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Home My Public Portal About4935 CAMELLIA AVE_Building__ S -- I TELE . CITY 16.630.CIE#BOB I-B2 APPLICATION FOR BUILDING PERMIT , fill COUNTY`OF"LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISIONLOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS S, _ DI TRICT N GRO P TYPE BY FOR APPLICANT TO FILL IN C o ' corysr. nn c { BUILDING STATISTICAL CLASSIFICATION S WER MAP ADDRESS aCamellia, BK CLASS. NO. DWELL. UNITS LOT NO, BLOCK WATER NOT REQUIRED RECEIVED ❑ - CERTIFICATE: TRACT 14467 MAP nn ^^ HIGHWAY NO. OF SLOGS. NO. �+N I '.HP a RCLE) STATE MAJOR SECOND L_OCA SIZE OF LOT54 NOW ON LOT U SJryE $PEI IAL USE OF CONDITIONS EXISTING BLDG. DWPI ing Garage rr p0 T y� OWNER NO. BUILDING YARD HWV STREET NAME EXIST. SETBACK WIDTH ADDRESS 4935 QpmP.1 I i n 0 Temr FRONT ARCHITECT OR EL P. L. ')EN,IN E ER )ENGINEER NO. SIDE AO P. L l gS d ADDRESS No TEL tt.. J h O UO ADDRESS CONTRACT ZR ZZ EArrow,- W �u�e% Ev �a/!tJ_J.YlYfi Cit r � O DESCRIPTION OF WO R% A? '�' 116D^z_ v y NEW X ADD ALTER REPAIR DEMOLISH Z Sq. FT. NO, OF NO. OF SIZE STORIES FAMILIES USE OF Pool STRUCTURE .SWl Tl Pool 6 / SIGNATURE OF APPLICANT VALUATION $ OO APPROVALS JDATE1 INBPECTOR's 1 rvATURE P.C. 6 3 PMT. FOUNDATION: LOCATION 4 q/, L� FEE $ FEE $ �'� FORMS. MATERIALS V azUl/Ij- FRAME: FIRE STOPS. D1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING. BOLTS AN STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES ANO 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 CODC- THE STATE OF CALIFORNIA RELAT. ING TO WOHKMENE TION NSURAN / r( LATH. EXT. SIGNATURE OF HOUSE NUMBER CDR- \ PERMITTEE RECT AND POSTED ADDRESS 152247E. Arrow,' Park FINAL _ JOHN F. LEWIS. PRINCIPAL ST RAL ENGINEER' PLAN CHECRVALIDATION OK. Al O. CASH _ PERMIT VALIDATIO CK. M.D. cnsH `8'Ti5.8Q AUG 9-2 3, D 443 .• AUG 9 1 D 1 8"..50~ .WORKERS' COMPENSATION DECLARATION - Gnsure, 6o certificate have I certificate`ofconsent toself //�s ' PUC //�sYMN FOR BURMNG PERl��r 1T insure or a certificate of Workers' Compensation Insurance, - (r�lll !/"ll Il u�r ud'u u ' or.r4„zriifVedcopy}t�h�ereof (Sec 3800, Lab C ) • COUNTY OF LOS ANGELES - BUILDING AND'SAFETY . Po❑IIIcy�N.738 [-1/Lompany BUILDING' Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS LC f BUILDING Certified copy ivfiled with county building inspec- gpDRE55 tion department.- r ' c- sp /'. - U` F 1 ,I�GY'F� - GTV-- 71p / 7 LOCALITY.`' Lam— Date, Applicdnt NO. OF BLDG . /J NEAREST - - CERTIFICATE.OF'.EXEMPTION FROM WORKERS' ' SIZE OF LOT O NOW ON LOT (jj CR O55 SL COMPENSATION INSURANCE ASSESSOR p (This section need not.be completed.if,the permit is for one TRACT BLACK LOT NO. MAP BOOK �a PAGE Q� PARCEL 0� hu ndreddoars ($100) or less.) - �s�F�� // TEL' USE ZONE. OP OWNER ��f'r/ - 1. NO. - l07 I.cerhfy that in the performance of the work for which this - - - _ - 'r.� SPECIAL - Y permit is issued, I shall not employ any person in any manner - ADDRESS -35 CONDITIONS a . .so as to,become subject to the Workers'Compensation Laws. 0 CITY p l iii, 7dG Date Applicant ARCHITECT OR - TEL. - NOTICE TO APPLICANT , after making this Certificate of ENGINEER - NO. -- 'DISTRICT. 'GROUP TYPE 'FIRE PROCESSED BY Q CONST ZONE V Exemption; you should'become. subject to the .Workers' L � D Compensation provisions of the Labor'Code, you musttforth- ADDRESS a with complywith such provisions of this permit shall be TEL. - v) P P req STATISTICAL CLASSIFICATION .APT. CONDO. Z deemed revoked. - - - CONTRACTOR NO.• G I - LICENSED CONTRACTORS DECLARATION LIG CLASS NO. DWEL1. uNlrS hereby offirmdhat I am licensed under provisions of Chapter 9 ADDRESS - NO. SEWER MAP ,..j_ - -,(commericing with Section 7000)of Division'.3 of the Business _ ,r and Professions Code,and my hcens isin full force and ffect. CITY. 7 CLASS '� BK.GPG.v"'�! VALIDATION SO. FT. NO. Of NO. OF CHECK - i ; 1 License,Number Lis Class`_ SIZE STORIES FAMILIES ONE r - ° �JI.