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Home My Public Portal About6355 OAK AVE_Sewer__ DFXARTbUMqT OF COUNTY ENGINLnM SEWER—SEWAGE DISPOSAL D_ iSZON OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGIMES WILLIAM J. FOX, COUNTY ENGINEER BUILDING � ^ I. ADDRESS a Ali i 6a A f-Pa FOR APPLICANT TO FILL IN LOCALITY pa C, r BUILDING 6 3 aCS n / �rr�®� dyod CROSSST. �� r��14 ADDRESS �y (� LOCALITY C OISTR 7 NO. GSERIAL NO. PERMIT NO. :NEAREST CROSS ST. ® 4 �P s ,zJ !.. I � O S OWNER C.EZX_BY Reedy for Inspection DATE ISSUED AMAIL i DDRESS (A;f�S Al. �f /L // 0/� �s USE 201E OCCUPnAN�CY BK MAP PQ CITY �A Cl TEL.NO. / ^�6a� ��a �� I ✓ "`�� I q CONTRACTOR jjn1 o J" �/d a gg, IMP.NO. ADDRESS ,, l JO N0. CITY ��)P� s�/� TEL.NO. �}! �j TRUNK\eERMIT NO. STATE REGISTRATION NO. {. ) ® COUNTY ROAD PER IT NO. DESCR IP L04,NOixx V,ISD O1Cr L iy�pa'. ��.�"LEGAL STATE ENCSQACHMENT �f- -PERMIT NO. `t BLOCK TRACTS ys l d�In stCl C b z IND TH RIAL SIZE OF LOT ® NO-OF BLDG • � 0 NOW ON LOTS CHARGES USE OF BUILDINGS WSJ CONNECTION CHARGE F E NO. DESCRIPTION OF WORK FEE \ REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO PUBLICSEWER Q E 8.50 RECEIPT NO. I D E IBY 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 = N0. I DAT IBY SEWER OR DISPOSALSYSTEM 1.00 DISAN•D%OR DISPOSAL SYSTEM DON SEWER 11.00 CXNNECTION DATi, SEPTIC TANK,SEEPAGE PIT OR PITS AND/ORORAINFIELD 2.00 STATION DEPTHH CESSPOOL—DRYW ELL SPECIAL CONDITIONS ONLY 2.00 MANHOLEUPPER REFERENCE LOWER TYPE OF CANNECTION LENGTH FROM IlK I$ I Y. OURB P.X. M.L.TO P.L. OWNERS PERMIT 00 G AUTHORIZATION TOTAL FEE .21422, I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE DWELLING TO THE$UBLIC SEWER �.� pvL / NEW HOUSE SEWERr�d` SIGNED THIS... . _DAY OF ._. _19.. / 06 `7' OWNER OR �+�40. CONNECT ADDITIONAL r OWNERS AGENT_.. I BUILDING OR WORK - --_- - �•� SEPTIC TANK,SEEP.PIT(S) ADDRESS..._......_._..._._ AND/OR DRAINFIELD . 1 HEREBY ACKNOWLEDGE THAT I HAVE READ T IS APPLI• CESSPOOL ORYWELL 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- 1 HEREBY CERTIFY THAT 1. AM PROPERLY REGISTERED DISCONNECT PLUG AND AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE.SEND AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN- ER OF THE ABOV D CRIBED RESIDEN L PR ERTY. BACKFILL SEPTIC TANKS❑ SIGNATURE i SEEP.PIT(S)0 CESSPOOLS E3 OF PERMIT _._. .._. ., .. -ARA9A RAG O/KR - - - - '- •_ - WORKERS' COMPENSATION'DECIARATIdN 20-0051 DPW 6199 Ag,eijy that I hove. a certificate of consent to self in.SLk. . a n . . 76A642D or.a certificote of Work-ors'Corripens flo. Insuranig.e, or a ce�rt. led copy thereof.(Sec. 3800, Lab Cm) APPLIcATiON FOR PERMIT Policyto.