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Home My Public Portal About9830 WENDON ST_Sewer__ E-6D S& APPLI.OATION FOR PERMIT 1 g& DI'VISION OF BUILDING ARID SAFETY SEWER-SEWAGE [DISPOSAL Department of County Engineer County of Los Angeles BUILDING . Wlvt.J. f 0X, COUNTY ENGINE ER ADDRESS " IT' CASSATT D.GRIFFIN,SUP'TOFBUILDING LOCALITYFOIL APPLICANT TO FILL IN NEAREST CROSS ST.LEGAL DESCRIPTION LOTNO. OWNER - � .,�,.� .-� ._BLOCK - TRACT tMAIL' ADDRESS,t„� NGVJ ON LtlT CITY TEL. Fd O.t.t,.”r USE OF If BUILDINGS .r''-+'�' b ''e;: y "�",� _ DISTRICT NO.. i GROUP � MAP ---- I -._ RK PG CONTRACTOR ADDRESS ,� t ,-y �° �+ i CONNECTION DATA CITY '; TEL. NO. �, �' "r��' STATION _' - DEPTH y9° I 1 MANHOLE REFERENCE REGISTRAT!: NO!, COUNTY _�.._.- --.� .--.------------- -- ------------ -------`�--------- ":�: --NO. DESCRIPTION OF WORK FEE --—_ ---- TYPE OF CONNECTION LENGTH FROM --- _ 1 ._ TO P.L. HOUSE SEW cR CONNECTING TO `. ._—___.._r. --. ..---.--__ ---. .. ....._. -. ..__.. I PUL'LIC SEJJER ��S 3.50, ..�' 4OUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL'BLDG. OR P C. N0. s_WORK TO HOUSE SE VER 1.00 _Co._IMP, NO. .'OB NO. -- -I. ALTER OR REPAIR EXISTING - SEVIE_R_OR D SP_O AL SYSTEM 1.00 TRUNK PERMIT NO.. ROAD PERMIT NO. DISCONNECT AND ABANDON SEEVIER ��-_-��--��- STATE ENCROACHMENT -_ - ------� - AioD�OR DISPOSAL SYET M 1.00 PERi.^!T NO, SEPTIC TANK SEEPAGE PIT OR I _ _l PITS AhDIOR DR_AINFIELD _ 2.00 INDUSTRIAL --- CFSS°OOI DRYINFLY -- i- WASTE,APPROVAL SPtCIAL CO 3DITIOKS.ONLY E.00_ CHARGES f -- — PERMcoNNECTION CHARGE FEE-- --- _ — -----" --� OWNEWS AUTHORIZATION TOTAL FEE ( REIMBURSEMENT FEE 1 HAVE THIS DATE CONTRACTED WIT�i THE HEREIN NAMED CON- PRO TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISLING D10'ELL.IN3 APPROVALS DATE !NSPECTOR`S SIGNATURE TO THE PUBLIC S WWF NE'vV HOUSE SEWER SIG14ED 7I?Is. I7r�Y OF -1 l , L OWNER OR ' �. .CONNECT ADDITIONAL OWNERS AGENT' `�' _BUILD£NG_ORVJORK _!! SEPTIC TANK,SEEP,PIT(S) AND/OR DRAINFIELD__ I HEREBY ACKNOWLEDGE: THAT I HAVE READ THIS 4APPLICATION CFSSPOOL❑ DRYWELL LI AND STATE THAT THE ABOVE: IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,.,eIJER OR PLUMBING AND SEWERS, SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF DISCONNECT PLUG AND CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE ABANDON HOUSE SEWER DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS C SEEP.PITS) [3 CESSPOOLS Jj -"�— SIGNATURE OF PERMITTEE WILLIAM!J.FOX,COUNTY ENGINEER VALIDATION R.A.WOOD. CHIEF PLBG. INSPECTOR T'• E-6•88673 11.55 & i HAPPLICATION FOR PERMIT 1 DIVISION OF BUILDING AND SAFETY SEWER--SEWAGE DISPOSAL Department of County Engineer County of LOS Angeles BUILDING i JOHN A. LA14tf31E, COUNTY ENGINEER ADDRESS J3I a 9 - CASSATT D. GRIFFIN, SUPT 05 BUILDING LOCALITY _ FOR APPLICANT TO FILL INLEGAL __ caoss sT : �._ '✓ �` DESCRIPTION LOT NO.. � — u OWNERS° ✓�. y�F;,y�.-_-4 r J-7: BLOCKMAIL TRACT .";; -ADDRESS r. NO. OF BLDGS. CIT'P"' 7€L. N0. SIZE OF LOTS y�NOW ON LOT USE OF BUILDINGS T / ry j`_-- DIST IRICT N0. GROUP MAP BK PG CONTRACTOR, ADDRESS -. •I^� -- CONNECTION DATA - ' STATION DEP'T'H _ CITY - 3 TEL. NO. } `- MANHOLE REFERENCE UPPER .