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HomeMy Public PortalAbout5145 CAMELLIA AVE_Building__ DEPARTMENT OF BUILDING AND SAFETYAPPMCATION FOR PERM" �®I N G ES COUNTY OF LOS ANGEL WM. J. FOX, CHIEF KNGINKXt FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY Dle'fRICT,NO. FLAN CK. NO. PERMIT NO. BUILDING i/� J / r03 7 ADDREp `T 3 LOCALITY RECEIVED SY DA [OF APPS DATE ISSUED NIAR[ST CROSS ST, SUIL.DING AD D REBS OWN SR / MAILLOCALITY v ADDRESS NKARKBT CROSS ST. L, TIL CITY %e, NO. `g FIRE NO. OF TYPE GROUP ARCHI CT OR Tm- ZONE PLANT [NGINQR NO. BLDG. O D. NO. I ORTBACK LIN[ y wDDR[Sl APPROVED TEL SY DATE CONTRACTOR NO. US[ APPROVED ZONE A BY DATI ADDRESS d. HOUR¢ NUMBERING i LEGAL LOT NO. BLACK MAP NUMBER 1 I 1 DESCRIPTION FIE D CHECK EY I TRACT NO. ARSIGNED NY--t-1 C-- r, TE NO. OF BLDGS. CORRECTIONS OIZI OF LOT NOW ON LAT C US[OF NO. OF 11 XXISTING■SDG. FA-m u[S DFBCRE TION OF WORK � 7` n /t/ r i w 3 - -J' NEW ALTiRATION I ADDITION REPAIR DEMOLITION 7] SQ. FT. NO. OF / 0 SIZI ROOMS / STORIES z EXT. WALL ROOF t' COV�ZING G�{f-' COVHRINO ! t� I �' US[OF OTRUCTURX r it A"ROV 1 INSP R'S SIGNATURK DAT[ 1 H[RKSY ACKNOWLKDG[ THAT 1 HAVE READ THIS AP- FOUNDATION, LOCATION I PLICATION AND STAT- THAT THE INFORMATION GIVKN IS FORMS, MATERIALS / 1 CORRICT. 1 AGRZX TO COMPLY WITH T'x[ CORRECTIONS LLST[D FRAM[i FIR[STOPS, HEREON AND WITH ALL COUNTY ORDINANCp AND STATS BRACING, BOLTS LAWS REGULATING BUILDING CONSTRUCTION. FURNACE: LOCATION, e V[NT GAO , ' ` SIGNATURE OF i DUCTS f F[RMITT .• LATH, 1 NT. ADD LATH, EXT. v �� AUTHORIZED AGT. PLASTER, INT. 79A06A• DO" I0-00T. C. # m FQ �- PLASTER, EXT. VALUATION FQi # 7.- FINAL Or i ..WpRKERS COMPENSATION DECLARATK)N hefebyaffir�ncar that I have r cortifiwidomp of lion Insurance,to >ef, A P P L I CATION O�R, BUILDING P E RM I T "insure, or a certificate of Workers' Compensation InWrance, - •. or a certified copy thereof (Sec 3800 Lab. C-) innj� ELFE . COUNTY OF LOS ANGELES- BUILDING AND SATY . Policy Nqr� — pa UrJ ' . . ® Ceitlfled copy-Is hereby.fumished. -rOR APPLICANT TO FILL IN PDDR ❑ CAE�rttfied copy is filed with the cqunty bulldirtglrtspec- BUILDING .s �i/4;h� } /� tion department. " ! . ADORM Date 'z Applicant Old CTT1' -f 0 t"yZIP LpGLl7j NO. OF rFA�ST CERTIFICATE OF EXEAAPTION.FR(j!N WORtCD2S.' SEE OF tOT' 6O x � NOW ON LOT CROSS ST. COMPENSATION INSURANCE ASSESSOR Cep -(This section need not be completed If the permit Is for one TRACT '14 t-OT MAP BOCK'' �cl d / PAC /3 PARCa �� hundred doNars ($100) or less.) �,y� V (I r!� NO. USE zOtE NIP 1 cert that In-the ffY performance of-the wock.for which this ),l l SPE{7AL permit Is Issued, l shall not.employ 4rry o In any manner ADDRESS /Tr. F .� /l ., —� �m ONS to as to bdgome sublect,to the Workers(CCompensatloD Laws O -.. -IrCITY �`I P Z1P - U APP A��ORL NOTICE TO Date APPLICANT: If, wafter making,this Cbrttflcate of ENGINEP DISTRICT GROUR �T ZIP PROCEsSH}BY • O Exemption, yoq should become sublect to The _Workers Compensotlon provlslons of fhe Wbgr Code, you must forth- ADDRESS O. with comply-with such provisions.or this permit shall be {( /�J/ --// - STA-nSTICAL CASSIFIC4TK)NN APT. Cb�DO. to deemed revoked. _ CONTRACTOR ' \ (it77t�s(, IncI �) Z LIC0 SED CONTRACTORS DECLARATION -7 b/ CLASS NO. cp-/ Hal UNITS cl1 hereby affirm that I am licensed under provisions-of Chapter 9 I NO.S Q (� SEWER MAP (commendnp with Se4tlga 7000)of Division 3 of the Business L� 4 Q _ andF'rofessloru Code,and Trty II Is IF full force and effect. 