HomeMy Public PortalAbout9467 OLEMA ST_Sewer__ DEPA>Ei'rt�aritv�l+ OF comv'rY ENGINEER % - SEWER—SEWAGE DISPOSAL 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J: FOX. COUNTY ENGINEER - BUILDING /
_� I ADDRESS
FOR APPLICANT TO FILL IN LOCALITY•
BUILDING - NEAREST C '^
ADDRESS CROSS ST. _
LOCALITY IRL..�
DISTRICT N0. SERIAL N0. {.` PERMIT NO.
:-rrrr ar !� v (,
NEAREST _ J i •, 6
CROSS ST. a �RECEIVED BY Ready for Inspection „' OAT.E ISSUED
OWNER 12eal sloes t/_ f"�(d,I�txl� '� !•-6 -�
MAIL USE ZONE OCCUPANCY MAP
ADDRESS mm - f /6 � K 3S
CITYawe
TELAO.
CONTRACTOR G(3=g8liLlMiV�6 jMbarg. Co.IMP.NO.
ADDRESS 6782 1I Golden Yiiot AVO JOB NO. rte—
CITY TEL.NO. ® a .67x..2 TRUNK PERMIT NO.
16TREGISTRATION NO. �. �COUNTY, ROAD PERMIT N0.
. LEGAL
DESCRIPTION LOT NO. STATE ENCROACHMENT
PERMIT NO.
BLOCK TRACT• 1.4535 INDUSTRIAL
- WASTE APPROVAL _
SIZE OF LOIfig a. y NOw00N LOTS CHARGES
BSO
UILDINGS Dff03,$jag & (j=aff#I CONNECTION CHARGE FEE
NO. DESCRIPTION CTF WORK TIME /
/ REIMBURSEMENT FEE'
HOUSE SEWER CONNECTING TO
PUBLICSEWER @ $ 3.50 Q`: RECEIPT NO. I DATE IBY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR EXCEP RECORDED
WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING r NO. I DATE I BY
SEWER OR DISPOSAL SYSTEM 1.00 `
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL-SYSTEM 1.00 CONN CTION DATA
SEPTIC SEEPAE
PITS AND/ORD AINFGELD T OR 2.00I
CESSPOOL=
8D8 ,D-6<
'6A642r, APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL.
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
TADORESS
1011N .A, LAMEIE, County Engineer � ��WILLIAM .A, JENSEN, Sup'f of Buildiang
Y TFOR APPLICANT TO FILL IN T
ES'.: P.IOtd OT NO OWNER
MAL .
R t'.CK TRACT
NO. OF BLDG'S': �,v"..
_1F LOT` NOW ON LOT CITY ,rte." TEL. NO.
_____...
USE '
61111.LJ!Ni+S D;STRICTIVO. GR'D:UPI MAP PRO
CESSED 23Y
ADDRESSA� fig`,� CONNECTION DATA _
CIYY °r S AT!O DEPTH '+
STATE, UhPE _
-_ MANHOLE..REFERE:N(E.
WFG i
:,l r341 G"Y Td O. ] L014}:.32
-_
NO. SO E.=i C`P.IPTI(JN OF WORK FEE TYPE.OF CONNECTION LENGTH FROM
f F OU'E S G{'R CONNECTING TO I � Y. CURB P.t L. M.L..TO P.L.
E, P.C.Nb
..�Y NK- .
E`-A_ FiT OR
PITS ANDS OR GRAI NF-EL.D �' $fO.00 I i CO.IMP. NO. JOB NO.
— '�QU E--SLLV 4.C ONNF GTING 70 -.— ._.---r .. TRUNK PERMIT NO ROAD PERMIT NO.
PR VA i'DISPOSAL SYSTEM @
$300
� y � � �
�E(O STR N.J ; AEEO K UES [ RN
WORK TO HOUSE SEWER
G $3.00
OVER SEEPAGE PIT,17 F2AiNF1ELG I ' I i � I
EXrN.,CESSPOOL,DRYWELL,MANHULE $5.00
_.__ —__._ _ HW-Y-UR ST,WIDENING
AL TEF:,REP.>IR OR AHA NDOiJ HO#.;SE
SEWER(DR DISPOSAL SYS rENI � S3.CIO
STATE ENCROACHMENT
I PERMIT NO. ' 1
INDUSTRIAL
i WASTE APPROVAL
OWNER'S PERMIT zi op ---
..._._.____.
--- FE
--
CONNECTION CHAkGE FEEAUTHORIZATION TOTAL FEE I __ ____-__ __. _-_--._—,_._
IHAVE_ AT THIS. DATE A CONTRACT WITH THE HEREIN NAMED CON- REIN SUR5EMCNT FEE
T14AC R TO CONNECT THE ABOVEDESCRIBED EXISTING DWELLING --- 'p--m,q y- - ---- - ------ --- --
TO THE P "BLIC SE}}��E R. APPROVALS DATE NSPECTOR S$GN ATI'-RE
SIGNED THIS _ DAY 3"_ 19 - _-- -- --- �._— ---� —- - -- -_ --- --
OWNER O NEW HOUSE SEWER __.__
OWNER%ACS-EN C7PdNE 'r ADDITIO NAL.
