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Home My Public Portal About5020 CAMELLIA AVE_Building__ j � DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES ® I N G WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING DISTRICT NO. PLAN CK.NO. PERMIT NO. /� , _ ADDRES5 G G mcH lfF�j LOCALITY t17 1-70 I RECEIVED BY DATE OF APPL. DATE ISSUED NEARECROSS S T. XO WC� lD.- �... BUILDING OWNER ADDRESS MAIL /� '/ LOCALITY 7 , ADDRESS I V /� O Lee Y� o wn:p =g K L. d ^ ^ NEAREST y _CITY / /J '� I 1 NO. �• P CROSS ST. FIRE NO.OF TYPE '/ GROU ARCHITECT OR m.- TEL. ZONE -- PLANS ENGINEER NO. h BLDG. 1 OR[).NO. ADDRESS SETBACK LINE APPROVED TEL BY DATE 7 CONTRACTOR ! ( ' NO. % USE APPROVED ADDRESS �f, r _ -ldly - ZONE AP DATE LEGAL rt / / CORRECTIONS DESCRIPTION LOT NO. BLOCK G ! (p TRACT j u W V I NO.OF SLOGS. SIZE OF LOT NOW ON LOT F ,� Z:z - � USE OF NO.OFNO.OF EXISTING BLDG. FAMILIES I ROOMS DESCRIPTION OF WORK C- _ NEW ALTERATION ADDITION O A REPAIR I MOVING DEMOLISH ��pL/L. - � •- � ..�SEJ.FT � 0 NEI 13F z SIZE V ROOMS STORIES {//v r �� T WALL ROOl IF COVERING �� I COVERING .` !�• USE OF NEW BUILDING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, SIGNATURE OF BRACING,BOLTS OWNER LATH,INT.: AUTHORIZED AOT LATH,EXT.: DBS-3 25M SETS 4-47 $ P.C 6 G O PLASTER,INT. FEE PLASTER,EXT. VALUATION FEE /� FINAL �� ?! DIVISION OF BUILDING AND SAFETY BUILDING Department of County Engineer County of Los Angeles APPLICATION WM. J. FOX, COUNTY ENGINEER IIIIIIIIIIIIIIN� --- FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING SoaO �/_ ' �� / ( j A /�1/� D19TRI�0. PLAN CK. OR REC.No. ERM ADDRESS No (_L`H /^tr -' LOCALITY L E e, 1 Ty e I- EIVED BY DATE OF ADPL. DATE ISSUED rEAREBT I A O OJ� D // 2 RQ69BT. I-fi V + BUILDING w�v �^ r - �/� F ADDRESS G /Y /y-/J j OWNER "� MAIL A' Q �L� A A V . LOCALITY ADDRESS 0�01�',�IOni /� ({ rG NEAREST CROSSST. _ CITY I P h i•� 0+ ;7c'-AT-4 /O FIRE NO.OF T OR ZONE ( PLANS�.. ARCHITECT OR n``,I/ /.r� 'rE{� ENGINEER (J �/V 'y C - NO. BLDG. SETBACK LINE ADDRESS / USE % APPROVED TEL, ZONE BY DATE CONTRACTOR No. p,>a HOUSE NUMBERING ADDRESS MAP NUMBER �o�b NO. ASSIGNED BY LEGAL CORRECTIONS —DESCRIPTION LOT N0. I j �j I BLOCK _ /�- TRACT I "f � /�e �'7 /A./G 'lam /1 I NO. OF BLT SIZE DF LOT /� (I�OL/J'''' NOW ON LOT EX ST NG BLDG. 40 � L. FAPIIO.LI[o DESCRIPTION OF WORK �+ NEW �`I ALTERATION ADDITION r J Z REPAIR DEMOLITION •Q.FT. N O.OF SIZE p� ROOMS I BT01111198 EXT.WALL C KDOF COVERING 7 ?�� COVERING J , U S F (.I INSPECTION FOR APPROVALS OCCUPANCYAS INSPECTOR'S SIGNATURE DATE FOUNDATION: LOCATION I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP• FIIRMS, MATERIALH ,%`��.��.�� PLICATION AND STATE THAT THE IN GIVEN IS FRAME: FIRE STOP CORRECT. BRACING, BOLTS I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION, AND STATE LAWS REGULATING BU)LDING CONSTRUCTION. GAB VENT,DUCTS SIGNATURE OF .(./� � LATH, INT. PERMITTEE f LATH, EXT. ADDRESS PLASTER, INT. AUTHORIZED AMT. PLASTER, EXT. P.0. HOUSE NUMBER COR- FEE O CJ � RECT AND POSTED VALUATION �'� • FEE FINAL 76A6..A DBS 3 7-62 4"N � 61 76A638A CE#603 2-63APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING ADDRESS DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LOCALITY f JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. DI�STRICT N TYPE S Bol FOR APPLICANT TO FILL IN V r CONST: �j BUILDING STATISTICALCL ICATION SEWER MAP ADDRESS O CLASS. NO. DWELL. UNITS BK PG LOT NO. BLOCK WATER CERTIFICATE: NOT REQUIRED RECEIVED ❑ TRACT 6 MAP HIGHWAY /� NO.OF BLDG S. NO. (CIRCLE) STATE MAJOR SECOND OCAL SIZE OF LOT (6C NOW ON LOT USE ZONE SPECIAL USE OF / CONDITIONS _ EXISTING BLDG. . C TEL. OWNER NO. BUILDING YARD HWY STREET NAME EXIST. SETBACK WIDTH s ADDRESS FRONT i ARCHITECT OR _ TEL. P. L. f - ENGINEER NO. SIDE ADDRESS --_- O CONTRACTOR L�C,LIE CG�/'/C. Co-NO.