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Home My Public Portal About4945 PERSIMMON AVE_Sewer__ DEPAVVI ENT OF COUNTY ENGYNEER SEWER-SEWAGE DISPOSAL 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES ADDRESS � d WILLIAM J. FOX, COUNTY ENGINEER -=n FOR APPLIgANT TO FILL IN LccaLlry BUILDIN NEAREST ADDRESS ` .`._t b CROSS ST. LOCALITY _ DISTRICT NO. SERIAL NO. PERMIT NO. NEAREST CRASS ST. - RECEIVED BY Ready for Inspection I DATE ISSUED OWNER MAIL USE ZONE OCCUPANCYI MAP ADDRESS _ ._°, BK PG CITY TEL.NO. CONTRACTOR CO,Ie?P. NO. ADDRESS JOB NO. - CITY '� ' - TELxItO TRUNK PERMIT NO. TE " REGISTRATION N0. 2_1COUNTY ROAD PERMIT NO. LEGAL '- STATE ENCROACHMENT DESCRIPTION LOT NO. PERMIT NO. BLOCK TRACT - ° INDUSTRIAL - WASTE APPROVAL _ SIZE OF LOT NO,OF BLDGS. r CHARGES NOW ON LOT USE OF BUILDINGS CONNECTION CHARGE FEE NO. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO z rx REIMBURSEMENT FEE PUBLIC SEWER @ $ 3.50 RECEIPT NO. DATE I BY 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 NO. DATE BY _SEWER OR DISPOSAL SYSTEM 1.00 _ DISCONNECT AND ItBANDON SEWER AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD 2.00 STATION DEPTH CESS POOL—DRYWELL SPECIAL CONDITIONS ONLY 2,00 MANPns F REFERENCE UP PE P _._ TYPE OF CONNECTtOLENGTH FROM OWNERS PERMIT I 00 Y. euR6P:L: M.L.rQ P.L. AUTHORIZATION TOTAL FEE 1 HAVE 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......., __ _. _•--------19;s_:_- NEW HOUSE SEWER _ OWNER OR CONNECT ADDITIONAL OWNERS AGENT r.::._._ '' ' BUILDING OR WORK SEPTIC TANK,SEEP.PIT(S) ADDRESS __ _, --------- AND/ORDRAINFIELD I HEREBY'ACKNOWLEDGE THAT I HAVE READ THIS APPL,• CESSPOOL E] DRYWELL Fj 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 - NECT PLUG AND AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY DISCONNECT HOUSE SEWER AND STATE OF CALIFORNIA OR THAT i AM THE LEGAL OWN- ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS(� ,>' d SEEP.PIT(S)[] CESSPOOLS SIGNATURE OF PERMITT 76A642A 663 7/53 CE808 3-64 75A642D APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, County Engineer ADDRESS WILLIAM A. JENSEN, Supt of Building LOCA- "4 ';TY L-1-4- 71, NEAREST FOR APPLICANT TO FILL IN CROSS DESCRIPTION LOT NO. _OWNER MAIL BLOCK TRACT ADDRESS SIZE OF NO. OF 8LDGS LOT NOW ON LOT CITY TEL. NO. USE OLDINGS F DISTRICT NO. GROUP MAP ESSED BY BUI CONTRACTOR / ADDRESS CONNECTION DATA STATION -5 DEPTH CITY NO. MANHOLE REFERENCE _U PP-ER- REGISTRATION NO. -3 R410t TI NO. ] - DESCRIPTION OF WORK FEE ,-TYPE OF CONNECTION LENGTH FR)6m HQU .--ii--Si-W-Elli CONNECTING TOY _ YCURB P.L. M.L. 7 PUBLIC SEWER $5.00 P,c.NO. SEPTICTANK,SEEPAGE PIT OR CO,IMP,NO. CIL -!�LTS AyIOIp DRAINFIELD $10.00 0 HOIJ-9k SE.WiFli-`C6ii�410ETTN—G TO TRUNK PERMIT NO, ROAD PERMIT �1��PR VATS DISPOSAL SYSTEM NO. =. 47- CONNECT CZ WORK TO HOUSE SEWER -53.00 0 OVERFLOW SEEPAGE CESSPOOL,DRYWELL,MAN H OLE 58.00 HOUSE HWY.OR ST.WIDENING U.11 ALTER,REPAIR UR SEW0- ER OR DISPOSAL SYSTEM $3,00 ST-�-E-F L) PERMIT NO, z INDUSTRIAL WASTE APPROVAL CHARGES OWNERS PERMIT s 21 00 -.