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Home My Public Portal About5133 CAMELLIA AVE_Building__ 78A eaeA c�fireoe 3-68 . ,APPLICATION 6°APPLICATION FOR BUILDI PEFR; MI LJ COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION JOHN A. LAMBIE, COUNTY ENOINEKR LOCALITY COLEMAN W. JENKINS, •UF'T OF BUILDING NEAREST CROSS ST. ° FOR APPLICANT T F IN DISTRIc TYPES o T. c D ,rj CON Print or • only) � BUILDING STATISTICAL CI.AA81FICATION S ER MAP ADDRESS 5133 North Camellia CLASS NO DWELL,UNITS BK PO LOT NO. Temple City BLOCK USE ZONE MAP, NO. TRACT SPECIAL NO.OF BLDGS. CONDITIONS SIZE OF LOT NOW ON LOT USE F EXISTING BLDG, BLDG.SETBACK FROM OWNER David Ber NOL FRONT PROP.LINE OF -(STREET). TYPE OF ISTING SETBACK HIGHWAY + YARD - TOTAL A D DR ES9 HIOHWA WIDTH FROM G.L. CITY ARCHITECT OR TEL SI DG.SETBLINE OF (STREET) FROM ENGINEER NO. SDE PROP.LIN TYPE OF IDTINO SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L CONTRACTOR Bryant Htg. Nod' 286-1141 + _ ADDRESS 1350 E. Las Tuna 221751 CORNER CUTOFF YES ❑ NO ❑ 8 CITY SanZDA CILCASS C-20 ySEE REVERSE SIDE FOR SPECIAL APPROVALS � TION OF WORK a r z NEW AREPAIR DEMOLISH I SQ. FT. NO. OF NO. OF CK SIZESTORIES FAMILIES USE OF STRUCTURheat COOL uIlit SIGNATURAPPLICANVALUATIO00 APPROVALS DATE IM•FECTOR'• •IEMATUR P.C. PMT. 12 00 FOUNDATION: LOCATION FEE S FEE S FORMS MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THI• ArFLICATION BRACING BOLTS AND STATE THAT THE AIbOVE 1• CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL CouNTr oROINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS ■u1LDING CONSTR . I CERTIFY THAT IN DOING THE WORK AUTHOR) H 1 WILL HOT EM ANY PERSON IN VIOLA. 'noN OF THE A OF CALIFORNIA RKLAT- LATH, INT. ING TO' ME '/C N" O LATH, EXT, SIGNATURE O HOUSE NUMBER COR- PERMITTEE- RECT AND POSTED ADDRESS FINAL Z JOHN7F. LEWIS, PRINCIPAL.STR RAL ENGIN R PLAN VALIDATI GKASHM M.O.O. �,. _ PEHNIIY VALIDATION CK. M.O. CAfH 5 t3 9 9AUG13 -1 D 1 2.00' APPLICATION FOR E§UILDING PERMIT �1 FOR APPLICANT TO FILL IN (Print or type only) IJ BUILDING COUNTY OF LOS ANGELES ADDRESS JDEPARTMENT OF COUNTY ENGINEER CITY Te le City ZIP BUILDING AND SAFETY DIVISION NO.OF BLOGS. BUILDING 3 ti SIZE OF LOT .2 1-NOW ON LOT ADDRESS tom--• TRACT BLOCK LOT NO. Q �7 LOCALI NdAREST OWNER NOLLrr��8 X84/ CROSS ST. ASSESSOR ` ADDRESS MAP BOOK PAGE PARCEL /� DISTRICT GROUP TYPE ESSED BY CITY Temple Cit -. ZIP /Q� CONST �;E E i ARCHITECT OR TEL 0 C/ rl ENGINEER NO. STATISTICAL CLASSIFICATION ER MA ADDRESS CLASS NO�L_DWELL,UNITS K3 PG CONTRACTOR T L _ E ZONE MAPJ NO. f ADDRESS 2 S Santa Anita 039486 ' SPECIAL LIC. CONDITIONS CITY CUSS BI ROA EPARTMENT APPROVAL REQUIRED YES❑ NO CONSTRUCTION LEND }}.. NAME AND BRANCH BL FRC M SETBACK FRM II. FR NT PROP.LINE OF (STREET) ADDRESS s, Fi stciftcadia HI AY } YARD = TOTAL SETBACK FROM TYPE OF EXISTING SQ. FT/ NO. OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH SIZE / I STORIES FAMILIES ONE } _ DES-C-RIPTION OF WORK NEW DD E:] BLDG.S FROM (STREET) x SIDE PROP. LI ITER ❑ HIGHWAY } YARD = OlvL. FROM TYPE OF EXISTING EPAIR❑ 91-DEP. HIGHWAY WIDTH EXISUSE OT NG BLDG, Residence EMOL ❑ + APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑ (PRINT) NO , IN OPEN SPACE . YES ❑l NO CY (SIGNATUR ❑ - IN COASTAL ZONE YES NO VALUATION CATEGORICAL EXEMPTION YES❑ NO I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND STAT[ THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION BIONSD (DATE) WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CSRTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EM Y ANY PERSON IN VIO ON OF THE LABOR CODE OF TA OF CALIFORNIA ELATING TO !! 