1/ 'f 1J � G VALDATFON y� Q SQ. FT. �7 ,/ tJO. Of tVO. OF C}iECX rLJcense Number J fV ( 11c Class Sig �/1 T STORIES FAMJUES Ot'E VALUATION El Contra �� ` C�/LS�.• NSC.nate y — DESCRI"ON OF WORK NEW ❑ 019 ❑I am exempt under Sec I—I ALTER 0 B.BP.C. for-this reason BR 116�9 AIR ❑ rk*tb: Dom(STING G� rjfiW DEMOL ElS I g f1at u re APPLICATff TEL, _ OWNER-BUILDER DECLARATION 1 ''v (�P�eNO. DATE Z-1841') 27 I hereby affirm that I am exempt from the Contractors License ft�lf�e—,061 "YA- /}��L. ��4a, Law for the following Teason (Section 7031.5, Business and ADDRESS e 7/ RNAL Professlgns Code): PPISIENT By �t ❑ , ds owner . o BUILDING /!t-s C��3,/1 •L �� Iof the `• I pr pprty, .or my employees with ADDS wages as their sole compensatloh;will do the work and -� thestructure Is not Intended or offered for'sale(Section LOCALIFY , 7041, Baslness and Profenlons Code. hk�r1NG '. TEL _ JL El❑ 1, as owner of the,properfy, am exclLslvely contracting CX]tJfRACTOR �' }��r Q ]JLf 05.L with licensed cgntractofs to construct the project,{Sec- ITM tion 7044, Business,and Professlgna Coc}e.) 1 , CONSTRUCTION LENgING AGENCY YARD' HWY FROM - I.hereby BfRrm that there Is q construction lending agency for FRONT WID TOTAL 254 . -14 the performance of the work for which this permlt'Is Issued P.L (Sec 309 , Clv, C.). SIDE P. � 'l.endw'sName rC. r P.C- Fee . Perm It Foe, LDMA Rsf. I - Lender's Address 0 I certify that I have read this application and'state that the kluanp F+e o7 LDMAP/C.b above Information Is correct. I agree to comply with all County tnwasXgation Fse.• :+S6c 1 A► IU:21 ordinances and State lows relating to building construction, Total Fe* �D LDMA Perm. and hereby authorize representatlYes of this County to.enter lyrgn a above ed property for I on pu � . j r Z — 2— IM tTiVlfa'ttOR DMLANATORY.LAHOUAG4 ,Slonaturii of'Appllcont or A eht Dan APPLICATION FOR BUILDING P RM FOR APPLICANT TO FILL IN (P,Ini or ivaG «+Iv) � �ry BUILDING" COUNTY OF LOS ANGELES ADDRESS DEPARTMENT OF COUNTY ENGINEER CITY ilP BUILDING AND SAFETY DIVISION NO.OF'BLOGS. BUI�.DING SIZEAF LOT NOW O.N•LOT /f ADDRESS . = TRACT BLOCK LbT NO. v �OC.,LITY TEL. NEAREST OWNER- NO. CROSS ST. ASSESSOR ADDRESS MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE PR ED BY CITY . YIP CONST. , ZpN1, ARCHITECT OR TEL. AJC ENGINEER NO. STATISTICAL.c IFICATIO 3 ER MAP ADDRESS CLASS NO DWELL.UNITS BK PG CONTRALTO TEEZ MAP LIC. NO. NO J SPECIAL LIC. CONDITIONS C I T C LA 35n RO DEPARTMENT APPROVAL REQUIRED YES NO �--1 CONSTRUCTION LENDER NAME AND BRANCH BLDG.SETBACK FROM FRO14T PROP. OF - (STREET) ADDRESS CITY FIIGHWAY' + YARD OTAL SETBACK FROM TYPE OF EXISTING SQ. FT. NO. OF NO. OF CHECK ONT PROP. LINE HIGHWAY WIDTH SIZE 8TORIES FAMILIES ONE + _ DE S-C RI PT ION OF WORK NLEW ❑ DD ❑ BLDG-.SETBACK FROM - , SIDE PROP.LINE OF (STREET) O CD AL TER HIGHWAY + YARD = OTA SETBACK FROM TYPE OF b(IDTING EPAIR SI PROP, LINE HIGHWAY WIDTH W _ h USE OF + Z EXISTITINOEMOL qG.' AP # TEL CORNER CUTOFF YES . BY (SIGNATURE) IN OPEN SPACE .YESq .NO � IN COASTAL PERMIT ZONE YES NO VALUATION`,,► " I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY - WITH ALL ORDI-NANCES AND LAWS REGULATING BUILDING CON- _ STRUCTION. IC THAT IN DOING THE WORK AUTrORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF -CALIFORNIA IN RELATING TO WORKMEN'S CO MPENSAT INSURANC[. SIGNATURE OF (PERMITTEE ADOR 49 o4 ! TEL INAL L/!1 C LT Y N O. E MAKE CHECKS PAYABLE TO: FREE � FEE,P HARVEY T. BRANDT, COUNTY