—Company- ❑ Certified copy is [urnished hereby SEWER - SEWAGE DISPOSAL ❑ j Certified copy is filed with the county building inspection t, COUNTY OF LOS ANGELES BUILDING AND SAFETY deportment. Date Applicant FOR APPLICANT TO FILL IN CONNECTION DATA CERTIFICATE OF EXEMPTION FROM WORKERS' BUILDING W STATIO1(5,'_/��. DEPTH COMPENSATION INSURANCE ADDRESS UPPER (This section need not-be completed if the work involved.b.y.the. –ZEM FE (f/7 MANHO PR permit is for;one hundred dollars($1001 or less LOCALITY .07V REFERENCE ADDRESS L A TYPE OF CONNECTION [NEAREST LENGTH G OS O�� .01, I rertify'that in the performance of this work for which this ROSS.ST Y CURB P I. M L TO PRI permif is issued, 1 sholl,not employ any person thany manner 'L LEGAL, -P c Np. so as to become subleift to the Workers'Compenvation Laws. PESCRI N LOT No. CO IMP NO JOB NO C Date— BLOCK TRACT IRUNK PERMIT NO ROAD PERMIT NO Applicant - _. r I - ASSESSOR AFFIDAVIT WAIVER INSTR No OA7E NOTICE TO APPLICANT: If, after making this Certificate of, MAP.BOQK 07�3k5. Exemption, you should become subject to like Workers.' I PAGE /7 1PARCE EASIMENT. RECORD NO.00 Bi.DGS. Compensation provi.siong of The Labor code, ,W ON LOT you must forthwith. SIZE OF LOT FJWY OR ST WIDENING ag? - comply with such provisions or this permit shol.1 be deemed USE OF revoked. BUILD9405 STATE ENCROA04NkENT LICENSED CONTRACTORS DECLARATIONQ ..PERMIT NO e$r#k11 `ii� I hereby affirm that I am licensed under provisions-of Chapter WNEF1 91 (commencing with Section 7000)of Division 3.of, the Busy. MAIL AD ORES V nest and Professions Code, and my license ! I. S :SV6 CHARGES Is full force and offoct. CITY TV TEL,Na. CONNECTION CHARGE F-VE License Number LIC.Class .-7 REIMBURSEMENT FEE CONTRACTOR GROUP (Ccontroctor Date- b1$TRiCT NO MAP ROaSSED BY El I am exempt under Sec.. f the L,A.Co.' AabRES$.49:M5_ AVG BK PIS cly 7414EL.N. L/j Plumbing Code and./or Ser. of the STAT 'LIC FINAL 0' LICENSE NO CLASS DATE tal.– VALIDATION B. &P. Code for the following reosQn. No. DESCRIPTION OF WORK FEE: 0 HOUSE SEWER C40NNECTINQ TOFINAL Dole PUBLIC SEWER 0 BY SEPTIC TANK SEEPAGE;PIT OR LU CL Signature PETS 4090 ORMAIRNEED ca OWNER-BUILDER DECLARATION HOUSE SEWER CONNECTWO TO Z PRIVATE DISPOSAL SYSTEM 1 hereby exempt from the'CbntrqCtOr'S License CONNECT 001i[IONAL BLDG OR; �,=:that I am Law 'owing.reason.(Sectors 7031.5,Buismess,and Pro-4 WORK TO HOUSE SEWER fessionS Code). OVERFLOW SEEPAGE OL. E PIT DRAINFIFIC EXIN DRYWELL MANHOLE x El Jas oWnerof the property,arm with woges as ALTER REPAIR.OR ABANDON.HOUSE their sole compensotion,wil.t do.the work and the structure SE-AiER CRV.SPOSAi,SYSTEM t, , I.- isnol iniended.or offered for sole (Section.704A; Busmess and Professions•Cod0. A. L4 1,as p-Wrier of-the property;am exclusively cpritrcittirig wi,Ih. 7, , 'licensed contractors)b construct the proje.Cjt,.(SBcIion 70"'.. OWNER'S Permit 4L 71 . 