1., WORKMEN'S CO k ENSA ION URANCE. � � 1C h-� SIGNATUR OF PERMITTE AIL ADDRESS TEL. FINAL 1 IBy CITY NO. DATE / J PM MAKE CHECKS' PAYABLE TO: FEE � FE J -2 HR AVEY T. BRANOT, COUNTY ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CAIN 7 3 6 Am 1, D 4U VA-"6 - 76Ae38A CE0803 7/73 • WOR�RS'COM"T�ON DECLARATION t - hereby,affirm that I,hdve a II fartlf le of consent.to self nsure, or a certlflcatd of Worke}_t'.Corppenstlon Insurance, or APPLICATION A O R U I L D�N G P E �� i certtfled co y thereof ($ec, 300, Lab. C.) f 1i tr po r4*r TE � COUNTY-OF LOS AN¢EL f �UILDING.A--1D SAFETY 'o11cy�Jo.�D�Tz-1_Com n • Certtflbd coy Is hereby rnIshed: BU I LDI tJG ' �r FOR APPLICA T TO FILL IN. �w Certlfled-copy Ir filed wUh the coon yt�bulldlnfl Inspec- BUILD{NG 1 - JI tloh department. ADDRESS LCwFY Ipte 1 RIEST A,ppllcanT EHY � vp CR055 5T` �•. CERTIFICATE bF EXEMPTION F ORKERS' 1 . OF BIfSGS • ' 1. : QOMPENSATIQN•INS U CE SLZt OF LO 6 O. oN LbT MAP BOOK' P PAStCEi This section need trot be co leted If The permit.Is fot one rAW iundred dollar}{;100).or•lep y TRACT BL LOT NO. D r ce�tlfy ihtrl In.}he performance of the-work for which Thiq TEL z 5PECIAL IL OWNER _NO. _ 66IC ONS 0 4rmlt Is Issued, I'sliall not employ any Person In bny'manner ADDRESS 1 i GROU TYPE FIRE BY {(J o as,to becQme subject to the Workors Compeniatlon Lawt. /� CONST. TGNE late bppllcgnt CfTY ZIP- STA TION - APF. CONDO. NOTICE.TO APPL-ICANT: If, after making this Certificate of ARCIifTECT OR - . ,-' - TEL _ xemptlon, you should become sub(ect fo the Workers' ENGINEER �' CLASS tJO. DWELL UNfTS' d' :ompgnsatlori provisions of the Caber Code, you must forth - SEWER MAP vlth �omply with such.provlslons or this, permit shalr be teemed revoked. CONTRACTOR St30.2 •`' UK VALI—� DARO . LICENSED CONTRACTORS DECLARATION • LCC hereby.affirm that I am Ilcerued under pcaylslons of Chapter 9. RESS.S. 9 NO. VALUATION commendbg with Sedlon700D)of Division Sof the Business and �C CIS 1 Yo.fesslons Code,and my ilcerne Is In fulr forte and effect. f 11 \ 14 _ CLASS �- 5(]. tJO.OF NO. OF CHECK, " Icenze Num LIc.Class SIZE STORIES FAMILIES ONE P ` - EW ❑ S 5 on}racto Da}eI■�. DESCRIPTION OF WORK ] I.arrr exempt from'.the licensing requirements_as 1 am a ADD licensed architect or a registered prof" lonaE engineer. kTER.wfj FlHAL j Q acting .In my professlon'pl capacity. (Section 7051, Q �TFz�R}� n DATE 7 -7-Z? — Buslnets ohd Professions Code). PAIR 4-t iSfNG 61DG. WI �.. DEMOL � RNAL ' By 1p.or Reg.No. Dgte� APPLICANT TEL OWNER-BUILDER DV_[AI ATION INT C?C�tC --NO;� i hereby gffirrn that I bm exempt from the Contractor's License ADDRPSS `�j r 9w for the fgllowing reason (Sactlon 7'031,5, Buslne}s-qnd l7b 'rofessions Code-):, l - BUILDING- I, as owner 9f the �operty, or my gqtnployees with ADDRESS . Q 5 A wages as their sold-�oMpensation, 4rtlldo tba,wgrk and tbs�tracture Is not Infended.or offered for sale.