� .VALUATION ' Contractor �(�1'1 � ir"-! Dated DESCRIPTION OF WORKNEW ❑ _ 'r1 , —� ADD (,} ❑I am exempt under Secaenp- 7 ter. •_ ALTER ❑ 00� yQ D .(f_�,- t a s for this.reasonREPAIR ❑ .$ � _ Date:4" EXISTIE OINGBLDG. DEMOL ❑ ,Signature '- APPLICANT 4L FINAL CH41CF OWNER-BU ILDER.DECLARATION (PRINT) hereby affirm that I am exempt from the Contractor's License -- - DATE., �/ z�.. 'Law-forlhe following,reason (Section 7031.5, Busmess'and ADDRESS '(�ci -�! 7 FINAL - --- --- I tTill41 Professions,Code): r PRESENT - - B t I_E'j' ' ❑ I, as owner of theproperty, or m em to ees with BUILDING T i �-. I _ Y P Y ADDRESS _ wages as their.sole compensation,will do the work and LOCALITY o D• t ` the structure is not intended ocoffered for sale(Section _ -❑ 7044,Business and`Professions Code.) - MOVING. - - TEL- - - I, as owner of the property, am exclusively contracting CONTRACTOR NO. with lice nsed contractors to construct,the project (Sec- ADDRESS •• ° � tion 7044,.Business and Professions Code.) -REQUIRED - -TOTAL SETBACK FROM EXIST., CONSTRUCTION'LENDING AGENCY - SET BACK YARD HWV PROP. LINE WIDTH. I hereby affirm that there is a construction lending agency for - FRON_T -- - - '- the performance'ofr the work for which permit-"is issued P,I. - - (Sec 3097, Civ. C.). SIDE, TT Lender's Name "CDMA Ref lq d Ck- P Fee$ 1 r a2 Permit Fee ;L� 3 Lender's Address _ 2 o I certify that I have'read this application andsiate that the -5/. �3 Issuance Fee / '�'K� LOtv{j1;,.P/p 8 above information is correct. I agree to comply with all County Investigation Fee 'ordinances and State lbws relating to building.constructian,. ' Total Fee 'd aJ �D ILDNA.'Perm. it ' and hereby authorize representatives of this County to enter .a u ave-t ah d property for inspection purposes. a It SEE REVERSE FOR EXPLANATORY,LANGUAG}„ r� `n ignalure o /pp icani COUNTY OF LOS ANGELES TEMPLE CITY N 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9901 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91980 BL 0508 1110030007 PHONE: (626) 285-0486 EXT: LEGAL ID: N0. OF CONST. BUILDING ADDRESS: TR: 14467 LT: 37 SQ, FT STORIES TYPE 4935 CAMELLIA AV 1 STRUCTURE: 2800 V-B TEMP CA 917803864 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: SPARKLETT 18589-014-024 THOMAS PAGE: 597 SAID: A5 LOCALITY: TEMPLE CITY, Cl TENANT: IEXIST BLDG USE RESID USE ZONE: R-1 )ISSUED ON: PROCESSED BY: 1EXIST OCC GRP: 110/03/11 SR TOWNER: TEL. 5-9 HLDGG. NOW ON LOT: VALUATION: i INAL DATE I FI A Y: CODE: 14935 CAM JEFFREY T;KATHLEEN M (626) 285-9196- 4,900 6h 4935 CAMELLIA AV TEMP 917803864 1 FEES PAID 1D SOON OF WORK 1 �REROOF OVER EXISTING ONE LAYER COMP WITH CLASS A FIRE RATED IEEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ISHINGLE IAPPLI CANT: TEL. NO: 1 KEEFERS ROOFING (409) 608-0622- AA BLDG PERMIT ISSUANCE 27.80 1 11216 BEGONIA COURT AB STATE GREEN BLDG FEE 4900.00 VAL 1.00 ISPECIAL CONDITIONS: UPLAND, CA 91784 1D2 PERMIT W/O EN-HC 4900.00 VAL 132.80 TOTAL FEES 161.60 1 1 CONTRACTOR: TEL. NO: I )APPROVALS DATE INSPECTOR SIGNATDRE 1KEEFER'S ROOFING (909) 608-0622- 1 11216 BEGONIA COURT LIC. NO 1 1LOCATION AND SETBACKS (UPLAND CA 91784 760903 C39 1 1SOILS ENGINEER APPROVAL -. ARCHITECT OR ENGINEER: TEL. NO: I 1 _ ( FOUNDATION/TRENCH FORMS LIC. NO: 1 SLAB/UNDER FLOOR �- RAISED FLOOR FRAMING 1 MAP NO: SEWER NAP BOOK: PAGE: FIRE ZONE: IMF: 1 1UNDERFLOOR INSULATION I I I 1144H269 3 001 1 I 1FLOOB SHEATHING 1 N0. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 1 1 1 0 NO 21 1 IROOF SHEATHING SCHOOL WITHIN HAZARDOUS 1SHEAR PANELS 1AIR QUALITY: 1000 FEET MATERIALS O NO NO FRAME INSPECTION I (FIRE SPRINKLER HANGERS I 1 I I i 11NSOLATION/WEATHER STRIP) I I INTEP.IOR LATH/DRYWALL 1 E$TE RIOR LATH )RATED FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS . T-HA. CEILINGS 1 I I LOT DRAINAGE RF,PORT ID: ❑PR261 ROUTE T0: 95050E I I I I I I