___- U--STATE - -,--- -- -- LOWER REGISTRATlt NCY. COUNTY No. I DESCRIPTION OF W w FEE - - � --- --- TYPE OF CONxECrION. LENGTH FROM HOUSE SEWLR CONNECTING TO Y. CURB P.L. M.L. TO P.L. _--{_PUBLIC SEWER _ @ $3,50 - -------__�_ __.._ —,..�_---- FPTlC 7ANK,SEEPAGE PIT OR PITS AND/OR DRAINFiLLD c_$3.00 I --�- OVERFLOW SEEPAGE PIT DRAINFIELD P C. NO. - EXTN ,CES$POOL,DRYWELL_MANHOLE G $2.00 ^� _p0• IMP. N0. JOB NO. �— HOUSE SEWER CONNECTING TO ^i,PRIVATE DISPOSAL SYSTEM - $1.00 _ _TRUNK PERMIT NO. —_ROAD PERMIT NO. CONNECT ADDITIONAL BLDG.OR STATE ENCROACHMENT WORK TO HOUSE SEWER ( PERMIT - 1 _.---- Cts S 4.00 .. 1 dM d ._ _ _ NO, ALTER,REPAIR OR ABANDON HOUSE --- _---J— ��--`----J----- ---ISEWER OR DISPOSAL SYSTEM (� ¢I,r,C ! I INDUSTRIAL _. ..----._ ---- -_..__ ..-- _.-----'------- WASTE APPROVAL CHARGES I: CONNECTION CHARGETEE OWNER'S PERMIT � -- - --- � 1 OO - REIMBURSEMENT FEE -�— -- - AUTHORIZATION TOTA—L FEE --- - I HAVE AT THIS DATE A CONTRACT WITH THt. RtREINNAMED CON- APPROVALS DATE IINSPECTOR'SSIGIN ATURE- TRACTOR TO CONNECT THE ABOVE DESCRIBED EXIT ,NC DWELLING TO THE PUBLIC SEWER, NEW HOUSE SEWER SIGNED THIS _DAY OF _l9__— CONNECT ADDITIONAL r OWNER OR BUILDING OR 'A'ORK OWNERS AGENT — SEPTIC TANK,SEEP,PIT(S-) ADDRESS AND/OR DRAINFTELD { I HEREBY ACKNOWLEDGE- THAT I HAVE READ THIS APPLICATION CE55POGi r1 URYW ELL 0i AND STATE THAT HE ABOVE IS CORRECT AND AGREE TO COMPLY _ ._ D WITH ALL COUNTY ORINANCES AND STATE LAWS REGULATING ALTER REPAIR EWER OR PLUK.BING AND SEWCRS. SEWAGL DISPOSAL SYSTEM _ I HEREBY CERTIFY THAT 1 AM PROPERLY REGiSTEREC AND/OR DISCONNECT PLUG AND �— LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND, STATE OF AB AN DO`I HOUSE SEWER CA. IFORNIA OR THAT 1, M THE LEGAL OWNER OF.'THE ABOVE ------------ UE�' YBEp`RESI f+N71 x OPER Y ' �� / �ACFC{iLt SEPTIC TANKS L1 — - —� S � 7 UsP,,,E� ir-•�,`.��,Ir ''`' - /,1r' "=f -,� ,'>SEP. Pt I tS) i� CESSPOOLS "dF'I>.RMI7TEE� i I JOHN A. LAMB C LJNTY ENGINEIgR VALIDATION ROBERT A. WOOL, CHIEF PLBG. INSPECTOR i CK. M.0. CASH - WORKERS'COMPENSATION DECLARATION I hereby affirm that I have a certificate 'of consent to self D :a: insure, or a certificate of Workers'Compensation Insurance, 92-009 or 2-000 a certified copy thereof (Sec.-3800, Luba;.) 92 DPW 6188 APPLICATION FOR PERMIT Policy No. Company Ll Certified copy is hereby furnished. SEWER - SEWAGE DISPOSAL ❑ Certified copy is filed with the county building inspection COUNTY OF LOS ANGELES BUILDING AND SAFETY department. Date Applicant FOR APPLICANT TO FILL IN CONNECTION DATA CERTIFICATE OF EXEMPTION FROM WORKERS' BUILDING - ' #,a �y rj E /� S•,,TION DEPTH COMPENSATION INSURANCE ADDRESS V t �J 1✓ (This section need not be completed if the work Involved by the. M,NHOLE REFERENCE UPPER permit is for one hundred dollars ($100)or less.) LOCALITY LOWER I certifythat In the performance of the Work for which this NEAREST *-� ( ',P.., ;— TYPE OF CONNECTION LENGTH FROM P CROSS ST. a M Y. CURB P.L. M,I.TO