(SActidh LOCALfTY 70.44; Business and �rofesslons'Cbdq). Mb1/ING TEL I,a;owner of the.prop" bm exclusively contrtkting C 2,'.-,l f4 o Q With llcensed,contractors td construct ttre Ajait (SesADDRESS - 4IbF 3-044, Business and Professions Codej. ° s 2�0,6 CONSTRUCTION LENDING AGENCY SET BkEQU ACK YARD. 1-IWY TOTAL saTeAac pTM ~0 31,0.9'=8 2 hereby affirm that there Is a conitructlon lending agencyfo} FRONT • he performance of thd'work for which this permit Is Issued P.L. - Sec. 3097, CIV. C.): SI P.L. .erlders Mame _ .ender's Address P.C. Fri L PernIt roe certify that I -have read this appltcatlon and state that the Issuance Few tell rbo4a Iriformatlon Is correct. I ogres to comply with all County InvKt on Fse lydlnances and State laws rblgting to building construction; Total FTs �1 Ind.hereby authorize representativ.es gf this County to enter rpo abovo-mentionad Pr rty for Inspec'flon purl p es. u f®'RIvim IbR DutANATQRY LA'N6UA04 t Signature of Applkant or Agent.. ,+L~-Dante` COUNTY OF LOS ANGELES TZKPLE CITY f 0508 BUILDING PXRMIT DEPARTKICNT OF PUBLIC WORKS 9701 IJB TQ7D19 ALTRR&TrIOH/REPAXR BUILDING AND SAYETY / LAHD DYVZWPIDaT TEMPLX CITE CA 917EO BL 050E 0617130037 PECNZ. (676) 785-0488 EXT: LNGAL IDS KO. OF CONST BUILDING ADDRXSSt TR. 15683 LTA 88 SQ. FT STORIES TYPE 5133 CAX3CLLIA AV STRUCTURZ. 77 VN T33P CA 917803856 ABBEBBOR INFORMATION YW®EHE NXIRM:BT CROSS STRiYt: 8589-013-010 THOMAS PAGE, 597 A4 LOCALITY. TE}[PLN CITY, C TXNAYT: EAST BLDG USAt RESID USE ZONE: R-1 ISSUED ON: PROCESSYD BY. EXPIRES ON: IXIBT OCC GRP. 17/13/06 ox 17/08/07 OWNXR: TIL. NO: BLDGB. NOW ON LOTt VALUATION: 1 DATE FIIAL BYE CODE. LIE BETH ANISITYH Irl" (676) 780-8731- 6,500 5133 CAMELLIA. AV TEMP 917803856 YEYB' P1ID DESCRIPTION OF WORK T/O RYROOF HOUSE G lQ2AG3 3319TALL M WM LIVE TILL VILLA ICBG PIR DESCRIPTIONi QUANTITY: UOKz AMOUNT: IR 7656 5.E LB INSTILL BUILD IIP MODIFIED ON FALT ROOT ARRA APPLICANT: TEL. NOz AM[Bg RODARTE - AA BLDG PERMIT IS91MNC Z 77.75 AC STRONG MOTION REBID 6500.00 VAL 0.65 SPECIAL COIDITIOYS. D7 PERKIT W/O RN-HC 6500.00 VA.L 166.70 TOTAL YRHB 194.60 COITRACTORi TEL. NO: APPROVALS DATE INSPECTOR SIGIIITIIRE SU99HIME ROOFING (567) 860-1896- 516 N. DIAMOND BAR BLVD. LIC. NO LOCATIOiN AND 8ETBACI9 DIAMKWD BAR CA 91765 755176 BOILS ZVGINEXR APPROVAL AR.CCHITXCT OR XNGINSEY: TEL. NO FO�ATIOY TRENCH FORMS LIC.. ffO: SLAB UNDXR FIAOR RAIBID FLOOR YR]MING MAP N0. SEWER MAP BOOK. PAGE: FIRE ZONE: CMP. II3IDERYLOOR INSULATIOiN 144B769 3 01 FLOOR RRMATHING NO. OF FIMILIXB, DWELLING UNITS. APT CCWD: ST1T CLASS. No 71 ROOF RMU THING SCHOOL WITHIN HXZ RD0US SHEAR PANELS AIR QUALITY: 1000 YSYP KATCRIALS YO NO NO FRANK INSPECTION RXQULRID TOTAL SETBACK FROM EXIST FIRX SPRINKLER HAYGYRS BXT BACK YARD, HWY: PROP LIKE. WIDTHi FRONT PL- IKSULATIOY WEATHXR STRIP SIDE PL- INTERIOR LATH DR7WILL XZTNRIOR LATH RATED YLOOR CXIL ABSEM. RATED WALL ABBXMBLIXS RATIM SEXYTB OPENINGS T-BAR CEILINGS LOT DRAIIALE EXPORT ID: DPR261 ROUTX TO. B90508