HomeMy Public PortalAbout9454 KENNERLY ST_Sewer__ DEPARTMENT OF COUNTY ENGINEER SEXIER-SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER BUILDING
ADDRESS
FBUILDINGOR O FILL IN
LOCALITY ,+asp r�
ADDRESS `� J - I(1 �I S� CROSS STNEAREST. b� ®V j'+A 4,V X/ r
LOCALITf�p yn ?f r `,�I+�y ` On' I e s DIST`RICT�NO SERIAL N0. ~ ' PERMIT N0. C
CNEAREST
ROSS ST. 1t_' b �" ` Y T v -" A
` , RECEIVED BY Ready for Inspection 6_1_1X
�may�DATE ISSUED
OWNER 1 I-A '��L(.j U 1 _1_1XI-
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ADDRESS ll. y. !s. r VN a Y��1 USE ZONE OCC-UPcANCY BK MAP PG
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CONTRACTOR ` CO.IMP.NO.
ADDRESS JOB.N0.
CITY - TEL. TRUNK PERMIT NO.
STATE
REGISTRATION NO. a COUNTY ROAD PERMIT NO.
LEGAL STATE ENCROACHMENT
DESCRIPTION LOT N0. PERMIT NO.
BLOCK TRACT INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT oy,106 N0.OF BLDGS - CHARGES
NOW ON LOT
USE OF
BUILDINGS !� 5 I� CONNECTION CHA EE
NO. DESCRIPTION OF WORK FEE
REIMBURSEMENT FEE �
HOUSE SEWER CONNECTING TO
PUBLIC SEWER a $ 3.50 RECEIPT NO. DATE 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. 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-DRYWELL
SPECIAL CONDITIONS ONLY 2.00 MANHO EFERENCE
UPPER LOWER
TYPE OF CONNECTION L TH FROM
Y. CURB P M.L.
OWNERS PERMIT S I 1 .00 /
AUTHORIZATION I TOTAL FEE
II
THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTI I APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED THIS__-,_-DAY OF---_ NEW HOUSE SEWER � " , � 2'0( 04
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT..........-_---..._. BUILDING OR WORK
SEPTIC TANK,SEEP.PIT(S)
ADDRESS--------------------- AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL E] DRYWELL 0-
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 IAM 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 DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS E]
SIGNATURE pL1C� � :InJ/ J^'y- SEEP.PIT(S)E] CESSPOOLS
OF PERMITTEE
76A642A 663 7/53
4
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 1009020010
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 -
PHONE: (626) 285-0488 EXT:
ILEGAL ID: ISEWER / SEPTIC: SEWER I BUILDING ADDRESS:
ITR: 15890 LT: 10 (EXIST OCC GRP: I 9454 KENNERLY ST 1
I 1BLDGS. NOW ON LOT: I TEMP CA 917803835 I
(ASSESSOR INFORMATION NUMBER: ICONNECTION TYPE: I NEAREST CROSS STREET: I
18590-011-015 (ORIGINATION: - THOMAS PAGE: 596 GRID: JS LOCALITY: TEMPLE CITY, Cl
I ILENGTH ML TO PL: STATION: DEPTH: I I
ITENANT. IMANHOLE REFERENCE: UPPER/LOWER: 11SSUED ON: PROCESSED BY:
I 109/02/10 SR 1
ICOUNTY IMPROVEMENT NUMBER: 1 I
10WNER: TEL. NO: (PLAN CHECK NUMBER: I NAL DATE FINAL BY: CODE: I
ITRAN, LIEN NGOC (310) 930-6907- IJOB NUMBER: I •..� I
19454 KENNERLY ST ITRUNK PERMIT NUMBER: I I
ITEMP 917803835 IROAD PERMIT NUMBER: IDESCRIPTION O ORK 1
IAFFADAVIT: NO (ALTERATION OF EXISTING SEWER 1
IWAIVER: NO
(APPLICANT: TEL NO: (EASEMENT: NO I
ISU, RICHARD (626) 376-1863- 1 I
1216 S. SUNNYSLOPLE IRECORD INSTRUMENT NBR: RECORD DATE: ISPECIAL CONDITIONS: 1
1PASADENA, CA 91107 (HIGHWAY/STREET WIDENING: I
I ISTATE ENCROACHMENT PERMIT NUMBER: I y
1CONTRACTOR: , TEL. NO: ._ 1 FEES PAID (APPROVALS DATE INSPECTOR SIGNATURE 1
ITRAN, LIEN NGOC (310) 930-6907- 1 I
14814 N. DOREEN AVENUE LIC. NO IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: INEW HOUSE SEWER
ITEMPLE CITY, CA 91780 NONE I I
1 101 PERMIT ISSUANCE FEE 27.80 ICONNECT ADDITIONAL I I I
I 115 ALT/REP HOUSE SEWER 1.00 EAC 30.40 IBUILDING OR WORK I I
1ARCHITECT OR ENGINEER: TEL. NO: I TOTAL FEES 58.20 1 1 I I
I - I ISEPTIC TANK, SEEPAGE PITI I I
I LIC. NO: I (AND/OR DRAIN FIELD I I I
I IDRYWELL = I I I
I I I I I I
SEWER MAP BOOK: PAGE: •I (ALTER, REPAIR, SEWER OR I I
I ISEWAGE DISPOSAL SYSTEM I I
I I I I I I
I I IDISCONNECT PLUG AND I I 1
• (ABANDON HOUSE SEWER I I
I I I I I I
I I IBACKFILL SEPTIC TANKS
I I (SEEP. PIT _ CESSPOOL
I I II I I
IGRAYWATER SYSTEM I I
I I I I I I
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I I I I I I
I I I I I I
I I I I I I
I I I I I I
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1 IREPORT ID: DPR266 ROUTE TO BS0508 I I I I