('} V f � O 1 i ADDRESS C• DESCRIPTION OF WORK '" t w NEW ADD ALTER REPAIR DEMOLISH _ - SIZE T �17-11:749S STORIES i FAMI SLIES x - USE OF STRUCTUREMw - SIGNATURE OF ' CV;' APPLICANT VALUATION $ APPROVALS gATq INSPECTO 'S SIGN T RIE P.C. PMT. FOUNDATION: LOCATION �) FEE $ FEE $ FORMS, MATERIALS /,.:✓ W+l." FRAME: FIRE STOPS, Ic I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. _ WITHALL 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 CALIFORNIA RELAT- ING TO WORKMEN'XOMP NSATI ON INSURANCE. - - EXT.IGNATUR O " L /�/ HOUSE NUMBER COR- - RECT AND POSTED _ ADDRESS_ �f. FINAL :•--- JOHN F. LEWIS. PRINCIPAL STIR URAL ENGINEER PLAN CHECK VALIDATION CK. M.D. CASH _ PERMIT VALIDATION CK M.G. CASH U04581"' SEP 20 1D 8.00- Ck WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers' Compensation Insurance, APPLICATION FOR BUILDING PE M or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. °E'39 4,7 Company State CompensatiorL ❑ Certified copy is hereby furnistx:'BtLCt! FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING r.2cffy tion department. - ADDRESS 50Camellia Date 2-20-89 Applicant :f''f," r`f CITYTemple City ZIP LOCALITY CERTIFICATE OF EXEMPTION FlRgvA WORKERS' - NO. OF BLDGS, NEAREST COMPENSATION INS- ANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one ASSESSOR hundred dollars ($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL TEL. USE ZONE MAP " Bobk� I certify that in the performance of the work for which this OWNER NCL'��. �...; } 'r NO. permit is issued, I shall not employ any person in any'"manner 5020ee�i!?"r ilia t SPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESS CONDITIONS ;. CITYTeMPIP C"t)it ZIP Date Applicant ARCHITECT OR TEL. NOTICE TO APPLICANT: If, after making this Certifj to of DISTRICT GROUP TYPE FIRE PROCESSED BY ENGINEER NO. CONST. ZONE Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- ADDRESS11 ti with comply with such provisions or this permit shall.be �EL� deemed revoked. CONTRACTORtNittll+ RIDOfi tg CO.�No nc'• STATISTICAL CLASSIFICATION APT. CONDO. LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS I hereby affirm that I am licensed tinder provisions of Chapter 9 ADDRESS 2 S.:l Dai S NO. SEWER MAP } MEMO (commencing with Section 7000)of Division 3 of the Business and LIC. CL ProfessionsCode, and my license is in full force and effect. CITY !.,oa Anzeles 9003X CLASS _ BK PG VALIDATION Q SQ. FT. NO.OF NO. OF CHECK VV License Number_X 17J,150 Lic.Class 0+4+39 SIZE STORIES FAMILIES ONE - LU J DESCRIPTION OF WORK €G'^l' 6if existingf� VALUATION � Contractor Date -20- 9 OU install. new py'i od, sheathing. ADD , 1 am exempt under Sec. z ALTER B.BP.C. for this reason Clans A I REPAIR $ 0 v Date: USE OF DEMOL ❑ k rt EXISTING BLDG. dL t Signature APPLICANT i TEL. FINAL LLJ PRINT Uaitec off �i0 NO. — H OWNER BUILDER DECLARATION "' i DATE I hereby affirm that I am exempt from the Contractor ense 182 �� St.� Lo si Angeles, CA 90031 Law for the following reason (Section 7031.5, Busin and ADDRESS FINAL Professions Code): ' PRESENTBy BUILDING D I, as owner of the property, or my employee with ADDRESS wages as their sole compensation,will do the wort and ' the structure is not intended or offered for sole'(Section LOCALITY 7044, Business and Professions Code). MOVING TEL ❑ I, as owner of the property, am exclusively ceWracting CONTRACTOR NO, with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY SET�BACKK YARD HWY TOTALSETBACK WIDTH I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name .y9.3LDMA Ref. # [FRONT C. Fee$ iY 'L$.'� Permit Fee •�•as plop,' Lender's Address 3 10 50 LDMA P/C# g I certify that I have read this application and state that the Issuance Fee • above information is correct. I agree to comply with all County Investigation Fee 0 ordinances and State laws relating to building construction, Total Fee 49.gid LDMA Perm. # and hereby authorize representatives of this County to enter upon the above-mentioned property for in a tion rPases. 