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Home My Public Portal About4924 CAMELLIA AVE_Building__ APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUIL EbsADDr, DEPARTAIENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LOCALITY L �' JOHN A.LAMBIE.COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. DISTRICT NO. GBIDUP I TYPE y�_1 P�RCF`...SED BY FOR AP/PLICANT TO/ FILL IN TYPE /ter I l!dSSEE B ADDRESS �T CAEL(�A A STATISTICAL CLASSIFICATION I SEBKR MAPP - / CLASS. NO. DWELL. UNITS LOT NO. ./�� BLOCK MAP �y HT,ATE YES O // 7 NUMBER 19!0 — TRACT 77(o 7 USEEZONE SPECIAL SIZE OF LOT / 1(p0 , NOW ON LOTS {y/ CON OITIONS USE OF EXISTING BLDG. 'Alem'gC gC V EXIST. SETBACK YARD HWY. STREETN ME WIDTH OWNER' ON/ J 4. FRONT J� , / / P.L. MAIL ADDRESS C/71� ZZ,'W G. SIDE clrY '7b- meLc� G/TY No`flTd_wff P.L. INSPECTfON RECORD ARCINEERT OR ENGO'I,i/�,p NO. _ ADDRESS .5/IMC AS /oAe30✓E e CONTRACTOR O ^ TEL DESCRIPTION OF WORK E NEW - ADD ALTER REPAIR DEMOLISH SO. FT. ' �O NO.OF FAMILIES SIZE (oJ/ o STORIES . USE OF STRUCTURE L)l Ape O 42 it SIGNATURE OF APPROVALS APPLICANT �5< C�n9E[Li/� ATE INSPECTO 'S SIGNATURE ADDRESS "//�� FOUNDATION: LOCATION / f U i - FORMS.MATERIALS -(/] 2� � P.C. 5 FRAME: FIRE STOPS, h FEE BRACING. BOLTS S-f VALUATION - S 61,0 FURNACE: LOCATION, _ 5 FEE GAS VENT,DUCTS O'I q� 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP. LATH. INT. « 7WC PLICATION AND-STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH AL OUNTY ORD ANCES AND LATH. EXT. /G STATE LAWS' REG TIN UILD NG' TRl{CTION. SIGNATUREOF HOUSE NUMBER COR. _ PERMIT_TE .o RED. AND POSTED ADDRESS `-1 FINAL CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL E PLAN CHECK VALIDATION CK. M.O. GSH PERMIT VALIDATION CK. M.O. CASH LACp2 1 0=9.Pn FEa . 2 1 A 9.0 0. TEMPLE CUT I n / II T6AS3BACE+"FB031.62 APPLICATION FOR BUILDING PERMIT u COUNTY OF LOS ANGELES BUILDING [% DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY _j_:4'�,1941 JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. DI�RICT N / G OU TYPE OC SS/FD B FOR APPLICANT TO FELL IN �' CONST. , BUILDING �lf/Y /� STATISTICAL CLASSIFICATI ON S WER.MAP ADDRESS Lf,Y �sy�" MBK / CLASS. NO., DW ELL. UNITS LOT NO. ,/, BLOCK WATER NOT REQUIRED-2�RECEIVED CERTIFICATE: TRACT / MAP J HI RHWAY UE) / NO. OF FLOGS. STATE MAJOR SECLOCAL NO. ON SIZE OF LOT y Q NOW ON LOT USE ZONE SPECIAL USE OF t� ` �I CONDITIONS EXISTING BLDG. //� A �f•j��JJ ��jjy/ OWNER /'(i71/NO/'JT6- ' / BUILDING YARD HWY STREET NAME EXIST. �, � SETBACK WIDTH ' ' . ADDRES w � v" f'� J/t/4-7 FRONT 7 ARCHITECT OR TEL. P.•L. T71 L-�ciJrLn 'C J c ENGINEER NO. 'SIDE ADDRESS TE , O CONTRACTOR �' , l_ / NOL / n / n/ y n �n �� u ADDRESS /� L!t A/ /.l '/J�LIn""`N' O DESCRIPTION OF WORK / t n y /��' u a FT.T. ADD ALTER NOROFAIR DEMOLISH OO FSH //O�^-' �./ �iA / '/ 1 SIZE STORIES FAMILIES USE OFR STIR SIGNATURE OF /7/! 3 r•�/�P�--_ J7�w wSL4 Z' �.G�r+�+�'�+'•.+'l/CC3»'sr" . APPLICANT VALUATION S 0-0 _ APPROVALS ,DATE INS��PECTO�B'''SJ'S.S'IGNATURE P.C. PMT. FOUNDATIOW FORMS, MATERIALS N, /�j FEE FEE S J I � FRAME: FIRE STOPS. / "' l �\ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS AND STATE THAT THE ABOVE IS CORRECT ANO AGREE TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS / BUILDING CONSTRUCT IDN. