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Home My Public Portal About5614 CAMBURY AVE_Building__ DEPARTMENT OF BUILDING AND SAFETY ` APPLICATION' FOR PERMIT COUNTY OF LOS ANGELES W WM. J. FOX. CHIEF ENGINEER L DINU FOR APPLICANT TO FILL IN I FOR OFFICE USE ONLY " BUILDING23 c$o. CAM B u2 �✓ DISTRICT NO. -' PLAN CKoND. - -- -PERMIT NO. ADORES9 37oZ g� LOCALITY T�M p e l r/y RECE VED BY DATE OF APP DCATE ISSU E�/ NEAREST LI `/ 6 OAk Ada O' 1 CI /� �/ NEARECROSS ST, BUIL GWNCR A•N - (� ^ C j P j` //f if • CO ADDR I S ] MAIL 7 OS ` 5A-tJTA ADORES/G` p/ /%Q/��./�N LOCALITY NEAREST '{7{�� CITY ^ / , v3 p NO. �Qr� ST. A, TEL.Q NEAREST. FIRE NO.OF 3 TYPE GRQjJP ARCHITECT OR G TEL. ZONE PLANS jr QTY_ ENGINEER u ND. BLDG. '/�J / ^ �Ppyp ❑. ADDRESS SETBACK,LINE �.c c APPROVE /� J•?/ _CONTRACTOR �/✓ •V' Y�R 1//Ly NV A I�'I L� _ BY O. tl� DATE ,,`` USE I- APPROVED _� ) . ADDRESS v A' f,I E ZONE i BY � DAT L ' LEGALCORRECTIONS DESCRIPTION }^ LOT NO. BLOCK TRACT I U Y O.OF BLDGS. N SiZE OF LOT G D Y NOW ON LOT USE OF Np, EXISTING BLD , DESCRIPTION OF WORK NEW ALTERATION ADDITION O - A - REPAIR MOVING / DEMOLISH � 5 ZE T Z D ROOMS G STORIES D r WALL .( rd tL I ROOF �1I oµovf COVERING V (� � COVE INS S I//✓V 1ct p USEOF BUILDINGWV / �C L.C— IPM / L Psi,swe-mr-a w , ►+ DerRceo r / Pi- Avd - 3 - r- , j 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT - INSPECTOR DATE FOUNDATION: LO TION AND AGREE COMPLY WITH ALL COUNTY ORDINANCES FORMS.MATE ALS AND STATE LAA WS REGUTATIFI6 BUILDING CON9TR UCTION. FRAME: FI STOPS, SIGNATURE OF D Cyfyl�p/�A^ w, / BRACING.BOLTS PERMITTEE I 1�// / 1''TI�'IF� C //. iv, LAT r AlI INT. �yv AUTHDRIZED AGT ! I ' /f A H, EXT. V (/ 9sg63eq-3 7-49 $ P.C.S PLASTER, INT. ' FEE ' PLASTER.EXT. VALUATION /Soa i FEE 31'f s� FINAL I DEPARTMENT OF COUNTY ENGINEER D1�%iSTMI OF SUMI)ING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER APPLICATION ' CASSATT D. GRIFFIN, 9UP'T OF BUILDING FOR APPLICANT TO FILL IN FOR OFFICE .USE ONLY _/ /�/ DISTRICT NO. PL m Cec..O/q REe.No. PERMIT NO: AO DRESS J Jl 11 V s (/ 29 913 LOCALITY T 1- 4a40 ://ff�1 I/-/,i 14n I, RECEIVED BY DATE OF APPL. DATE ISS`ED NEAREST CROSS ST. OWNER JS L}L /I�� I( ADDRES O ig M AIL ' AD REBS , (O l_..fL.�6 V)^ fit✓ LOCALITY • (� LI^, /1 ` NEARES ' CITY FP I+..1!-f/Q_ I rlr NO. �OY�3 CROSS STT. (/T�/[bf/CJ r ENGINEERNo. OF ARCHITECT ORS I No• ZONEFIR Ii 'I PLANS �� 'I Y I GSL •. SLOG. ADDRESS SETBACBLDG. ADDRESS I L TEL.' I USE /� APPROVED CONTRACTOR NO. ZONE A�� BY. 1DATE ADDRESS QO HOUSE NUMBERING ' LEGAL I MAP NUMBER 2�-0 0 NO. ASSIGNED BY�,11ES:1 DESCRIPTION( LOT NO. BLOCK ' - CORRECTIONS TRACT t.! / n /�. .. / NO. OF BLDG9. SIZE OF LOT b�//JJ�� /� I .NO/WJ ON LOT ��iE 16 fes'(/�S TD USE OF NG BLDG.les 4 ./ IB/J Y/A , I FAMILIES EXIST[ IES d V;!F-4 /</a/./�� V t_?',Q�/ /&LBT DESCRIPTION OF WORN 1n c - aq«d /CNS . D - NEW ~ ALTERATION ADDITION �'' a _iY/I - -0 Z REPAIR DEMOLITION I I D 50. FT. Q (� NO. OF SIZE �J (T ROOMS O STORIES ( / 1FXT. WALL - �,� �� p n- 11' COVERING / L-0vL I COVERING CaA•I/ 1A - U5EOFSTRUCTURE .n �}+ U, �J� r/el a �/ h ra r ii !/zr APPROVALS INSPECTOR'S SIGNATURE DATE FOUNDATION: LOCATION / FORMS, MATERIALS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP I FRAME: FIRESTOPS, PLICATION,AND STATE THAT THE INFORMATION GIVEN IS BRACING, BOLTS. ;- CORRECT r .- 1AGREE,.TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION, AND STATE-LAWS REGULATING BUVIjDIPtG CONSTRUCTION. GAS VENT. DUCTS SIGNATURE OF /An/ r I LATH. INT. - PERMITTEE I / //./� LATH. EXT. ADDRESS' PLASTER, INT. AUTHORIZED AGT. PLASTER,'EXT. $ 3 2cZ [FEE IS �,� `L OC/ HOUSENUMSERCOR- I RECT AND POSTED. k y VALUATION FINAL UI V'��\ ✓— TEA"" 0063 9-34 1 .. ' _. 