HomeMy Public PortalAbout5115 CAMELLIA AVE_Building__ I _
DEPARTMENT OF BUII.DING AND SAFELY APPLICATION FOR PERMIT
BUILDING� I �®I
COUNTY OF LOS ANGELES
WM. J. FOX, CHIMW QIGINMM
FOR APPLI T IN FOE OFFICE URE ONLY
DIffTRICT NO. PLAN CK. NO. IT
BUILDING HO.
ADDRXS;Ssjzs 60
LOCAI..ITY RXC[IVKD BY DAT[OF APPL DATY ISGUm
BUILMING
cR �' ADDRESS /� I(/ Lt 1A
OWN r.
MAU L LOCAL.tTTM `4 /P� r $,
ST
CITY _ N -:2''A5 FIRE 0. OF TYPE GROUP
ARCH R� T'[L ZONE PLANIS
[NCII / NO. SETBACK LIN[ 6 f Owl
ADDRMS ,` R APPROVKD
Tam BY DAT[
CONTRACTOR NO. US[ gPROVI[D
BY DAT[
ADDR[QS �\� fT //J�HO [ NUMBERING
LKQL -21
DESCRIPTION LOT NO. C / BLOCK MAP NUMa `� KLD CHECK BY
TRACT NO. ASSIGN® BY ❑A
SLxIZ OF LOTS('k/2 N °OW ON LOSCOREEGTIONS
T
U8[OF NO. OF
QCI STING 111-MG, FAII�W.�
DFSC EMON OF WOEL
NEW ALTZMAT10N ADDITION
0
R[FAIR DEMOLITION A
Q
pq. FT. NO. OF Z
BIZ.[ ROOMS / ISTORI[S
QCT. WALLROOF
COVKRING T COVERING
US[OF I TRUCTURi
APPEOVALS
INSPTGTOR'B SIGNATURE DAT[
1 HQt[SY ACKNOWLEDGE THAT V READ THIS jPl' OUNDATIONS LOCATION
PLUCATION AND STATZ THAT THE FOR ION GIVENFORMS, MATERIALS
CORRECT.
I AG PLY W [ CO CTIONS LISRAM[z FIR[OTOPS,
XR AND H ALL ORDI ES D STAT[ BRACING, BOLTS -�1' r
A—
S R TING HUI G CT7 FURNACEi LOCATION,
GAS VENT, DUCTS
f �
r - LATH, INT.
ADD
LATH, QCT. , /} - z�- Y►
AUTHORITY AGT.
M-ASTLR, INT.
7 9A 63 5A• Dass so-00 P. C. • '
FEE FL.A.BTER, QCT.
�v.
FINAL
VALUATION Irk / �Y'
DEPASTMET OF BUILDING AND SAFETY APPLICATION FOR MEN=
COUNTY of Los ANaELE 'C
27 O/a B v ' `. D ' �+ '
1N1�1. J. FQX. OHIEF [NOIH[GR 0,
FOR APPLICANT TO FILL IN S OFFICE IISB ONLY "
q DINTMOT NO. N P[1O�1rr D.
"DRlq l/'3 S c Ni S '� 17 /Z
LOOALITY REO[IVED■Y DAT[orA!<PL DSA/Tt IrLED
NEARpT 1 L/s( /V-ST.
�UILDINO
OWN[I! 3- ADDRd Avrf/1/3
AD� l!-Mo e- Q� LO -r aL
R14s P IC �L GRROSS W4E!Nxtl3lrT
Q . 41 O s
Fl R[ NO.OF TYr[ SROUr
A.;DHITEOT OR _ Tm- ZON[ PLA."m
[NOINEER NO. �y
OKI-RACK LIN[ v N
'6 G APPROVED
TiLlv
ONTRAOTOR' NO. RY DATE
zoo"' tY� � oATt
I /DESCRIPTION LOTN0.