10 Business and Professions Code). AUTHORIZATIONIf TOTAL FEE CONSTRUCTION LENDING AGENCY I HAVF AT THIS DAVE A.CONTWAr T-WITH THE H(REIN NAMED rONTRACTOR TO is CONNECT'l[HE ABOVE DEKf?ow exisTANQ,D.WfillitiG.TOJ-4 PU611i�'SEWErV *;.M I hereby offirM that there 1. a cbnStrUctfon lending agency for :the performance of the work for which this permit is' issued.(Sec. 3097, Civ..C SIQNED THI$ DA.If QF 19 OWNER 09 Lender's'Norne OWNER&AGENT ADDRESS Lender's Address I certify that I hqive read this opph.co.hon and state that the above information IS carred. I ogr460 to comply Mirth all County ordinances and State laws. r6g.Ulotirig. Plumbing ond..S 4wers and here authorize represent S of this.County to enter 'pr this. County. upp.. ovo- entiOned pro erfy r inspection dbrposq IE "a ur ci, SEE REVERSE FOR EXPLANATORY-LANGuAGE �'Sllgn ttv=eOf TO.it`166 Dal . 55aM-6THSJ 3.5'3 APPLICATION FOR PERMIT & -S DIVISION OF BUILDING AND SAFETY SEWER--SEWAGE DISPOSAL --- Department of County Engineer County of Los Angeles BUILDING 'WM-Jy FOX, COUNTY ENGINEER --ADDRESS BUILDING OakOakCASSATT D.GRIFFIN, SUP'T OF BUILDINLOCALITY ! ^t� Pmn FOR APPLICANT TO FILL IN -NEAREST LEGAL �T ry _CROSS ST. __ DESCRIPTION LOT NO.E Cry 00t o.�+ .4Y 1,50 OWNERLI�,', BLOCK k a= lot 2 13.i 6-137 -MAIL ----- ADDRESS ", ""r, p�ryry,, _SIZE OF I,OT15O 01-f NO,"OF BILDGS. 2-0 .�_ NO If ON LOT _ CITY TEL. NO. USE OF Home for missionaries aUILDING5 DISTRICT N0. GROUP MAP .... - jr_ —,°g} T L Geddes ,y i ,,.f I BK PG CONTRACTOR 1rie Lin eddes ADDRESS 151 N Third CON NECTION DATA C[TY ArCadia TEL. NO. do 7-813',5 .._ STATION� � DEPTH �:.. " STATE MANHOLE REFERENCE— .UPPER-REGISTRATION NO. /923 -L)+17 81 - COUNTY ,-fpm---/f¢-f�{Jy- LOWER_ NO,�—DESCRIPTION OF WORK FEE — _ = � �= 'Y �-��'..,.�,�_'� --- -- TYPE OF CONNECTION LENGTH IF HOUSE SEWER COhNC7 r 'ING TO Y. CURB P.L. M.L, TO P.L. LP U_ 1C,SEWER .�_._._ ((N 3..50 I. ---.._.------- HOUSE SEWER CONNECTING TO I - ----- _I PRIVATE DISPOSAL SYSTEM 1.00 j f. CONNECT ADDITIONAL BLDG.OR j P. C. NO. 4fORK TO HOUSE SEWER 3 00 j� - CO. i dP Op_ _J0a NC.__, - ALTER OR REPAIR EXISTING TRUNK PERMIT NO. ROAD PERMIT NO.. I SEWER OR DISPOSAL SYSTEM 4 00 DISCONNECT AND ABANDON SEWER I STATE ENCROACHMENT .�. J AND/OR DISPOSAL SY TEY 3.00 -PERMIT NO, PITS A TANK. RAINFi.E PDT OF. INDUSTRIAL PITS AND/OR DRAINF;ELD 2.00 WASTE.APPROVAL CESSPOOL-DRYW ELL � SPECIAL CONDITIONS ONLY _2,00 --- �— --- CONNECTION CHARGE E OWNER'S PEFu'YIIT S 1 1 00 ----- AUTHORIZATIONTOTAL FEE 2 100 REIMBURSEMENT FEE IH.AVe: THIS DATE CONTRACTED WITH THE HEREIN NAMED CON- TR�.CTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS DATE 11NSPECTOR*S SIGNATURE TO THEPUBLIC SEWER —— NEW HOUSE SEWER —j�_ -------- SIGNED THIS ____DAY OF -- -- t9— OWNER OR CONNECT ADDITIONAL OWNERS AGENT - _ BUILDING OR WORK SEPTIC'T'ANK,SEEP,PIT(5) ADDRESS._-_ ------ _ _ _AND/ItiR