ENGINEER PLAN'CHECK VALIDATION CK. N,o. CA„4- _ VALIDATION cK CASA 91 .7-7 9.JNN 76ASMA ax* o3 5/719 ...2�4. �'� -1 2-.O 0 A98 WORKERS'COMPENSATICHJ DECiARATION ` I hereby affirm that I havecertificate consent to self APPLICATION FOR BUILDING P E ISM I T Insure, or a certificate of Workers' Compensation ation Insurance, or a certlfled copy thereof (Sec:3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING Certified copy Is hereby furnished. FOR APPLICANT TO FILL IN ,,,mom �¢ Certified copy Is filed with the county building Inspec- BUILDING tion department. ADDRESS !7 Date Applicant CITY ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.C?F NDG& p ,¢ COMPENSATION INSURANCE SIZE OF LOT q' NOW ON L ST. (This section need not be.com leted If the permit Is for one - TRACT O BLOOC — LOT NO MAPF PAGE PARCH hundreddollar ($100)or less. 4?7r,W41MI10" USE Qt E I MAP I Certify that In the performance of the work for which this n ND NO. permlt Is Issued, I shall not employ-any Person In any mapper /T � /� S?, �S so as to become sublect to the Worker Compensation Laws. . Date Applicant CITY PIT ZIP NOTICE TO APPLICANT: If, after making this Certificate of ARCHffECf / tt o DISTRICT TYPE RRE ftBY O. Exemption, you should become subject to the Workers' �/fCONST'/ t3Compensation provisionsof the Labor Code, you must forthW610 /9 }} JJJ �/ w with comply with such provisions or this permit shall be 0.: deemed revoked. To- STATISTICAL C=D�YELL APT. Z CONTRACTOR z LICENSED CONTRACTORS DECL.ARAWN Lir, CLASS NO. UNITS I hereby affirm that I am Ilcinsed under provisions of Chapter9 ADDRESS NO. ((�commendng with Seitlon 7000)of DivWon 3 of the Buslnes and LIC. SEWER MAP Profeslom Code, and my license Is In full force and effect. CITY CLAM BK PG. VALDATFON SQ. Fr.I3 NO. OF NO. C CNEGK License Number LIC.Clm. SUE CJ STORIES EAMES C E #�9 9.`a O _ V TION oa,ao DESCRIPT'ON OF WORK I - 33597 Contractor Date ADD _ I am exempt under Sec mfr"�" ' ALTER , e - 33597.6 B.BP.C-'for th is reason 2 F ( REPAIR : �/ Y 0621 -88 DO1°' USE OF DEMOI SUSTIING Signature APPUCA TANAL OWNER-BUILDER DECLARATION PRI DATE I hereby affirm that I am exempt from the ContracYpr's Llcense Law for the follovying reason (Section 7031.5, Business and ADDRESS IFIN41131, \� Professions Code): lily BUILDING I, as owner of the property, or my employees with ADDRESS wager as their sole compensation,will db the work and the structure Is not Intendd offered eor oered for sale(Section LOC411TY 7044, Business and Professions Code}. MOVING TEL I, as owner of the property, am exclusively contracting NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY YARD HWY PROP. LINE WI I hereby affirm that there Is a cpnWuction lending agency for FRONT the performance of the work for which this permit Is Issued P (Sec 3097, Clv. C.} SIDE P.L. Lender's Name LDMA Ref. tY Lenders Address P.C: Fee Sc ► Permit Fee ' I certify that I have read this application and shah th¢t the lruonce Fee P/C# Q above Information Is correct. f agree to comply with all County Investigatlon Fee ordinances and Stat laws relating to building construction, Total Pee LDA1A Perm and hereby authorize representatives of this County to enter . f upon the above-mentioned property for Inspection purposes. M RfVMU KM DXPLAMATOW LANQUAW Signature of Applkartt or Agent Date WORdiry COMPENSATION DkIARATK)N .