �
PUBLICSEWER Q $ 3.50 RECEIPT NO. �I\ DATE /BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR EXCEPT ON 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
DATA
SEPTIC TANK,SEEPAGE PIT OR \
PITS AND/OR ORAINFIEL•D • 2.00 STATION DEh`TH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE
UPPER LOWER
TYPE OFICONNECTION LENGTH F OM
OWNERS PERMIT $ 1 00 Y. /CURB P.L. M L.TO P.L.\
AUTHORIZATION .TOTAL FEE 00
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE-ABOVE,DESCRIBED'EXISTING APPROVALS I NSPECTOR'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
........._...
ADDRESS`:---._:-__..--.-_. SEPTIC TANK,SEEP.PIT(S)
-...----•---•-----------...---....--•--...--•---• AND/OR DRAINFIELD -
t HEREBY ACKNOWLEDGE THAT I HAVE READ THIS-AP,PLI. CESSPOOL E] 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 AN$ELES COUNTY ABANDON HOUSE SEWER
AND STATE OF-CALIFOBNIA-OR THATaI AM THE LEGAL OWN-
ER OF-THE'ABOVp-`DE"CRIBED_RESIDENTIAL PROPERTY. BACKFILLSEPTIC TANKS
�
SEEP.PIT(S) OLS
CESSPOEl
SIGNATURErte," i
OF PERMITTEE------------------------ ` "
76A642D 663 1/53
DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER I ADDRESS
FOR
R APPLICANT TOFILLFILL IN Q� LOCALITYBUILDING
NEAREST
ADDRESS �� CROSS ST. Ns
LOCALITY D/IISTRICT NO. /{f SERIAL NO. PERMIT NO.
NEAREST V
CROSS ST, r ,� 4 _ / .l Zj �ECJE VED BY Ready/for Inspection DATE ISSUED
OWNER=rX ,MAILy 1W L��J ! �'YI // W 7�l 7 /a.53
ADDRESS t� / ��L�-yea, � a� 3�i/, USEZONE OCCUPANCY MAP
BK PG
CITY ` V TEL.NO.� l� v
/ \
CONTRACTOR �� A- - r S� I 3
_ CO.IMP.NO.
ADDRESS �
JOB N0.
CITY TEL.NO llm � �„� TRUNK PERMIT N
REGISTRATION NO. �j �y 9 Q; COUNTY
"� / ROAD PERMIT NO.
LEGAL
DESCRIPTION LOT N0.( /® r/�� [ �'C�J —SPATEENCROACHMENT
BLOCK TRACT INDUSTRIAL
a_ s NO.OF BLOGS. WASTE APPROVAL
SIZE OF LOT�� 1� Q NOW ON LOT CHARGES
BUILDINGS A. CONNECTION CHARGE FEE
NO. DESCRIPTION OF WORK FEE_
HOUSE SEWER CONNECTING T0� 6EiMBURSEMENTiFEE ,✓` —
PUBLIC SEWER $ 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 00
ALTER OR REPAIR EXISTING NO. ` > *DATE BY
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 CONNECTI(A,DATA
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 2.00 STATION �+ DEPTH
CESSPOOL--DRYWELL
SPECIAL CONDITIONS ONLY 200 6 MANHOLE REFERENCE
p UPPER ` LOWER
TYPE.&CONNECTION LENGTH FROM
OWNERS PERMIT $ 1 00 Y. CURB P.L. M.L.TO P.L.
AUTHORIZATION TOTAL FEE .42- 0 0
1 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..........._.._......_._____..._I9_._._ NEW HOUSE SEWER (�• t}, �/� F� � _
OWNER OR CONNECT ADDITIONAL
OW N ERS AGENT--•------------------------------------•-----------.-------•-•-•---•---{ BUILDING OR WORK
SEPTIC TANK SEEP.
ADDRESS___......____._...____. I 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 1 AM PROPERLY REGISTERED
AND/OR LICENSED AS,,REOUIRED BY LOS ANGELES COUNTY DISCONNECT PLUG AND-
AND STATE OF CALIFORNIA 0 THAT 1 AM THE LEG �OWN- ABANDON HOUSE SEWER
ER OF THE ABOVE'DESCRIBE RESIDENTIAL PROP TY. BACKFILL SEPTIC TANKS
SIGNATURE SEEP.PIT(S)� CESSPOOLS❑
OF PERMITTEE_...-------- ------_ Mo Isrim
n
76A642D 663 1/53 V