HomeMy Public PortalAbout5652 SULTANA AVE_Sewer__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 0705300006
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: ISEWER / SEPTIC: SEWER I BUILDING ADDRESS: [
ON FILE (EXIST OCC GRP:
I IBLDGS. NOW ON IAT: I 5652 CA A 9178 A
1
(ASSESSOR INFORMATION NUMBER: (CONNECTION TYPE: I TEMP C91780233 27 I
15387-025-016 (ORIGINATION: 1 TNEAMSTPAG SS596REEGRID: H3 LOCALITY: TEMPLE CITY, Cl
(LENGTH ML TO PL: STATION: DEPTH: [ 1
TENANT: IMANHOLE REFERENCE: UPPER/LOWER:
IISSIIED ON: PROCESSED BY: EXPIRES ON:
I 105/30/07 SR 11/26/07 [
ICOUNTY IMPROVEMENT NUMBER:
[OWNER: TEL. NO: IPLAN CHECK NUMBER: IFIN�S� 7TE� FINAL BY: CODE: 1
[PEI, WENDING (626) 289-0204- (JOB NUMBER: 1 /TL�f/7 v
15652 SULTANA AV ITRUNK PERMIT NUMBER: 1
1TEMP 917802327 IROAD PERMIT NUMBER: IDESCRIPTION OF WORK [
[ 1FFAFFAD VIT: NO ICONNECT NEW CONDO TO PUBLIC SEWER
(APPLICANT: TEL. NO: JEASEMENT: NO
IKIM WONG PLUMBING INC. (626) 286-6122- I [
11300 E. LAS TUNAS DR 1RECORD INSTRUMENT NBR: RECORD DATE: ISPECIAL CONDITIONS: I
1SAN GABRIEL CA 91776 1HIGHWAY/STREET WIDENING:
1STATE ENCROACHMENT PERMIT NUMBER:
1
ICONTRACTOR: TEL. NO: I FEES PAID [APPROVALS DATE INSPECTOR SIGNATURE 1
1KIM WONG PLUMBING INC. (626) 286-6122- 1 1
1300 E. LAS TUNAS DRIVE LIC. NO IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT:INEW HOUSE SEWER 1 1
ISAN GABRIEL, CA 91776 752619 HIC *I
I 101 PERMIT ISSUANCE FEE 27.75 ICONNECT ADDITIONAL [ I [
I 103 CONN TO PUBLIC SEWER 1.00 CON 46.95 IBUILDING OR WORK I I I
(ARCHITECT OR ENGINEER: TEL. NO: I TOTAL FEES 74.70 1 I I I
IREES, LISA (323) 796-1882- [ [SEPTYC TANK, SEEPAGE PITI I 1
1111 CORPORATE CENTER DR. LIC. NO: 1 (AND/OR DRAIN FIELD [ [
1SUITE 305 A C-60196 1
MONTEREY PARK, CA 91754 i IDRYWELL I I
I I 1
1 SEWER MAP BOOK: PAGE:
I
IALTfiR, REPAIR, SEWER OR 1 [
1 ISEWAGE DISPOSAL SYSTEM I [ [
1 IDISCONNECT PLUG AND I I I
[ABANDON HOUSE SEWER I 1 I
[ I (BACKFILL SEPTIC TANKS
1 I (SEEP. PIT _ CESSPOOL
[
I
1GRAYWATER SYSTEM 1
1 I I I I
1 I I I I
1 1 1 I 1
1 1 I 1 I I
I 1 I 1 1
I I I I
I I I
[ [* ADDITIONAL DATA ON FILE
I I I I
I I I 1 I I
1 1REPORT ID: DPR266 ROUTE TO BS0508 1 [ [ [
DEPAW.rX09" OF C1 umm ENGmr4m ^j .. SEWED-SEWAGE- DISPOSAL
DIVISION OF BUILDING AND SAFETY :I PERMIT APPLICATION
coumm OF I:OS ANGELES
WILLIAM J. 'FOX, COUNTY ENGINEER ADDRESI D Snt�Z` T�
FOR LOCALITY APPLICANT TO FILL IN �
BUILDING /�xs� � Jf/ CROSS ST. G
ADDRESS i9 7'k� 'g
LOCALITY r DISTRICT NO. SERIAL.NC. PERMIT NO.
NEAREST •� �^ x .sj A [4,161.1-101s.
CROSSST. / �
ECEIVED BY ReAdY for'InepeoUan DAT SSU D
OWNER
MAIL US&ZONE OCCUPANCY )1IAP
ADDRESS BK PG
CIT TEL.NO.
CONTRACTOR
CO.IMP.N0: I --
ADDRESS ��r�� m�4d OLol JOB NO.
CITY TErLAO. jej jTRUNK PERMIT NO. �-
REGISTRATION NO. 0 / COUNTY C' g
ROAD PERMIT NC. �
LEGAL f � .� NCROACHMENT_
DESCRIPTION LOT NO. STATE E
�l� PERMIT N0.
BLOCK TRACT INDUSTRIAL
WASTE APPROVAL
SIZE OF LO TK^+ ' N0. F BL a
G '"• J�;�z.�� NO ON LOT
„� CHARGES
USE OF __
BUILDINGScs. CONNECT CHARGE FEE
NO: DESCRIPTION OF . ORK FEE REIMBURSEMENT FE
1 HQUSESEWER CONNECTING TO
PUBLIC SEWER IS S. 3.50 RECEIPT N0.
'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 I •J DATE I,BYSEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER ~
AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK.SEEPAGE PIT OR
PITS AND/ORDRAINFIELD 2.00 STATION . DEPTH
CESSPOOL—ORYWELL �''`2` f -C� ` -
SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE
- `i1rP.Ei� C?T LOWE
TYPE OF CONNECTION LENGTH FROM
OWNERS PERMIT ; .;I pp = CURB M.L.TO P.L. 7 /
.AUTHORIZATION TOTAL FEE G;'t10
I HAVE THIS DATE CONTRACTED.WITH.THE-HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INS PECTd S'SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER + �.DAY OF..... �� .___19� ' NEW HOUSE SEWER s vSIGNED THIS...
OWNER OR CONNECT ADDITIONAL
OWNERS AyGENT.y:._...��,.��'_o��'.��J-•�•....._.-_._. _._.._......_. ._ BUILDING OR WORK.
ADDRESS-,s _S�C�..C�.Y ?• .._.. f.:�a.:......._.........._... SEPTIC TANK.SEEP.PIT(S)
AND/OR DRAINFIELD
1 -HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- CESSPOOL DRYWELL
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 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
SIGNATURE r SEEP-PIT(S)[] CESSPOOLS[]
...� , .
OF P.ERMITTEL. .._..._......__._._..._......_.._.�s; —���._=-s.�
_--40D 06S 1/58 �`