� -1 hereby affirm fI at I haver .iWt+ff� of consent to > If e, APPLICATION ._ . .F O R�� 1 l�I LDI'N I PERMIT . �• fruuro, or p ceitlfrcate of Workers'.Comperfsatlon Insurance, .._ _ or a'certifled copy thbmof (Seo 3NW!" Lnit C) C'OUN II;OF LQS AH6•ELEf. .SWLDING AND SAFETY Policy No. Cofn'pany BUILDING. ❑ Cer�ffled copy is h"by fu hi d, - FOR APPLICANT TO FILL IN ADORL35 .�)�l�� ( >�'j(r'w A - ❑ CertfflecF.copy b`filed with the counfy_bal(ding:lnzpet- BUILDING _ . .� M Ayr . flon deparirtlAnt. ADDRESS1. t3ote .Appll68nt, t3Ti` IQLff ZIP aCJ LOCJUJTY. _ v ✓� w A CF�2TIF.ICAT> OF EJ�AAMPTION_R20M Sf7�f5F Lbs T Ow ON LOT COMPENSATI QN INSURANCE (7hI ibctlon need.not,be,tom letASSESSOR ff th>¢permlf'ls for orfe S6� BLOOC LOT NO. PAGE• PAR(g �Q hUndrea dollars (;Ibd)br letsa BOOL(;- owr AUW A1# No. S 1 certify that-In,fhe.pbrfotmgnta,of iho-work for.wblda'thks , pqr It is Issued,'].shall rtot emplgy ar4y person �n any manner ,r.mpf NLUA_ A- &:,. / mp{ so as-to bgFome kyblod tgthe Workoti! Corhpensaflon.tavt 1.-v r-: Cry /feteevnP c4 o. Date { ;'Applicant. OR TD_• DI P TYPE NOTK:F.TO AJSPlItAW:.;K,,after:rr;dktng this: (—---of' - f3JNNEER NO. c' TYPE E O Exemption,. you should, b"me .subjed to the '.1N . or Compensatloh provJslormpt;The Laboe Code, you mU#firth- - ADDR wlth ctbmply with--such}..provisions or this permlt.'shall be: STATISTJCKQASSIFICATfgN, AFI OQtDO. dgemed Sevoked. *. - — _UCU SED,CONTRAGTORS DECLA�ATIOW. Y UK_ QASS NO: PWHI- UNfTS -` I hereby Arm'thot a am IIcdnood ur4er Provisions of C hupw 9 ' SEWER MAF - (commgncing with Sectloo'700Q)•of Dlylsloh 3 of tho'Busingss _ Ly_ V Y QAT}Ori' and Profes4lons Coiib,pncJ my:llcer> fs( full#brc�and effect. _ a°ES,- BK. ' S4. F F. NO:-OF NO. Of~. -CI JKX T f kI>Qr" N'm 1pir .''.° •' .. -�' i� 'g ass:. , SITE MES FAMILIES ONE- u, cof;,r4�tar s'G * r hilonD w C� ❑. �S a - Co :n Ej -am exempt under Seu "} t�-� lb �Je IV/1U>4 !',frL A n ADO Noll. ALTER , B.&P.G'for tlals r*asank Ki d,t�. �±044 USE OF 1L��-t ; - safe: DISMOL LI ter, _Signature T� �. - ; OWNg2-BUIED6R DECLARA710NV. FIAT!+ I h"by.affirm that r'am exempt from thq ConlracTods Llcenie 7'r a LaFfligna..Cocle The�foIIolMnq,reasprr{Sect n;7031.5; "Inau qnd'.,. A HNAL. Pr )::.'. . _ �, as ov+mer• of the property;'or my employees with q Ips 4`�. KCT L , .. wages asthelr blerompensatfon,'will 0L--,the work and the sfrcdure,Is.not Intended or offered for sale fSedion - LOCAkrry e'r / Poo � 98.63 , 704 , "Them and�rofessfaru Cddb:) MOW 4" TEL ._ _ _ _ I; an oyvCONTRACTOR NO; ner.ofthe property,:am exclusively tontracjing 1 ITEMS _ with Ilcgrlped-cgnfraatofs to,consfruct to_prolecl,(Sec- ADDRESS - _ _ _. Tt�TAL tion 7044,'�uslness-and Professlons.Cod*.). ' CONSTRUCTION LENCSINC�ACEN YARD .REQUIRED FROM - .. ,_ { .1 hereby afflrm that thsit q Is a construction lendlrp:agency for -the perfo"ance gf,he work for.which thl#'permlt'ti iswed P. (se- 3097, ay. C), SIDS P.{. Lenders Nami 0000-M1 '11Y 4/K nAdcrs P.C. FM permh Fos X7 .Lendsirs - I certify that I have read this application and state that the 4 hax7ncs F« . P/t 1 " '•< s b, above Informatlon Is correct..I ogre to comply with all County lnvMtlgatrorr. �//� { - ordloancers-anti Stale Idws,r4f atlno to•bulldrhg construct on, Tolul F« ' LDMA P. . small—by authtirize repr n Ives of this C66nty to pnter L e a efilfohb7J InspectI rip r f fO RlfVrt'Jm FM DQLANATbRY LAI1GOAdl M 11s . . - r .. ...f_ ,- - Sigrwt"of'Applknnf or Apenf' Da» tWORKTRS'COMPENSATION DEaARgTION " t "I. kwreby afirtfi that I have a certQome of rllbn int to ce, APPLICATION FOR' BU LIllNG-PERN,IT '(M.yro, or a�erttftca#e of�(Vorkers' CornpensaTlb� InwSance, . - - . .. . .. " 1 r q cWWIed copy thereof ($bc.