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. I I ! 1 TION OF THE LABOR CODE O THE STATE OF ALIFORNIA RELAT- ING TO WORKMEN'S COMPS ION IN I SUflAI 'I LATH. EXT. r SIGNATURE OF , � ,HOUSE NUMBER COR- I I J PERMITTEE ✓ �•-i-- RECT AND POSTED ADDRESS FINAL JOHN F. LEWIS. PRINCIPALS TUBAL ENGINEER PLAN CHECK VALIDATION Cl. M.D. =ASH _ PERMIT VALIDATION cK M.G. CASH , 9 3 2 J 12 Jnid 9 1 D 6.00 „ TEMPLE -CITY 76a838ADE 8031-BY APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER ADDREss C \� BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. DISTRICT N g.rE0U TYPE - P OCES ED BY FOR APPLICANT TO FILL IN .-j, 0 . h-o''( coNST. � , BUILDING I STATISTICAL CLASSIFICATION SF,WER MAP ADDRESS 4924 Camellia Ave., BK ..PG/ CLASS. NO.• DWELL. UNITTS^SI cj _ 6 LOT NO. 65 BLOCK WATER CERT FICATE: NOT REQUIRED u\ RECEIVED TRACT 14467 [ MAP )/nI HIGHWAY SIZE OF LOT 54' X 160+ NOW ON LOTS 2 NO. .�.LI J (c lRaEl STATE MAJOR SECOND/LOCAL USE ZONE SPECIAL USE OF House & Garage / CONDITIONS y EXISTING BLDG. O f/ OWNER TEL J A No ATI BUILDING EXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS 4924 Camellia Ave. FRONT ,,--1/' ARCHITECT OR TEL. P. L. <6 ENGINEER NO, SIDE CL ADDRESS TEL. I //�'il'1�1lliil l;`v!n .�1 �1. �^ a'6� 0 Owner CONTRACTOR Builder NO. ! '� — ✓ '� J// . ..GF+a4L'.p A�'iF3'i.{1lJ a m ADDRESS DESCRIPTION OF WORK ,.,r ' ` �fL `"' ” u � _` v / � 1 �y-vl//.mob t2 v// �� yt" ' c�f��+>L �6p'FT. ADD ALTER NOROFAIR DNOOO FSH. B"' l. Z SIZE 181 X 387 STORIES FAMILIES ,(f. SUSE TRUOCTURE ;wi=ng mm,'ng POOL �� . �" /y� J SIGNATURE OF iiii—APPLICA VALUATION , 7 eo " C-LJ �J APPROVALS DATE IrvrsP�Ecwro:Re..s.S?I G�NA/i/une FE j PMT / FO FORMS. MATERIALSDATION T/1Jfl7Yl `EYP— +�^l'— L- FEE $ FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE. LOCATION. J } 4 WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT,.DUCTS BUILDING CONSTRUCTION. I .CERTIFY THAT IN DOING THE WORK 1 AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA LATH. INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- INGTO WORKMEN'S COMPENSATI INSU RgNCE. LATH, EXT. SIGNATURE OF HOUSE NUMBER COR- P OR- I PERMITTEE RECT AND POSTED ADDRESS` FINAL JOHN F. LEWIS, PRINCIPAL STR TU RAL ENGINEER PLAN CHECK VALIDATIONO M.G. GASH _ PERMIT VALIDATION CK. M.D. GASH LfIL6 9328'Q JAN 9 2 3 D ,r 5 d v �,D0 3 8 6Q JAN '? n 1 D 1 8.50--- v COUNTY OF LOS ANGELES — BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby affirm that I have a certificate of consent to salt insure, BUILDING ADDRE G - COP - or a Certificate of Workers'Compensation Insurance,or a Certified _ ZL VL GOP f Sec. W,Lab.C.) •. <� p Q Po O COO�8n Af��f C- S. SIZE OF LOT NO.OF BLDGS.NOW ON LOOT LOCAL? L ❑ Certified copy is hereby furnished. I NEAREST CROSS ST.'- rtified copyis filed with the county building inspection TRACT BLOCK LOT NO. tle!p'a�rtf/g8�nl/.�/^J� USEZONE MAP NO. Date2PPCL Applicant O ASSESSOR MAP BOOK PAGE PARCEL ! SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' ownW NG ^Z�/!