HomeMy Public PortalAbout4934 CAMELLIA AVE_Building__ 76A638A CE#803 8-BB APPLICATION FOR BUILDING PERMIT -
COUNTY OF-LOS ANGELES 1111_111
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY ZIA
JOHN A. LAMSIE. COUNTY ENGINEER NEAREST /•
WILLIAM A. JENSEN. SUPT OF BUILDING CROSS ST.
DISTRICT N OUP TYPE P CE D BY
R
FOR APPLICANT TO FILL IN Q � CONST.
BUILDING
/ STATISTICAL CLASSIFICATION SEW MAP
ADDRESS - /V
CLASS. NO. DWELL UNITS
LOT NO. 64 BLOCK WATER
CERTIFICATE: NOT REQUIREDlia RECEIVED ET
TRACT MAP HIGHWAY
NO.OF SLOGS. NO. .) ICIRCLEI - STATE MAJOR SECOND CA ;
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OF - CONDITIONS
_
EXISTING BLDG. Z � � !1'
L
OWNER O. BUILDING EXIST.
__ t SETBACK YARD HWV STREET NAME WIDTH
ADDRESS -e C.G<y FRONT
ARCHITECT R TEL. P. L
ENGINEER NO, SIDE O
P. L. V
ADDRESS d
TEL O
CONTRACTOR N U
ADDRESS A/u / -•-�- w'
DESCRIPTION OF WORK G-S �� 7 yv,' / . � O
NEW ADO AL R REPAI DEMOLISH
SOFT. (' NO. OF `-NO. OF / ?
SIZE STORIES FAMILIES
USE OF t
STR CTURE _ �p/ , `/ S
SIGNA RE OF Gly VI J• G j /C ' /Y/
APUAPLICNT I ✓
VALUATION $ &o
r? -✓
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. Q`1 FOUNDATION: LOCATION
FEE S FEE S FORMS, MATERIALS
FRAME: FIRE STOPS.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THI APPLICATION BRACING. BOLTS
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION.
WITH 'ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFO NIA RELAT
ING TO WORKMEN'S COM NSATION INSURANCE. LATH. EXT.
1 _
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS FINAL
JOHN F. LEWIS. PRINCIPAL STR URAL ENGINEER
PLAN CHECK VALIDATION CK. M.D. CASH PERMIT VALIDATION cK. M.O. CASH
LLf�0.8 7 1 6. PrAY24 1 D 9.00~ v