HomeMy Public PortalAbout9836 KEY WEST ST_Sewer__ DEPAI TMENT OF COUNTY ENGINEER, "SEWER-SEWAGE DISPOSAL - Z
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENDINEER I BUILDIADDRE S tf3/6
ADDRESS QQ JJ({��
�F+COR APPLICANT TO FILL IN (� _ LOCALITY `a �"
BUILDING If
ADDRESS 7 CS�� L� (���� W LSA J f GROSS ST �,5 -e<0
LOCALITY (/�y►1 (�L//++ f< DISTRIC/T�/0. SERIAL NO PERMIT N0.
NEAREST
CROSS ST ��f�J� S 1S, LYr C?C L �+� C '� �•,L/� / •� +� S
`_ , RECEIVED BY
Ready for Inspection f DATEISSUED
�/V
OWNER JQ I-1 / P 4S r—_00 r L" �/o -x-3
MAIL
ADDRESS I�3 4 CC L `� Cy 4T S I S USEZONE OCCUPANCY MAP
t I BK PG
CITY '( C-6, (IL L. TEL NO/
CONTRACTOR
+_ CO.IMP N0. J_7Q
ADDRESS JOB NO.
CITYJ� n ��TEL.NO �{if TRUNK PERMIT NO
REGISTRATION NO $ `y �.fCOUNTY ROAD PERMIT NOLEGAL ?
Sr
DESCRIPTION `LOTrNO. (=T jQ� STATE ENCROACHMENT
PERMIT NO
BLOCK TRACT C) S WASTE APPROVAL
USTRIAL
'
SIZE OF LOT „S �x 1 OF BL
� NOO W ON LOTT
l?N C CHARGES
USE OF /�
BUILDINGS df CONNECTION CHARGE FEE
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE
PUBLIC SEWER @ $ S50
RECEIPT NO DATE BY
HOUSE SEWER CONNECTING TO .�..a.....•e..b- •I -.-.
PRIVATE DISPOSAL SYSTEM I W
CONNECT ADDITIONAL BLD6 OR { EXCEPTION RECORDED
WORK TO HOUSE SEWER 100'
ALTER OR REPAIR EXISTING NO. ATE.r BY---�,
SEWER OR DISPOSAL SYSTEM 1.00 ISO
DISCONNECT AND ABANDON SEWER -
AND/OR DISPOSAL SYSTEM . 1 00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 2.00
STATION -�=C`� DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2 00d ���MA HOLE REFERENCE
e:.a 4,1<UPPER LOWER
TYP OF CONNEC kON LENGTH FROM +�
OWNERS PERMIT $ I DO W.—
CURB P•L�-�-- M L.TO P L 7
AUTHORIZATION TOTAL FEE 47.1 ,
IHAVE 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---...._..AU-6.........___--•195 3 NEW HOUSE SEWER
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT. .......p......./.../..yy-----__�_....__.�._... _ ,BUILDING OR WORK '
Co /�aJ / - SEPTIC TANK,SEEP.PIT(S)
ADDRESS `-_ _ -_ - - -•• AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI. CESSPOOL[] DRYWELL
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE El
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 DESCRIBED ESID NTIAL PROPERTY. BACKFILL SEPTIC TANKS[:]
/,�/✓ SEEP.P[T(S)E:] CESSPOOLS-[:]
SIGNATURE
OF PERMITTEE-----...--_---._..----._.-•.:�<--.•-•[--.-.-
76A642D 663 1/53
DEPAlVrb NT OF COUNTY ENGINEER ' ~SEWER-SEWAGE DISPOSAL. 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX. COUNTY ENGINEER I BUILDING
ADDRESS
FOR APPLICANT TO FILL INBUILDING (+ LOCALITYEAREST /J� /" /��" j
JV
ADDRESS &3 �. �W �s% J '! CROSSST.1`7�/ GIS 'P/ C9''Dld'vf/
LOCALITY DNEAREST DISTRICT M0. SERIAL N0. PERMIT NO.
C ROSS ST CD X.D Vii✓
/J RECEIVED BY Ready for laaoeotioo Q' GATE ISSUED
OWNER -Jo flv W14 i f L Fc<)i_ G /'/E G/ U —/0 —Gra
MAIL -
ADDRESS 9L+ �� �:,5-3 G _
� C.y V Sr ti USE 20NE� OCCUPANCY BK MAP PG
CITY ?'(_&V.-(*L JZ TEU-N0A ( -7;'1 -74
CONTRACTOR Co.IMP NO
ADDRESS C'3� I r
404 JOB N0.
-77_
CITY EL TRUNK PERMIT NO
REGISTRATION N0. ® COUNTY
_ pp ROAD PERMIT NO �,�a ��8
LEGAL DESCRIPTION L040 D( 51.x! .T{.Q i j STATE ENCROACHMENT
PERMIT N0.
BLOCK TRACT ( �C) INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT SJ IX ' N0.OF BLDGS.
J_IQ NOW ON LOT ON L`' CHARGES
BUEOF
DINGS If L -S I�tr ✓CJS; CONNECTION CHARGE FEE
NO.I DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE 6
PUBLICSEWER @ $ 350 RECEIPT NO I DATE BY
HOUSE SEWER CONNECTING TO -
PRIVATEDISPOSALSYSTEM 100
CONNECT ADDITIONAL BLDG OR EXCEPTION RECORDED
WORK TO HOUSE SEWER 1 00
ALTER OR REPAIR EXISTING NU_ ,DATE --•BY�o,
SEWER OR DISPOSAL SYSTEM 1 00 •c =` "
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1 00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR _
PITS AND/OR DRAINFIELD 2.00 STATION3 �- DEPTH
CESSPOOL–DRYWELL
SPECIALCONDITIONS ONLY 200 �/ �ye�UPPER EFERENCE LOWER
TYPEfOFCONNEC ION LENGTH FROM �j y /
OWNERS PERMIT $ 1 00 Y.— CURB J� Pt M L.TO P L. �)
AUTHORIZATION TOTAL FEE
1HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE.PUBLIC SEWER Q
SIGNED THIS------ __DAY OF___-.---G____._......195.I NEW HOUSE SEWER 3
� �-� CONNECT ADDITIONAL
OWNER OR �S� L �„ ��C,ciJ F�'I J - BUILDING OR WORK
OWNERS AG ' n
ADDRESS - . SEPTIC TANK.SEEP.PIT(S)
- - - - - - AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL[] DRYWELL
CAT
IONAND STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER.REPAIR,SEWER OR
REGULATING PL-UMBING 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 THE LEGAL OWN-
ER OF THE ABOVE D RIBED RESID PROPERTY. BACKFILL SEPTIC TANKS
SEEP.PIT(S)(] CESSPOOLS Y ��O
SIGNATURE Q '/ :v
OF PERMITTEE----__.._.. .. --•_--- .... _._.._ ._ .. _. _ -
70A042D 663 1/53