-- 1 CONNECTION CHARGE FEE AUTHORIZATIONt TOTAL FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- R E IMBURSEMENT FEE T EXISTING DWELLING TRACTOR TO CONNECT 'THE ABOVE DESCRIBED To THE PUBLIC SEWER. APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS--DAY OF— OWNER OR NEW HOUSE SEWER OWNERS AGENT— CONNECT ADDITIONAL BUILDING OR WORK ADDRESS___ --SE,SEPTIC TANK,SEEP,PIT(S) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELID AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING ING AND SEWERS. CESSPOOL 0 DRYWELL HEREBY CERTIFY THAT IAM PROPERLY REGISTERED AND/OR ALTEDW.REI�AIR,SE�WER(5R L LICENSED AS REQUIRED BY OS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA ALIFORN I A, OR THAT 1 AM THE LEGA WNER OF, AND INTEND TO DISCONNECT PLUG AND ------------------------ RESIDE IN, THE ABOVE R*l!r9fi jBED IDENTIA PERTY. ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC:TANKS ❑ OF PERMITTEE_ SEEP,PITS) El CESSPOOLS rl! ---"VALIDATION ROBERT A. WOOD SUPERVISING MECHANICAL ENGINEER M.O. CASH APR 8 1 0 - _ r 6A642D APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER SEWAGE ®I5P05AL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FNE ING ESS ;' -- JtJHhC A. LAMBIE. County Engineer � _ d _✓u� it __.�-_ WILLIAM A. JENSEN, Supt of Building ...... LT !'FCRAPPLICANT TO FILL IN 5 ST - -_.. r. �.: OWNER �e' r'4:.5 `l �tw.$i+ '•. DESCRI P7 i01`! " �' `c' ,,y L,07 NO T.-___ ' MAIL y h ._... �A ADDRESS s —3,:�s ds r—• �i BLOCK TRACT y .Is _ N.O. OF BLD US[. j 1. SIZEhaOW ON L6T �J CITY TEL, NO. USE O # 9111 LD INGS + t '��•'�,,�"", "`'''Q; �•al�_C Ys�a_. DISTRICT NO..GF.O 11P SK MAP PR9Ci:59ED BY CONTRACTOR s PG �q�ly�`-',v """. Q g.� 4,,9r' -,Q•rs' ADDRESS t,.ia �4 _.'_4�'�-�" .'�— CONNECTION DATA -_ 1.� STATION Dt PTf1 CiTY"'_j.Sy.. C.3 Y ;*E NO. _ =-•: -_-______. __�.— _— ,s- `'J __ RE:G iSTRATION NO 4, MANHOLE REF ERE.NCE ---_ _— _�� fd O. DESCRIPTIO J OP Ui C?RK FEE T'YP0 Of cotily ECTION LEN GTH ,, -- - — — -- _— .- -- r---_. .7 HOUSE SEWER C..NNE...rING 70 Y. ._JRB F L. M L TO P'1L. PUBLIC�iEWER $5.U0 - - — --- ..-- P.C.NO. SEPTIC 7 NK,SEE AGL A;T @R - OB NO vq PITS.AND/OR DRAINFIELD @ 510.00 CO..IMF, NO. L) I HOUSE SEWER CONNECTING TO TRUNK PERMIT NO- ROAD PERMIT NO. PRIVATE DISPOSAL SYSTEM w`�. $3.00 I. CONNE:CTADDi TiONAI,.BLDG.OR — AFF7 DAJi7T>AIYCiI EASF.MCNt , RECORD. ,NSTR. NO. � DATE WORK TC HOUSE SEWER @ $3:00. t I I X71.1; GJL,DRYWf LL,MAhiNOI.E@ $500 _- --.. .____ _ _�_ ___v.- HWY, OR ST WIDENING l;• ,wg -A6A NOON HOI� £ �J . 5 NEFP s3* SYSTEM L $'3.OD —__. __-..__ _.___ - - __ _. __.._ .j .__ bI"ATE kPIC RCA CI4 M ENT PERMIT N O (� .,x�• N " Q,.� 1NDUSTRI.AL y /q WASTE APPROVAL,� ::"J,_ ._ 3�' ✓�[_-d" �.. CHARGES. OWNER'S PERMIT z 00 -- -- -- - - --- - - -- -- —— ---- e-- ry„ CONNECTION CHARGE FEEAUTHORIZATION TOTAL FEE 'i HAVE AT THIS D4TE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT. p�gF=E [TC1 ACTOR '+) CONNECT THE A5.OVE DESCRIBED EX.iSTING: DWELLING - _- APPROVALS THE P'JNL . SFJJ_.n.. DATEiC5 PECTOR SIGIf A73RE GPdE[? TH15____—.DAY 'JP._.----NER OR NEW HOUSE SEWERNERS AGENT, _. .__— -----___ CONNECT ADDITIONAL.11LDING OR WORNSEPTIC.TANK,SCEP,PIT(S) HCRESY ACKNOWLEDGE THAT i HAVE READ THIS APPL ATION AND/OR DR.AINFI._LD DSTATE TH1,T YHE ABOVE: 1S C:ORRECT AND AGREE TO COMPLY'HALI. CO NTY ORDINANCES AND 5'i ATE LAWS REGULATINGI1M9fNG AP3C P'rf W'ERS. CESSPOOL, 0 DRYWELL HEREBY ERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWf_R OR ' vENSED AS RT_'QUI RED BY L.OS ANGLES CO LINTY AND 5TATF. OF SEWAG DISE OSAL SSTF_M-TORN IA OR THAT i AM THE LEGAL OWNER OF. AND INrENO TO - _-__ DISCONNECT PLUG AND SIDE IN, TH?.+'ABOVE, DF,CRISEO`R*:SIDEN IAL PROPE RTS " ABANDON HC'US SEWER GNATURE ti .. �. ',. BACKFILL SEPTI TANKS OF PERMITTkE _.-._ - - _ _—.mss.....i✓-_-•. '"; 5EF'P,PIT(5) ❑ CESSPOOLS [,31 VALIDATION ROBERT A. WOOD SUPEr"2WISING MECHANICAL ENGINEER CK. i� M.O. CASH Y