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Home My Public Portal About10519-10520 OLIVE ST_Sewer__ DEPARTMENT OF COUNTY ENGINEER SEWED--SEWAGE DISPOSAL w 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER BUILDING _. ADDRESS FOR APPLICANT TO FILL IN LOCALITY BUILDING NEAREST ADDRESSF_ _ CROSS ST. LOCALITY DISTRICT NO. SERIAL NO. PERMIT NO. NEAREST --- —-- A S CROSS ST. RECEIVED BY Ready for Inspection DATE ISSUED OWNER MAIL ADDRESS USE ZONE OCCUPANCY MAP — � BK PG CITY TEL.NO. CONTRACTOR ' w CO.IMP.NO. ADDRESS JOB.NO, CITY 1 nt TEL.NQC';,; TRUNK PERMIT N0. REGISTRATION NO 1 C$4'�';,7-4 ❑, STATE iISTSOUNTY ROAD PERMIT NO. LEGAL - DESCRIPTION LOT NO. STATE ENCROACHMENTPERMIT NO. BLOCK TRACT INDUSTRIAL WASTE APPROVAL SIZE OF LOT NO.OF BLDG& NOW ON LOT CHARGES USE OF BUILDINGS CONNECTION CHARGE FEE NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER $ 3.50 RECEIPT NO. DATE BY HOUSE SEWER CONNECTING TO _PRiVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL SLOG.OR EXCEPTION RECORDED WORK TO HOUSE SEWER 1.00 ALTER OR REPAIR EXISTING NO. I DATE I BY SEWER OR DISPOSAL SYSTEM 1.00 DISCONNECT AId6 ABANDON SEWER i AND/OR DISPOSAL SYSTEM_ 1.00 I CONNECTION DATA SEPTIC TANK,SEEPAGE PIT OR _ PITS AND/OR DRAINFIELD 2.00 I STATION DEPTH CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 2.00 I MANHOLE REFERENCE UPPER A TYPE OF CONNECTION LENGTH FROM Y. CURB P.L. M.L.TO P.L. OWNERS PERMIT ; i 00 AUTHORIZATION TOTAL FEE I I — I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED COAPPROVALS INSPECTOR'S SIGNATURE DATE CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER SIGNED THIS-2 OR , NEW HOUSE SEWER S!' .DAY OF. 14w_. — I CONNECT ADDITIONAL OWNERS AGENT �. BUILDING OR WORK ADORES3......;:_. r � SEPTIC TANK,SEEP.PIT(S) r t� AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL[ 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 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 RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS E] SIGNATURE ,a SEEP.PIT(S)E] CESSPOOLS OF PERMITTEE4P--r R __..__.:_ 76A642D 663 1/53 WORKER!'COMPENSATION DECLARATION ; I hereby affirm that I have. a cerlifkcate of consent to self 100021 DPW 3/87 insure, or a.certfffbbte of wari=g xortlpensation Insurance,;,or 2D t�l�p p� a ceriified'co y the'r`eof(sec. 3BOQ,Lab C,) E i�[1'IJ LICATI®l'i�u7 SP "PERMIT Policy.No�o- 896a+Cornparty_ GTTA Ins. Gp s. u`� d.P+a ❑ Certified copy-is herebf furnished. SEVER o SEWAGE- DISPOSAL Certified copy.is filed:with the.county building inspection COUNTY OF LOS ANGELES BUILDINGAND'SAFETY department: Date 175-90 Applicant Owen Bios. Pluitlbin FOR APPLICANT TO FILL.INCONNECTION.pATA 'CERTIFICATE OF EXEMPTION.FROM WORKERS' + BUILDING 1,0519 01 ive St. STATION a; 0 DEPTH COMPENSATION INSURANCE ADDRESS. v (this section need not be completed if the work involved by the I LOCALITY MANHOLE REFERENCE U av LOWER permit is for one hundred dollars($100)of less.) TYPE OF CONNECTION LENGTH NEAREST �� I certify that in the pe.rfor.mance of the work for which this i'. CROSS ST. v,. CURB. P.L. M.L.TO P,L. permit is'issued,I shall not employ any person in.any manner I P.C.Na. 50 as to becorri6 subject to the Workers'Compensation Laws.Laws. OWNER Owen Development CO.IlAP:NO. /9 JOBNO, MAIL 2.03.5 S4 M.yr t 1 e Ave.