OLOOK
TAAOT
O.OF LD
Hr� f
o12[OFLOT NOW ONL.OT
Un[OF NO.OF ol N0.OF
O
DESCRIPTION OF WORK m
N[W ALTIRATION ADDITION > - rv•C, O
7•
REPAIR MOVING D[MOLISH p
Q4 FT. HO.OF
BIZ[ Q ROOM2 fTORIp
WALL ROOP
OOVEIRIN GGO OOV[RINO /
US[OF N[W
Af
BUILDING
t
ac3S'
FD
1 H[RIKY AOKNOWLEDLI[ THAT 1 HAV[ READ THINI
APPROVALXAl-PU12ATION AND RAT[ THAT TH[ ADWE 1■ BDRREOT
AHD AOR[E TD OOMPLY WITH ALL COUNTY ORDINANOpFOU �MAIONW TERIALS /NJ T - A/
AND N'TAT[ LAWS RMUL AT ■UILDINO OONNTRUOT10N.
M[1 FIRE KTOP16
o1L1NATURZ OF/ / ■RAOIN0 00LT1
P[RMITTI �✓ LATH. INT.
AUTHORIZED ALIT LATH, EXT.
7&AA3QA-3 sio }�$ p.0.• PLAlT[R.INT.
i FE[ PLALT[R,ExT.
y
VALUATION r~' FINAL ^
f :APPLICATI-OMFOR
BUILDING PERMIT
FOR APPLICANT TO FILL IN ADDS
BUILDING- %
ADDRESS LOCALTY l
� N EARBT
QTY L PS ST.
OF BLDGS ASSESSOR
SIZE OF LOT '1 WON LOT' MAP BOOK PAGE PARCEL
DISTRI GROUPTYPE FIRE PROCESSED BY
TRACT BLOCK LOT NO. r CONST. ZONE
lirNNA :z
OWNER hh p' TEL
TISTI CLASSIFCATIONSEW R MAP
ADDRESS l CLASS NO. DWELL UNITS BK PG
QTY ZIP USE ZONE MAP
ARCHITECT O TB,. je— NO. 2�
ENGINEER NO. SPEQAL
CON DTII ONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO —
TEL
CONTRACTOR NO. BLDG.SETBACK FROM
LIC FRONT PROP.LINE OF
ADDRESS NO. TOTAL SETBACK FROM TYPE OF EXISTING
LIC HIGHWAY +. YARD FRONT PROP.UNE- HIGHWAY WIDTH
CITY CLASS _
CONSTRUCTION LENDER + �� a
NAME AND BRANCH BLDG.SETBACK FROM 0
ADDRESS UTY SIDE PROP.LINE OF (STREET) O
50.FT NO.OF NO.OF CHECK HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING Y�
SIZE STORIES FAMILIES ONE1 7- SIDE PROP.LINE' HIGHWAY WIDTH a
DESCRIPTKNJ OF WORK NEW
ADD CORN CUTOFF YES ❑ NO ❑
ALTER IN OPIENY6 YES ❑ NO ❑
REPAIR
USE OF DEAhOL IN TAL PERMIT ZONE YES ❑ NO ❑
EXISTING BLDG. �(
APPLEt7oeQ.v�lcjkNT No. T�Z.s �9 GS /7JjQ �.L
BY(SIGNATURE) �/ y
I HEREBY AOQJOWLEDCE THAT I HAVE READ THIS APPLICATK)N AND STATE
THAT THE ABOVE IS CORRECT AND ACS TO COMPLY WITH All ORDRNAbKES
AND LAWS REG TNG BULDING CONt5FRUC)ON.1 CERTIFY THAT N DOING THE
WORK AUTHORIZED HBZEBY 1 WILL NOT EMPLOY ANY PERSON IN V OLATK1 N Of
THE LABQR CODE OF THE STATE Of CALIFORNIA IN RELATING TO WRKM
OE?J'S COM-
Z -
I I NSURANCE-
SIGNATURE OF FINAL 9 BY
PERMITTEE DATE
ADDRESS /y
R TEL P.C. Fee$ J Permlt Fee
QTY NO. _
Issuance Fee
VALUATION$
t+] Total Fg. Cn0
PLAN CHECK VALIDATION M.O. CIVU
ASH _ PERT,VALIDATION M.o. CASH
1 2-3 NHAR 17 23 D b 9.7' 5 ,&--,:-. 1 2 .4 ^1fVt 17 1 'D 5
4% 7eAE3ee CK f9O"6176 -
% A, —