HomeMy Public PortalAbout4822 CAMELLIA AVE_Building__ APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN (P.i.t o. ITO. oh141
BUILDING - COUNTY OF LOS ANGELES
ADDRESS HP DEPARTMENTOFCOUNTY ENGINEER
CITY ,ii.��,. "zip v BUILDING AND SAFETY DIVISION
P ,l A NO.OF EILDGS. BUILDING Q
S1ZE OF LOT 60 V NOW ON LOT //,� ADDRESS
TRACT BLOCK LOT NO_ �/ LOCALITY
TEL. NEAREST
OWNER j "'N NO. e.- ,CROSS ST.
('/ .E 1 ASSESSOR
ADDRESS-/ N, C MAP BOOK PAGE PARCEL
CI TY7(?mpil 0—;Jno - ZIP - 19 _ D _ DISTRICTQQ GROUP TYPE FIRE SSED BY
-I U U T CONST. _ NE _N ..
`ARCHITECT TEL _ ,lam ZQ� — � •�
ENGINEER �• O. 6'� -
STATISTICAL CLASSIFICATION
TION SEWER MAP
ADDRESS / c- CLASS NO.u OWELL,UNITS BK PG.
/
CONTRACTOR TEL.
NO, USE ZONE NADP
LIC.
ADDRESS NO. - SPECIAL
LIC. CONDITIONS
CITY,
CONSTRUCTION LENDER CLASS
ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑
NAME AND BRANCH SLOG, FROM
FR '
FRONTNT PROP.LINE OF (STREET)
ADORES CITY _
HIGHWAY } YARD - TOTAL SETBACK FROM TYPE E%(STING
SQ. FT A Y Np. OF NO. OF CHECK FRONT PROP. LINE HIGHWAWIDTH
SIZE STORIES / FAMILIES 'ONE
Y
}
DESCRIPTION OF WORK
fiddidion opNEW ❑ U
ADO SLDG.SETBACK FROM
La SIDE PROP. LINEOF (STREET) 0
a/ALTER HIGHWAY } YARD = TOTAL SETBACK FROM TYPE OE E%(STING V
EPA( SIDE PROP. LINE HIGHWAY WIDTH,
USE OF } = n
EXISTING BLDG. I Z
APPLI CAN TEL CORNER CUTOFF YES ❑ NO ❑
(,RINT)
BY (SIGNATOR IN OPEN SPACE YES ❑- NO ❑
p - IN COASTAL PERMIT ZONE YES ❑ NO ❑
VALUATION'!
00
I HEREBY ACM NOWADGE THAT I HAVE READ THIS APPLICATION / /LdG /•-J/ ��'��'
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- ��/7'l �itOrj //✓S/P" C�'T ST✓GCaG D�
ST VC TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY-I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO /NY T zol�
WORKMEN'S COMPENSATION.INSURANCE.
SIGNATURE
PERMITTEE
ADOR ESS -
FINAL ,..1_ Y7J/ BY
TEL.
DATE �Y'
/ /
CITY NO. 2
MARE CHECKS &kYABLE To:, FEE'$ FEE S
HARVEY T. BRANDT, COUNTY ENGINEERP-C
PLAN'CHECK VALIDATION cK. Mo. CASH PERMIT VALIDATION CK. M.O. / ASH
6 4 8;;SEF 15 1r D ti 9.2 5 A9O ,
36AG30A CE f 003 5/74 '