HomeMy Public PortalAbout9417 LIVE OAK AVE_Sewer__ DEPAIVfNUENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGRSS
INEER I BUILEDING /Tmoi 7
ADD
'f FOR APPLICANT TO FILL IN LOCALITY or
BUILDING1, �/ NEAREST
ADDRESS Gf 1-7 ;W/._ Q ;6 _ &441 CROSS ST. F,
LOCALITY, C., DISTRICT NO. SERIAL NO. PERMIT N0.
NEAREST A6ea
CROSS ST. A L 2, A 46® RECEIVED BY Ready for Inspection DATE ISSUED
OWNER i � /' —
MAIL USE ZONE OCCUPANCY BI(MAP PG
ADDRESS
CITY tTEL.NO. �! 6OO 0Y� 1;2-9
CONTRACTORA p CO.IMP.NO.
ADDRESS ®e g / r ./
JOB N0.
CITY 9Q�� TELAO. Q � ��� TRUNK PERMIT NO.
STATE
REGISTRATION NO. a OUNTY2
' ROAD PERMIT N0.
LEGAL t+ D/�� STATE ENCROACHMENT
DESCRIPTION LOT N0. J PERMIT NO.
BLOCK TRACT (j � INDUSTRIAL
WASTE APPROVAL _
SIZE OF LOT 73,7h �O NQW ON LOTS
CHARGES
USE
BUILDINGS !1 c�� CONNEC CHARGE FEE
,(J IGi
NO.I DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO REIMBURSEMENT F
PUBLIC SEWER Q $ 3.50 RECEIPT NO. I ATE I BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.ORCEPTION RECORDED
WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING N0. I DATE I 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 C� DEPTH /
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 O EFERENCE 1`8
_ TYPCONNECTI LENGTH FROM
OWNERS PERMIT $ : 1 00 Y. CURB P L. M L.TO P.L.
G>
AUTHORIZATION TOTAL FEE
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INS PE TOR'SSIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
1•
SIGNED THIS--_...............DAY OF-------_...... ---_--- NEW HOUSE SEW R
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT----- -"dC.Y. _.._. BUILDING OR WORK
SEPTIC TANK,SEEP.PIT(S)
ADDRESS"----_--------_-------_
..----•-."...----------.-.-....-•---_.......----._..-..-•----- AND/OR DRAINFIELD '
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI• CESSPOOL I] DRYWELL E]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 1. SEEP.PIT(S)[] CESSPOOLS I]
OF PERMITTEE- _."_"-_-` - ....._."_-
76A642A 663 7/53
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 0808180003
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 )
PHONE (626) 285-0488 EXT
ILEGAL ID ISEWER / SEPTIC SEWER BUILDING ADDRESS
ITR 6561 LT 755 UN 002 IEXIST OCC GRP I 9417 LIVE OAK AV
1 IBLDGS NOW ON LOT TEMP CA 917802427 1
ASSESSOR INFORMATION NUMBER ICONNECTION TYPE NEAREST CROSS STREET
18587-005-027 (ORIGINATION THOMAS PAGE 596 GRID- J3 LOCALITY TEMPLE CITY, Cl
I ILENGTH ML TO PL STATION- DEPTH
TENANT IMANHOLE REFERENCE UPPER/LOWER- 11SSUED ON PROCESSED BY EXPIRES ON
I 108/18/08 SR 02/14/09
ICOUNTY IMPROVEMENT NUMBER I_
(OWNER TEL NO PLAN CHECK NUMBER iFIQ DA FIJVj�\BY CODE
DOLORES ABIDIA - IJOB NUMBER i !-� v\\
19417 LIVE OAK AVE TRUNK PERMIT NUMBER
TEMPLE CITY CA 91780 IROAD PERMIT NUMBER. IDLy3CRIP�TION OF WORK
IAFFADAVIT NO 140 FT 4" SEWER LINE REPLACEMENT
IWAIVER NO
1APPLICANT TEL NO EASEMENT- NO I1
(URGENT ROOTER (818) 504-9404- 1 I 1
17949 AJAY DR IRECORD INSTRUMENT NBR RECORD DATE 1SPECIAL CONDITIONS
ISUN VALLEY, CA 91352 (HIGHWAY/STREET WIDENING- I I
I ISTATE ENCROACHMENT PERMIT NUMBER
I I
ICONTRACTOR TEL. NO. I FEES PAID 1APPROVALS DATE INSPECTOR SIGNATURE 1
(URGENT ROOTER (818) 504-9404- 1 1
17949 AJAY DR LIC NO IFEE DESCRIPTION QUANTITY UOM AMOUNT INEW HOUSE SEWER
ISUN VALLEY, CA 91352 887603 C36 I . I V
1 - - 101 PERMIT ISSUANCE FEE 27 75 (CONNECT ADDITIONAL 1 I I
1 115 ALT/REP HOUSE SEWER 1 00 EAC 30 45 IBUILDING OR WORK 1 1 1
1ARCHITECT OR ENGINEER TEL NO I TOTAL FEES 58 20 1 I I I
1 - 1 ISEPTIC TANK, SEEPAGE PITI I I
LIC NO
1 (AND/OR DRAIN FIELD I 1 1
I 1 DR:-WELL 1 1 1
I _1
SEWER MAP BOOK- PAGE (ALTER, REPAIR, SEWER OR I
1 1 iSEWAGE DISPOSAL SYSTEM 1 1
I I IDISCONNECT PLUG AND
1 1ABANDON HOUSE SEWER 1 1 1
1 IBACKFILL SEPTIC TANKS
1 1 ISEE'P PIT _ CESSPOOL
1 1 IGRAYWATER SYSTEM 1 1 1
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 IREPORT ID DPR266 ROUTE TO DS0508