I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL 0 DRYWELL[3 AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY 1777'13 ALL COUNTY ORDINANCES AND STATE LAWS REGULATING; ALTER,REPAIR_SEWER 6R � t PLU1,18ING AND SE',.ERS, SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/CR --- -- -- (' LICENSED AS REQUIRED SY LOS ANGELES COUNTY AND STATE OF DISCONNECT PLUG AND CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE _ABANDO_N HOUSE SEWER _ .DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANK5[',, PIT(S) [I CESSPOOLS[] SIGNATURE s .t'.; � - ,.�r� r"rT.e':.->. -OF PERMITTEE - WILLIAM J.FOX.COUNTY ENGINEER VALIDATION R.A.WOOD, CHIEF PLGG. INSPECTOR DEPA-RTMENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER BUILDING CASSATT D. GRIFFIN, SUPT OF BUILDING ADDRESS - FOR APPLICANT TO FILL IN LOCALITY BUILDING _ADDRESSl r �i CROSS ST. t y DISTRICT N0. SERIAL NO. PERMIT NO. LOCALITY _ e A NEAREST GROSS ST. i RECEIVED BY Ready for Inspection DATE ISSUED OWNER tib:- 7S "C t::` :.�•islir .' MAIL USE ZONE OCCUPANCYBK MAP PG ADDRESS CITY TEL.NO. CONTRACTOR ',z fd' s�/�y CHARGES REIMBURSEMENT FEE _ L+''.: ,c/ Y �. � CITY "c 3 ADDRESS REQUIRED NOT REQUIRED I_ 1 r TEL NO ' SOB NO. REGISTRATION ` CONNECTION CHARGE FEE LG ST CO.IMF.NO. LEGAL RECEIPT NO. f DATE I BY DESCRIPTION LOT NO. -_— ----- ' -- BLOCK TRACT WAIVER FOR RECORDING SIZE OF LOT — — — NO.OF BLDGS. — RECEIPT NO. 4 DATE f BY NOW ON LOT I { USE OF BUILDINGS TRUNK PERMIT NO. NO. i DESCRIPTION OF WORK FEE — --- 9'' HOUSES E7RCONNECTING TOy ROAD PERMIT NO. PUBLIC SEWER @ $ 3.56 I= ---- y MOUSE SEWER CONNECTING TO ! STATE ENCROACHMENT _ PRIVATE DISPOSAL SYSTEM 1.00 ! PERMIT NO. _ CONNECT ADDITtONAL 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 011 _ PITS AND/OR DRAINFIELD 2.00 I MANHOLE REFERENCE CESSPOOL-DRYWELL ff _UPPER LvJcR - SPECIAL CONDITIONS ONLY 2.00 I TYPE OF CONNECTION LENGTH FROM Y. CURB — P.L. -WL.TO P.L. OWNERS PERMIT $ I 1 00 -- AUTHORIZATION TOTAL FEE _ -- NAED CON RACTOIR TO CONNECT THDATETE ED ABOVE D SCRIBEDWITH THEI EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE DWELLING TO THE PUBLIC SEWER --- ' i, NEW HOUSE SEWER SIGNED THIS.. - DAY OF ............19._ ��M�'� s CONNECT ADDITIONAL OWNER OR OWNERS AGENT BUILDING OR WORK SEPTIC TANK,SEEP.PITS) ADDRESS.-_ _ -.... t_ - _. AND/OR DRAINFIELD_ 1 HEREBY ACKNO EDGE THAT I AVE RE THSS APPLI- CESSPOOL[] DRYWELL E] CA"0" AND STATE THAT THE ABOVlCtS CORRE T AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR SEWER REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND DISCONNECT ABANDON HOPLUG PLUGAND AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN- ER OF THE ABOVE DWSCRIFED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS El SIGNATURE SEEP-PIT(S)L-] CESSPOOLS El -- OF PERMITTEE-- - 76.A642D 663 12/52