-3800 Lab. ) ... .. . - T�C �J SND COUWN OF LOS ANGELES -Bl11Lb11id AND SAFETY Policy Noj � nlpany /,/' (�_ BUILDING Ceftr'fled copy Is hereby,furrilshed, FO APPLICANT TO FILL IN gppl Caeffied copy Isfi led wlth the gountyrbulHIN Inspec- BUILDING tlori department; ADDRfSS " Dates Appllcaar,I /l✓G�na)7 ,Tio o C7 FryM� ZIPy 4o.,OF%DGI, NEAREST CERTIFICATE OF E MYON•FROM WORKERS' Ste. LOT �7f/�r = NOW ON LOT CROSS 5T. - QO7tAPENSATION INSURANa 1 L (This•sectlon need-not'be;com feted ff .the permit is for one TzR 11 BL LOT 6 �yygp :d p hundred dollars{$100)br less.. �JTEL +L �. NO USE ZONE �I certify thortAnthe perforrrionce of the wont for which thts �f _ SPECLAL _pgrmlt 4 lyued,)'shgll.not.gnlploy-or,y person fn arty manner .. ADDRESS lcot4DMONS p as to become sublect to the Workers'Compensation Law' O CrrY (.C.. -ZIP - U OG Date-, Applicant +� DISiW GROUP TYPE FIRE PRO�SSEDgY NOTK:E•TO ,A. ICANT:•'ff; after.maklnq thh Certificate .of CONST. ZONE Exemptlorr, you .should bbcorrle wbled .to the Work&W f� r Com nsatlon, ovisto of the Lo yo ' • ""' Lam/ -� . ✓ , pe � fts bar Code,. c must forth- ADDRESS- i with Comply ,with suoh pfovislons or..thla permit shad be141 ST-�TISTICAL.Q-AS&RCa4TFON ;APT. OQt.DO. .. cn deemed revoked.. CiDrKLG _z } CLASS NO. us ICkt:�,CONT A70RS DECLARAVOK f� S^'t #r tK- I hereby affirm that I am licensed under provla4oruof Cbaptsr 9 Q - ' • 8 t (Fommenciaq with Sbetloo 7000)o$E.Divislon-�'of the$usingas dC //� and Professloris Code;and my Ilcenid Is In,`full fgrce and effect. �' a+` BK PG. (o . V - 1. 1. OF NO. Of 4ECX _ s�+ [' Q L - ticense N'U'rbW, �y/'�,y, ��� LIG CkTss I STORIES FAMILIES YALUATFON. contrc?�t(c F�Inc Of WORK NEW = i!'+ �� rY�•�•I . t. ❑I am exempt under Sec ADD , { ALTER r�r t T 1 C]F=r B.&P.C, for ibis mason /-S REPAIR u $ , Dete: . a eiDo: = REPAIR Q '��L17�rr+i� �1 1t�49 Signature APPLICANT Ta .J FINAL OWNER-BUILDER DEC1ARATIO" NO. 7 L 1 hereby affirm that I arrt exempt from the Contrectoir'slJoense ADDRESS DA7i for-the followlriq• reason (Sgctioa 7031.5, Bdsineri anti �9RAL'' Professlo. Code — ` I, as owner:of itis property, oe.my employees wH(i �111LD1 # `�,(� G �, Ct-C EJ 1 if�/01 wafles ga th?lr.sole compensation,will do the work'and ADD , 422 1 1 M�{� the sltucture 1 -pQt Intended ' offbred for sale-(Sectlon • OC�1lTY TEL \., , ' -•7044 Business and Professions Code,) ;r I, as o�vner,ofthe prgperty, am exclusively contracting CONTRACTOR NO. i y with licensed-contYBctors to'conittryd the,-prolect4Sec, � , RESS tion 7Q44, Business and Professions Code.) i TO AL r. .CONSTRUCT IINI)ING AGENCY YliTtD FMK I hereby cfflrrA that there is a co ctipn Iendingagency for FROM the per ormdnte of the wgrk for which thh-hermit-L+-Is ued ' .L'. � ... (Sec 3097, Cly. C ). SIDE P.L Lender's NarAp P.C F" CO Rerm It Fee r a Lenders Address . 1 Certify that (.have read this application and state that the Issuance Fee ` LDMA P/C. '. above Information fs Correct. I agree to aoroply with all County fhwdlpatlon Fr,q / �y� _ L ordinances and State laws roj lgting to bulldlN construction, Taff Fie. b . a and hereby authorize repcesentativbs of this County to eater u e bove-mentl ed Property for Inspection prhpdsea C)-- $U WMW Mg�LANATORY LANGUNK F Sl/arrw�t ra off Appl oohhtt-oor Agent' VJQRKLRS'COMPETJ�4TION�&-CIARATION I hereby c-a certificate c t I have a,certCome ni corn'lrm-toiself