P L. permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation laws. OWNER !a i� CO IMP.NO. JOB NO. 1 MAIL F^' v a;�' TRUNK PERMIT NO. ROAD PERMIT NO. Date Applicant ADDRES s� 11 NOTICE TO APPLI ANT: If, of r makin this Certificate 4{ AFFIDAVIT WAIVER EASEMENT RECORD.INSTR.NO DATE g CITY:, TEL 1\10 p�, .Z I Exemption, you should become subject to the Workers' LEGAL Compensation provisions of the Labor code, you must forthwith DESCRIPTION LOT NO, HWY.OR ST.WIDENING comply with such provisions or this permit shall be deemed revoked. BLOCK TRACT STATE ENCROACHMENT LICENSED CONTRACTORS DECLARATION NO.OF PERMIT NO. LOT SIZE OF LOT - NOW ON l01 1 hereby affirm that I am licensed under provisions of Chapter USE OF R 9 (commencing with Section 7000) of Division 3 of the Bus)- BUILDINGS - CHARGES ness and Professions Code, and my license is in full force and effect. CONTRACTOR '� "�,L-,:. CONNECTION CHARGE FEE License Number LIC.Class ADDRESS REIMBURSEMENT FEE Contractor Date DISTRICT NO. GROUP MAP PROCESSED B'( CITY TEL.NO. K PG } STATE LIC. / y. LL f am exempt under Sec. of the L.A.Co. LICENSE NO. CLASS L/ if Plumbing Code and/or Sec. of the NO. DESCRIPTION OF WORK FEE F!NAL HOUSE SEWER CONNECTING TO ,C"'.i/"'y LATE V LID_AT ION r� ? & P. Code for the following reason i PUBLIC SEWER f Cd SEPTIC TANK,SEEPAGE PIT OR F'NAL f� PITS AND/OR DRAINFIELD Date HOUSE SEWER CONNECTING TO BY IU PRIVATE DISPOSAL SYSTEM Signature CONNECT ADDITIONAL BLDG.OR {f: OWNER-BUILDER DECLARATION WORK TO HOUSE SEWER Poo- Law Z OVERFLOW SEEPAGE PIT,DRAINFIELD 1 -a I hereby affirm that I am exempt from the Contractor's License EXTN.,CESSPOOL,DRYWELL,MANHOLE Law for the following reason (Secton 7931.5, Buisness and Pro- ALTER,REPAIR OR ABANDON HOUSE fessions Code)' SEWER OR DISPOSAL SYSTEM ❑ 1,as owner of the property,or my employees with wages as their sole compensation, will do the work and the Structure''} ;' 4, I not intended or offered for sale (Section 7044, Business J nd Professions Code). OWNER'S Permit S TITE t`S 1,as owner of the property,am exclusively contracting with AUTHORIZATION TOTAL FEE J T`4@1� ? j Ii licensed contractors to construct the project (Section 7044, 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CONTRACTOR TO � .r Business and Professions Cade). CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER :' CONSTRUCTION LENDING AGENCY 1n,�4 i{ l hereby affirm that there is a construction lending agency SIGNED THIS OF y .�.,� 19_ 01111", ? �3t161 a for the performance of the work for which this permit is OWNER OR TIJALZ OWNERS A ENT issued (Sec. 3097, Civ. C.). ADDRESS4 17 � Lender's Name _ ( �r1r@„j"' a� T,,.41 G '4' { Lender's Address 31 1 Certify that I have read this application and state that the above information is correct. I agree to comply with all County ordinances and State laws regulating Plumbing and Sewers, and hereby aLio 'z representatives of this County to enter UPo^the abov m t1 ned property for inspection purposes. iluk)14 Ilk^ / , ) r oture of P rmi a Date SEE REVERSE FOR EXPLANATORY LANGUAGE