0-� .. ,��,,,,,,..• `s SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Appliecint or Agent Do tel , r r WORKERS'COMPENSATION DECLARATION I hereby affirm that I Hove a certificate of content to self insure, or a certificate of Workers' Compensation Insurance, APPLICATION FOR BUILDING P RMIT . or a certified copy thereof (Sec. IT,Lob. C.L State Compensation COUNTY OF LOS ANGELES BUILDING AND SAFETY PolJcy No.1039547 Company Certlfled copy Is hereby furnls rauce FOR APPLICANT TO FILL IN Certlfled copy Is filed with the county but Ing In BUILDING 5020 Camellia tion department. AD04ZES5 Date 2-20-89 Applicant ciTyTem le City zip .9178 . LOCALITY 4e-W1 CERTIFICATE OF EXEMPTION F WO RS'. No. OF BLDGS. COMPENSATION IN SIZE LOT NOW ON LOT` ST. (This section need not be completed If the permit Is for one ASSESSOR hundred dollars ($100)cr less-) TAT BLS LOT NO. MAP BOC( RAGE ARCH TEL OWNER Bob Hiaes a _ USE ZONE I certify that In the-performance of the work for.which this SPE LCO CI A permit Is Issued, I shall not employ any person In any manner ADDRESS 5020 Camellia, -'� .so as to become.subject t0 the Workers'Compensation Laws. cmTemple City zip 91780 Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of V4G4NARCHI'ER No pSTRI�i GSE Tom' ZC BY Exemption, you should become subject to the Workers NEER Hobe NO. OONST ZOO Compensation provisions of the Labor Code, you must forth- AD0�55 �/ ..�M— 3 with comply with such provisions or this permit shall be APT- deemed revoked. CONTRACToOnited RoofingCo. ��IZAL CK:4TtO D c. LICENSED CONTRACTORS DECLARATION Li CLASS NO. DWELL UNfLS I hereby affirm that I am licensed under provisions of Chapter 9 RFsS 1821 D NO. (commending with Section 7000)of Division 3 of the Buslnees and LIC MAP Professions Code, and my license Is In full force and effect. Cm Los Angeles 90031 CLASS C._q Q BK. PG VALIDATION SO. FT. NO.OF NO. OF C*CX License Number 1_37 Llc.Class C-39 SIZE STORES FAM1LIE5. OEE VALUATION Contractor 2-20-89 DESCRIFrK)N0Fw0Rr,,Jear off existing i 2600.00 f. install new plywood sheathing. ADD , I am /axe B.RP.C. for this reason ClaFig A REPAIR $ Vie' USE OF BLDG. garage V DIEXtSTINZ Signature APKKANT TEL nature OWNER-BUILDER DECLARATION PRINT IIs a 20-291— DI I hereby affirm that I am exempt from the Contractor's License AI�uRtss�DAly St. Los Angeles, CA 90031 Low for the following reason (Section 7031.5,`Business and Professions Code): NG I, as owner of the o or m employees with ADDRESS rn 111+v prop", Y rrlP Y� wages as their sole compensation,will do the work and � 9 r}r the structure Is not Intended or offered for sole Section LOCALITY v/�'J 7'f) ry• c1 '� r 7(}4�, Business and Professions Code). MOVING To 1 i(��! ElI, as owner of the property, am exclusively contracting CONTRACTOR- NO. { l cc W" licensed contr9pors to construct the project (Ser ADDRESS ✓ y I _ ±"4 tion 7044, Business and Prbfe*ohs Code). CONSTRUCAON LENDING.AGENC-Y SET y� F1WY PROP. LINE WIDTH c� .I hereby affirm that there is a construction lending agency for FRONT �7�.-� the performance of the work for which this permit Is Issued P GC/ (Sec:3097, Cts/. C.). 51 P.L Lenders Name LDMA Ref. 0 $ P.C_ Fee$ none Permit Fee , Lender;Addretss I certify that I have read this appllc*tlon and state that the Isuonce Fee 10.50 LDMA P/C i above Information Is correct. I agree to comply with all County Investlgatton Fee ordinances and State laws relating to building construdlon, Total Fee 49.88S '� Ow - ani hereby authorize r ntatl of this County to enter upon the ve menti pr r Inspection purposes. 2-20-89 t� fi Itt11NQM Fort IlDtxwMATan LAi+auAoa Stg of APPIpA or Agent Date