PPLI_CATI 1�^. FO R ,�VALDING �R�AIT insure, or a certificate of Workers' Compensation Iruufanw, I' or=a bertJfled'copy thei-of (SeG 3800, Lqb. C:) - • COUNTY OF LOS ANGELES BUILDING AND SAFETY. r, Policy No. ;_Company. - " Gbrt)fied copy Is herebyfumlahed. FOR APPLICANT TO FILL-IN �ADp� certtfied•cbpx Is filed with'the county'bullding fnipec- BUMDING 'flon'd6partmaht: ` ADDRESS YM f iDate. Kppllcant y„ CITY -- - --- - LP D' LOCALITY - CERTAtATE OF E)M PT16N l`R0A WC3RRKERS" NO.OF-BLD©S. - - NEAREST-- ,':, `.'CQlVW�NSO4T10N INSURAIK� S17E OF LOT moi. NOW ON LOT ST. -T IK r{bttfb'n"need nbt be-completed if tho permit is for',on - -- - rr f ,lwndre4 do,ao (VQO)or.a. ) ' p : TRACT BLOac LOT No. t PAGE PARCH 1. If'rpttfy'that In-We' performance of the'work for yrhlal�ythb OvVr>ER permftls,lssue� f shall not employ anx�sph In any manner _ _ ADDRESS _. _ SP.EGTAL _ .... . .. _ l }ct,a#`tU rrie wb(ect To t}ii Woifcert'G`o'rti' nsatfdd'taw✓f. a Dbtb'r 1lpplltanf. N(JTI, O APPLJ,CeANf: If; after.+Fnaking ih CerttFic&te.af ARC�IITECT OR TEL DISTRICT._ P TYPE__.- . . . . SIRE_ BY. Ekempt,on,`you:'shbuld bei oin'e subject to the Workem. COt6T. Gompehsatr6h•#ovlslons•of the iabor`Code;•you must•#orth c Y ✓ c . width, oompIy,.with 4Yucfr provlslbrm.or this,.permlt &ball be`.- ADDRESS deemed rpJoked: i•n.:', STATISTICAL C1A9SI TKkJ: AFT. UNDO. No. LICSN.SEA cONtRACTORS DKLARAT)ON • ' - - - - -- ----- DC CLL55 N0.- -DWELL UNITS L1,Qreby affirm I am�IG*ruad y{fdgr proylsldns of Chapter 9 ADDRESS NO, t ((�pPPmmenc wt i Secilgq 7000 of Ivtsion 3 of JIM Bualness and _ SEWER MAP i rr•.: i -.,..,'.' Wefeeiloru�Code, qnd my Ilse�s¢}►.In full force and 9��(act -. - (37y - - _ r -- - -- -- - - I - {- •-- Y. i ,[.'." - S - aK. Iii. Llcinsr N mL =? - F Contractor ; I _ ADD �.Fam exempt under Seca - �- - ALTER. B ip.C_ for this ritaton, FAIR - - - - Ddte:-- = vsE DUSTING BLDG../ "- Q DEMOLANKibkNT Slgnaluro = -- - n`1 `f`T e/ /` FKAL I OWNER+3JJILDER DECLARAT}ON l J[ • _y_ _ _ - I h�rebyafflrrrifhat lam-sxempt-from the ContractoewUcense L¢w for the followln>j:te8'sorii(Settlo'r-7031.5, Busine&s and �:- "Pr¢feiilolSt'Code :. -.. - - - 1 as owner of tlae ��NG ° 9 ° °.6r property or my employees with ADDS_ °'.-02 . -- -- -- — TT - -- - -- - wa4ei as their sole compehiaTlon,will do the work and -"- r the stnrcturo Is not Intended or offered for sale(Section LOCALITY h - -7044; Business and_-Profeaslorn'code� �NG' ---L --- - - -TEL : I; ars owner of the propelty, am excluslvely contracting j' OR NO. •a 7. " Qonstru t the projecr'(Soc ADDRESS - With flcensed confractors to , Pon 7044,•Business-and Professlorrs Code} ' - -CONSTRLJCTION LENDING AGENCY' _ _.. SET - YARD- HWY - �. CK 11 .•I hereby affirm that there is a conttrucfion lending agency f« T I Ao ,11`ici I . rthi perfbrtnance of the woHc-for• which this permit Is Issued - -P L-- - - _ . . :.- _-. . _ _ -- -- --. -,' --.- ----•--. -. -:- _- _ ___I -, --- _ •, - �•3097, Cly. G Slpf , B ... �. P.L. `. 