- TR K PERMIT NO. ROAD'PERMIT�NO, Dafe. Applicant.- �' ADDRESS . NOTICE TO APPLICANT: If,'after making. this Certificate: of AFFIDAVIT WAIVER EASEMENT RECORD,INSTR.NQ, DATE CITY Mon:,,' 3' TEL.NO. — Exemption, you should become subject to, the Workers' LEGAL Compensatidn provisions of the Labor code,you must forthwith I DESCRIPTION. LOTNO: klWi,.ORST.WIDENING comply With such provisions:or .this perm'it shall be deemed revoked. -• if •' BLOCK TRACT .. STATETN�ICOROA'CHMENT ' LICf1VSED CONTRACTORS:DECLARATION 1� NO:of BMS, PERMIT SIZE OF LOT , NOW ON LOT ;`hereby'affirm that I,am licensed under..provisions of Chapter U: '. USE Or � � 1-` 9+(commencing-with 'Sec'tion 7000).of Division 3 of the Busk BUILDINGS CHARGES ness and Professions Code,•and my License is in full force and effect. CONTRACTOR Owen. Bros'. Plumbing, Inc. CoqECTION CHARGE FEE } License Number 231 741 Lit,Class (36_M ADDRESS 4265 N. Baldwin Ave.., REIMBURSEMENT FEE 0 Owen Bros.. Plbg• 1—'.5-90 DISTRO'140.. GROUP MAP PROCESSED.BY (� COniraClar', - Dale CITY . R1 � TEL.-NO — I .. - BK PG- Z STATE LIC. � C, ;Elf am.eitompt u.nderS6ci of the L.A,Co, 1; 1 :LICENSE.rNG. 23':1 74.1 , CLASS 636-20 V% , NO. DESCRIPTION OF'WORK FEE . L' Plumbing Code and/or Sec. of the FINAL ER HQUSE SEWER CONNECTING TO DATE ' VALIDATION �' T it+UF3LIC:_SEW _ j B..$'P. Code for the following reason `' rn SEPTIC TANK,SEEPAGE PIT.OR FIfV.AL .i I P(TS AND70R.DRAfNFIELD Date ! !1 _ "' pROWATE.DISPOSANSYSTEMG TO BY'., �+ .., :•( 1 J� !• Signoture CONNECT ADDITIONAL BLDG.OR. .s OWNER-BUILDER.DECLARATION. WORK ro HOUSE SEWER :I / ,OVERFLOW SEEPAGE WT,DRAQ,IFIELD� � ${.• •; � I"hereby affirm that I am exempt.from the Contractor's:License , EY((TN.,CESSPObL,'DRYWELL,MANWOLE �t Law for the following reason,(Becton 7031.5, Buisness and Pro- li' ALTER;REPAIR.OR ABANDQN HOUSE _ f0gions'Code): -_,EW DISPOSAL SYSTEM ,r41 ry 1 e JL ❑ 1,as owper of the property,or my employees with-wages as 1, their Tole cornpensdtion,will do the work and the sfrycture " " 330733.Q }l, „ is not intended or offered for-sale (Sectio.n.7044, Business i F and Professions Code). OWNERS Permit $ 13' ) �TEMS ❑.I,as owner of the property;am exclusjvel:y,contraeting with A.UTHO.RIZATION >-OTAL.FEE' ":7 i TOTAL :��_°"'Bio licensedcontractors to.'construct the project (Section 7044, 1 HAVE..AT THIS•DATE A CONTRACT WITH THE HEREIN NAMED CONTRACTOR TO ,^L�fr'j• BUSineSs and Professio'n5 Code,). CONNECT THE.ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWERk:HEV .. Is, CONSTRUCTION.LENDING AGENCYCRAM I hereby-tiffirm that there is o ''Construction lending agency SIGNED THIS DAY OF i9_ �. e•Sl for the performance erformance of the work for which this', permit is: OWNER OR OWNERS:AGENT'. issued (Sec.3097., Civ:Ci).. X ADDRESS. 1Y: t~ L`ender's Name. - v90 Lender's,Address 8072 1 o,d csJa I certify that I hgve read this application and state that the .I above info'matio4 is correct. I agree'to comply wl'th.all County ordinances and :State laws regulating Plumbing and Sewers, an herebyY.authorize Tepres staff.' of th...County to enter n .e abovefinenfi ed .perty for inspection purposes. w 1-5-90: igpoture of Permit Date SEE REVERSE FOR EXPLANATORY LANGUAGE