/ WITHIN IWC FT OF SCHOOL? YES NO COMPENSATION INSURANCEI _I ADDR (This section need not be completed if the permit is for one hundred DISTRICT yG�ROUP [TYPECONST' FIRE ZONE CESSE V dollars($100)or less.) CJTY—� .ZIP p �j�] o i'{5� " ,I I Certify that in the performance of the work for which this permit <� ��6 v, " K g V 1/1I i3 issued, I shall not employ any person in any manner So as to ARCHITECT OR ENGINEER TEL.NO. become subject t0 the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CGIIIDO Data Applicant ADDRESS CLASS NO. - DWELL UNITS - NOTICE TO APPLICANT. If, after making this Certificate Of TEL.NOREQUIRED TOTAL SETBACK FROM EXIST . Exemption, you ShOUItl become subject t0 the Workers' TOR CO ^7 / SETBACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith O ! '�40 3�Z Faorrr comply with such provisions or this permit shall be deemed revoked. 47 PL LICENSED CONTRACTORS DECLARATION c1T'//L.� - 'L-i( cLLA `f V ploE o I hereby affirm that I am licensed under provisions of Chapter 9 Z_ SEWER MAP V (commencing with Section 7000)of Division 3 of the Business and S ZE NO.OF ORES NO.O FAMILIES Professions Code, m li eense is in full force and ffeyt7. NLIN ❑ BK PG O License Nu er o Lie.Class J CRI I �WORK. �� - 4, ADD ❑ Contract ate _- ALTER ❑ Z �` � —(I REPAIR ❑ I am exempt under Sec. $ B.BP.C.for this reason '�� - J �1.� DEMOL 1:1 Dare. - 1JSE OF EXISTING BLDG. URM ❑ LDMA P/C N i Signature q NT(PRINT,l TEL.NO. LDMA Perm p El 1, as owner of the property, or my employees with wages asOA_rx - OZ W*C;(�i their sole compensation, will do the work and the structure is ADDRESS FINALDATE ~ .. 'S �yfl. not intended or Offered for sale (Section 7044, Business and G 07 i Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL i 'F M OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN JQ S �.i1 t.-' ❑ 1, as owner of the property, am exclusively contracting With THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FIN ' licensed contractors to construct the project.(Section 7044, YES❑ No❑ TOTAL 141:1 ® 22 Business and Professions Code.) WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING `' y440. 22 {, OCCUPANTREOUIREA PERMITFOR OONSTRUCTIONOR MODIFICATION FROM THESOUTH /�'�� CHECK a .:CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SOAOMD)SEE PERMITTING CHECKLIST ��0= Il/ _ r FORGUIDELINES. - CHANGE �rlrl 1 hereby affirm that there is a construction-lending-agency for YEN El NO❑ - - the performance of the work for which this permit is issued(Sec. HAVE HEAD THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE$CAOMO 3097,CIV.C.J. PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES { 91 COUNTY CODE,TITLE 2,CHAPTER 2.21 SECTIONS 2WA W THROUGH 1.a)Ta1 CONCERNING 1130013-01101 -/25/GAJ 3 Lenders Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAGMD. Lenders Address 2(J 51 ; ASI 5:5` �. ovmmwAawr I Certitythat I have read this a plication and state that the above P.C.FEE PERMIT FEE ('J is c. I agre comply with all county / Q ortlinanc d State laws relating t building construction,and hereby I rile rep(esentatives o this County tO ante Upon ISSUANCE FEE I e abo t' d p f0 nsp on purposes. 3 . no < D INVESTIGATION FEE TOTAL FEE m sp na Ap.n1 on SEE REVERSE FOR EXPLANATORY LANGUAGE. _