1 Car< s Name g _ LDMA t Lenders Address:- - — - P.C_'F�e 5--. - Permit Fee -I.cedlfy ttwt-I have read this application and state.that the -- — _ ._. __. - Issuance Fee fJ V LphWiP/GM- -_ , --•--- above InfomxMon is correct. I agree to campfy with all County In- Fee -- oi•diogrtcee Pro 5".'1aY,*xeIG.tiPg.tQ kLul(dir19 wDstruct(Qn, _ S ,• ni < ' ffee and hereby authorize'repreeentatives of thls.County to enter TotaLDMA-Rwm. /--- — _upon the above--mentiproperty for.inapectlon ». _ _ _ --- -- ----. _---f _ --- I ^ fd RFVM a pt DUMLAMATO[Y 1.ANGUAo41 j t - ' APPLICATION FOR wi-DING PERMIT COUNTY OF LOS ANGELES BUILDING; AND SAFETY WORKER'S COMPENSATION DECLAMATION FOR APPIJCANf TO FILL IN r A�� I hereby affirm that I have a certificate d ,t b Goff t,erie, I I�cLLT fl��f or a owmicate d Workers' Cai pwmetlon Murano,or a-df%d l copy mored(sea 3800,Lab.C.) CITY pLlf- C'_T7 zp- 1 - LOCALITY Pc&cy Na compam SLZE OF LOT NO.OF BL.Do MOW ON LOT Q Certtned tippy b hereby fumhhvd. W-AREST CROSS ST. ❑ CerttW copy is fled wlth the county bur g Inspection TRACT BL1 LOT NO. USE ZONE MAP NO. Dabs App6carrf A38Es80R PAGE/3 SPECu,L COlariONS CERTIFICATE OF EXEMPTION FROM WORKERS' ClV � �T '� ` - � ��-- of scraoL2 TEs NO COMPENSATION INSURANCE (This section need not be coapieted H the penNt Is for one hundred ADDRESS doRam($100)or lees.) D18TR}CL GROUP TYPECONST FRE mrE PROCE BY Z3P I certify mat n the performance d me work for which this permnn ] �j�-� F Q b Iseueci, I &hall not empty any person In arty manner ab as b Ter CLTY PLE �'/1 I•T d� J` GI�{IO become etrl]}B6t t0 the W ri'A"'COimpeneaBW Laws- ARCHITECT ORE TEL N0. ST;'ITtSTICALCLTpN APT COfDO Date AppS--d ADDRESS CLABS Na- DWELL UWS NOTICE 7O APPCC.WT.- n, after makhg this Cer3fnoafe d FEOIIFED' TOU1L St�BAC'.K FROM EXtaT F_xemld ptlon, YOU d,«, beoorne iub}ect to the V4brkera' CONTRACTOR - TEL Na - SET RACK ltwY PROP LPJE WIDTH CcflXxw ation provf dons of the Labor Code, yvu must 1pr b mfr FRONT comply wfth such provk4ons or fhb permlt shall be deemed revoked. ADDRESS LIC,NO. PL LICENSED CONTRACTORS DECLARATIONBIDE CSTY LIC,CLA88 P L I hereby-afrun that I am Iiceneed rriderprwbbne•of Chapter 8 N (comng wfth Section 7000)d DMd Budan slon 3 the neas d SQ FT.SIZE a OF STORES tJo OF FAMUES NEW ❑ SEWER AtAP PO CLU Professions Code,and my 7cense Is M full force and effect, LJceree Number Lia. Clam DESCFF7"G y. ADD ❑ ' o Cordraator Date ALTER D .CJD U Lu I] I am mwnpt under Sea REPAIR El z B.BPr-for this reason E r.A DEMOL ❑ LDMA P/C+ DataUSE OebOEMNO BLqV URM ❑ APPLICANT(PWT) TEL NO. Uxf.A Perm I0. _ l a& owner d the property, or erT�ioyeee with wages as 6 K.CT.i th* Sole compen&ation, will do the work and the structure is ASS not Intended or offered for sale (Section 7044, Budnem and kNAL DATE [} �r I--�Prdeeeione (Ade.) w\1 THC APPLICANT OR FUTURE'BUIU)W OCCUFO.NT I-MIOLE A�i�ZA�JIA A1494AL / �!L'V+Ji T7 � L17..4. I LJ L, m ovrw d the prop", am exckmtvBty conbpctklg with ORA COIrOVq A HAZARDOUS WU6iU1 EOIYl.TO di tiFE�4EA TFMM THE AIIOIM$MP OH TFE HAZARDOUS►YO'BMLB Ii�OFLL4pN 011]E7 FINAL gy koreed omtBciom to cOrlatuot the pro)ect (8ecdm 7044, _ Bmlrreae and Prolesabrts C-0 r ) vas El NO El TOTAL 39 -25 NLL THE M@O® USE OF THE BUI LMO CV Tl-E APPLJ('JJ T OR Rfru E BUl-DM CONSTRUCTION LENDING AGENCY °CCLFMT A Pv�T FOR coNaTAucTraN OR►roorlcviorr FROM THE soUTH C:.EC i .yr COW AA MAANGEJ�DWRICT cecAQW off PE IL T a-EaCJST FOR I hereby affirm mat there b a construction Iendng agency for YE8❑ No❑ l the perfonnartice d tha work for which thts permit is Issued(sea 3087,Civ.C.) �a E r PWE READ ��Mr Rcourfl�ExTa 2-20-100 TFFIOUGH 2n eQ oe ANGELES COUNTY CODETMLE 2-CHAPTER 220 (y��y� ��(7 / y�p Landes Name MREA&B,REPOFrrM AMD FOR COVUN q A PEFUT F'FIOM T}f SCIR QMD. HAZARDOUS4-0 COPOCEFfANG LRM-"l 5! 