BUILDING OR WORK
ADDRR. S
I HEREBY' ACKNOWi_ E THAT I HAVE READ THIS APPLICATION- TIC RANK SEEP,PIT(S)
AND/OR DRAI NI-IELD
AND STATE THAT THE: AE,OVE, 15 CORRECT AND AGREE 'r6 COMPLY
WITH ALL COUNTY ORD NANCES AND STATE LAWS REGULATING
❑
PtU P191YdG AND SEW ERSCESSPOOL DRYWELL. ❑ -
I. HEREBY CERTIFY THAT ! AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR i
LIC EN_aED AS REQUIRED BY Lbs ANG!ES COUNTYSAND STATE OF SF:WAG G SPOS4 YSTEM
LA.r IFORN IA OR THAT i AM THE LEGAL OWNER OF, AND INTEND TO DISCONNECT PLfdG —_--__-----
_HESIDE IN, THE ABOVE DESCRtBED "�IUl.NTI AI_ PROPERTY. ABANDON 10IJSL SEWER
SIGNATURE
OF PERMITTEE d" "'-"""`s BA KFILL EPTIC'TAN!;S ❑ -- -.
—__ _ -.. __..._—.-_ ___...._ SEEP.PT(S) ISI CES5€'OO S ❑
VALIDATION_—— ROBERT A. WOOD
CK. M. CASH
SUPERVISING MECHANICAL. ENGINEER
Q. ;;..„
L iI3 7 6 J ,l. It1 J
I
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 I SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 1010250007
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
(LEGAL ID: (SEWER / SEPTIC: SEWER 1 BUILDING ADDRESS:
ITR: 14533 LT: 28 (EXIST OCC GRP: 1 . 94OLEMA ST
,9467 67 CA 917801342
1 LDGS. NOW ON LOT: I
(ASSESSOR INFORMATION NUMBER: ICONNECTION TYPE: I NEAREST CROSS STREET: OAK 1
15382-014-053 (ORIGINATION: I 'THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, Cl
I ILENGTH ML TO PL: STATION: DEPTH: I I I
;TENANT: (MANHOLE REFERENCE: UPPER/LOWER: 11SSUED ON: PROCESSED BY:
110/25/10 SR
I ICOUNTY IMPROVEMENT NUMBER: I 1
(OWNER: TEL. NO: IPLAN CHECK NUMBER: IFINAL'DATE FINAL BY: CODE:
1DANG, WINNIE (626) 500-8516- 11JOB NUMBER: 1 ��-
19467 OLEMA ST 1,TRUNK PERMIT NUMBER: 1 � `
ITEMP 917801342 IROAD PERMIT NUMBER: IDESCR'IPTION OF WORK qI
I IAFFADAVIT: NO IREPAIR HOUSE SEWER
WAIVER: NO I
1APPLICANT: TEL. NO: ,EASEMENT: NO I
INGAN, SAMMY (626) 379-3176- 1 1
14221 ABNER ST. IRECORD INSTRUMENT NBR: RECORD DATE: ISPECIAL CONDITIONS:
1LOS ANGELES CA 90032 (HIGHWAY/STREET WIDENING: 1 `
STATE ENCROACHMENT PERMIT NUMBER: 1
I
ICONTRACTOR: TEL. NO: I FEES PAID 1APPROVALS DATE INSPECTOR SIGNATURE
1SAMMY PUN FU NGAN (626) 379-3176- I
4221 ABNER ST LIC. NO IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT: NEW�IOUSE SEWER I i\I
ILOS ANGELES CA 90032 735342,C36 I I
1 101 PERMIT ISSUANCE FEE 27.80 ICONNECT ADDITIONAL I I
1 115 ALT/REP HOUSE SEWER 1.00 EAC 30.40 IBUILDING OR WORK 1 I I
1ARCHITECT OR ENGINEER: TEL. NO: I TOTAL FEES 58.20 1 I I I
1SEPTIC TANK, SEEPAGE PITI I I
; LIC. NO: I 1AND/OR DRAIN FIELD I I I
1DRYWELL
1 SEWER MAP BOOK: PAGE: 1 , I I I
! 1 ALTER, REPAIR, SEWER OR
SEWAGE DISPOSAL SYSTEM I I I
IDISCONNECT PLUG AND I I I
ABANDON HOUSE SEWER I I I
BACKFILL SEPTIC TANKS
1 SEEP. PIT CESSPOOL -I I
1 1GRAYWATER SYSTEM
! 1 1 1
I r 1 i
IREPORT ID: DPR266 ROUTE TO BS0508
I 1 1 I I
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