11880296 SB ' WORKERS' COMPENSATION DECLARATION - - - - I hereby affirm that I have o certificate of consent to self p 'f�a I�I�� F '^y BQ I�ff �I�•y( 11"c"., PERMIT - insure, ora.certificate of Workers' Compensation'Insurance,' U'llll P�� `CAR-liI��YV U �II�I�. U��LSDOIIV�/ P�11�111\70� U 1 or a certified copy thereof-(Sec. 3800,'Lob. C.) COUNTY.OF LOS ANGELES I BUILDING AND SAFETY " Policy No. W0007146Compony air ns Iran e: �. Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING - ADDRESS Certified copy is filed with the county building inspec- BUILDING - - - - _ L 4on department. ADDRESS 5614 N, Ca�hury - bate 7.—.1-88 - Applicant Virgin Roof Co. CITY ZIP 917RO - LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' - - NO.OF BLDGS. NEAREST 'COMPENSATION INSURANCE - SIZE OF LOT NOW ON LOT CROSS ST. - (This section need..not becompleted if the permit sfor one ASSESSOR - ,::.hundrecldollars($100).or.less.), TRACT BLOCK LOT NO. MAP BOOK ," ..... _ TSI. � USE Z E MAP I certify that`in the performance of the work for which this OWNER^ NO,. .• NO permit is issued, I shall not employ any person in any manner - + SPECIAL so as to become subject to:the Workers'Compensation Laws. ADDRESS / CONDITIONS O "Dare Applicant - CITY - ZIP - _ �l NOTICEARCHITECT OR TEL. Exempt TO APPLICANT. If,bafter ecome Ito the of DISTRICT GROUP TYPE FIRE PROCESSED BY - C) ENGINEER NO. Exemption,' you should become subject fo•Ihe Workers - -� CONST. ZONE U' Compensation provisions of theLaborCode, you must'forth- W. gDDRESS '�� with comply with such provisions or this permit sholl be - - D_i deemed revoked. - . - - TEL. STATISTICAL CLAS IN TION APT. C ED CONTRACTOR Vir in ROOF CO. NO. 287-0 z LICENSED CONTRACTORS DECLARATION - .- -. - - - LIC C1A55'NO.=DWELL. UNITS_ - ' I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS P.O. $ g J NO. T (commencing with Section 7000)of Division 3 6f the Business and ' LIC SEWER MAP Professions Code, andmy,license is in full force and effect. CITY' CLASS BK VALIDATION , SO. F?. NO.OF NO. OF CHECK Lice_nse`Number 160650- Lic,Class C'19' - SIZE STORIES one FAMILIES ONE VALUATION DESCRIPTION OF WORK existing oa NEW ❑ -Comiactor--Vi-�gin_•Roof Co. Date 6-30=89 am exempt under Sac $ 2686.00 " n n ADD . - ❑ , - ALTER B.BP.C. for this reasonDWelhn REPAIR $ ' -' Date: USE.OF ❑ ' E%ISTING BLDG. DEMOL Signature - APPLICANT - TEL, FINAL 9 OWNER-BUILDER DECLARATION - PRINT ViY in ROOF SCO. NO. 2 - .DATE. —f/ -'I hereby affirm that I am exempt from the Contractor's License Cow for the following reason (Section 7031.5, Business and ADDRESS P.O. BOX J San Gabriel 91778' FI / 'Professions Cade): - - _ - 01 T6 A ❑ BUILDING / I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and - the structure is not intended or offered for sole(Section LOCALITY .t #te.e -e e •k� 7044, Business and Professions Code). - MOVING - TEL - El1, as owner of the property, am exclusively contracting CONTRACTOR NO. ) •-• 59.25 with licensed contractors to construct the project (Sec- ADDRESS ' e •,i.5 9. 2 5 tion 7044, BusinessandProfessions Code). , CONSTRUCTION LENDING AGENCY SE7OBACK YARD HWY ,IOTA SETBACK WIDTH, - - �07, 1 ,3-88 - I hereby affirm that there is a-construction lending agency for. FRONT he performance of the work for which this permit is issued PA. (Sec:3097, Civ. C.). SIDE P.I. 'Lenders Nome � - `. LOMA Ref. M m Lender's Address - P.C. Fee$ Permit Fee - - o I certifythat I have read this application and state that the PP - Issuance Fee lO.SO LDMA P/C R above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, _ - 4 a. ,.._ $ and hereby authorize representatives of this County to enter - Total Fee ^tDMA•Perm off- Q � ,�'• upon the above-mentioned property for inspection purposes. - - 6-15-88 SEE REVERSE FOR EXPLANATORY LANGUAGE ' 5 noNie of Applicant or Agent - Dote -