2 7 Larders Addre¢& Q ,� 4993 1 Ah 8:27 I oertffy that I hm reed this applica8on and state under penalty PC FEF P17�/fi FEE perkry that the above IrdDrmation Is correct I agree to ONTOy with all county UdrW cee and SWe laws rotating b bulking and hereby a of this County tpStxNx'E FFE , m VVESTUATION FEE TOIL FEE /] SEE REVERSE FOR EXPLANATORY LANGUAGE COUNTY.,OF LOS ANGUMES 7AKPLIC CITY # 0508 BUILDING PERMIT - DEPARTMENT OF PUBLIC WORKS 9701 LAB TSB RESIDKKTIAL ADD BUILDING AND SAFETY / LAND DEVELOPMENT TMPLE CITY CA 91780 BL 0508 0509130066 - PHONEt (626) 285-0488 YZT: LEGAL ID: NO. OF CONST NEW BUILDING ADDR388: TR: 15683 LT: 86 BQ. FT STORIES TYPH OCCUP GROUP 5145 CAIEILLIA AV BTRUCi'URE, 0 1 VN R3 TEMP CA 917803856 ASSESSOR INFORMATION N WMZR, GARAGM: NEAREST CROSS BTR=!P. LA ROSA 8589-013-008 OTB3R: THpOS PAGE: 597 GIR : A4 LOCALITY: TEMPLE CITY TY@1ET. EXIST BLDG USE. USX LONE: ISSUED ON, PROCESSED BY: HXPIRES ON: EXIST OCC GRP, 09/13/05 JZ 09/08/06 COMM: TRL. NO: BIJGS. NOW ON LOT: VALUATION: D7jI FINAL BYi CODE: TTPAAR JOE L PAULINE (626) 287-5728- - 1 5145 CAMBIA AV TEMP 917803856 FEHB PAID DESCRIPTION OF WORK CHANGE FROM ONNER BUTLDHR TO CONTRACTOR BEE ALSO PERMIT PIH DESCRIPTION. QUANTITY: BOM: AMOUNT: BL -0208010046 APPLICANT: TEL. NO: ELLI= CUSTIS (626) 355-4110- AA BLDG PIRMIT ISSUANCR 27.75 524 H ADA TOTAL FENS 27.75 SPECIAL CONDITIONS: GULENDOBA, CA 91741 CONTRACTOR: TEL. NO: - APPROVALS DATE INSPECTOR SIGNATUIYE ELLIOTT CONST (626) 335-4110- 524 E ADA LIC. NO LQCATION AND SETBACXB GLENDORA, CA 91741 514543B SOILS EQG33TM APPROVAL ARCHITXCT OR ENGINEER, TEL. NO. FOUNDATION TRENCH FORMS LIC. NO. BLAB UNDER YLOOR RA-ISED FLOOR FRAMING MAP NO: BEMER MAP BO-OKI PAGE, FIRE LONE: CMP: UNDERFIOOR IWSULATION 3 01 16T LHV3L FLOOR BREATH NO. OF FAMILIMS. DRILLING UNITS. APT/COND. STAT CLASS: NO 21 2ND LEVEL FLOOR BREATH + SCHOOL MIT= HAZARDOUS ROOF SHEATHING AIR QUALITY. 1000 'FIHT MATERIALS NO NO NO FIRE DHPT. 7RAM3 INSPECT �— REQUIRED TOTAL SETBACK FROM EZIBT BLDG DEPT. FRAME INSPECT SET BACQ YARD: HMY: PROP LINE. M23YTH: FRONT PL- BHEAR PANELS BIDE PL- INSDI,ATION 1fI]►THSR STRIP ,s0 !— TN'ITOR LATH DRYMALL IITNRIOR LATH � LOT DRASEAWi SLOIS DETECTION DEVICES FIRE DEPARTMENT APPROVAL REPORT ID: DPR261 ROUTE TO, BS0508 t-- COU3= OF Lob ANGYI.E8 TEMPLE CITY / 0508 BUILDING PERMIT DIPARMIENT OF PUBLIC WORKS 9701 LAB TUNAS ALTERATION/RXPAIR BUILDING IIID SAY= / LAm DEVYIAPKKffT TEMPLE CITY CA 91780 BL 0508 0604130013 PHOQEi (616) 185-0488 HTT, LXQA ID: NO. OF CONST BUILDING ADDRESS: TR: 15683 LTA 86 SQ. TT SltORIRB TYPE 5145 CAMELLIA AV STRUCTURE. 157 VII TRMP CA 917803856 ASSEBBOR IEFORMITION NIDMBIRi NEAREST CROSS STR.ELT: LA ROSA 8589-013-008 THOIQB PAa7: 597 03ID. A4 LOCILLITY, TEMPLE CITY, C TIIANT. EXIST BLDG UBIi RESID USE SONE: R-1 ISSUND ON, PROCZSSED BYi EXPIRIS ONc EXIST OCC GRP: 04/13/06 JK 04/08/07 090M. TEL. NO t BLDGS. IOM ON LOT: VILUATIOE: F IMT DATE F INILL Bim: CODE c UTAR SUNTHORN J;PAULINE (646) 987-5718- 7,000 / /"3- 5145 CA]�IA AV J--[/' TZKP 917803856 FENS PAID D= IPTION OF WORK COVER PATIO 157 B.F. PEE DESCRIPTION: QUANTITY. UOMt ANOUNTt APPLICANT. TIL. NOi SAME >B OIINER - AA BLDG PERMIT ISSUANCE 27.75 AC STROQG NOTION RRBID 7000.00 VAI, 0.50 SPECIAL COII)ITIOES. AX BUILDING RIVIEA FIE 54.70 D7 PERMIT W/O EN-HC 7000.00 VILL 87.70 T077►L FEES 165.15 CONTRACTOR i TIL. NO. APPROVILS DATE INSPICTOR SIQIIATORE SAME AB OMNRR LIC. EO LOCATION AND SETBACSB SOILB ENGINEER APPROVAL ARCHITECT OR IIGIIIIRs TEL. NO: _ FOumATION TRENCH FORMS LIC. NO. SLAB UNDER FLOOR RAISED FLOOR FRAMING . MAP NO, SMFKR M" BOOK. PAGE. FIRE ZONE. CMPI UIDERPLOOR INSULATION XX 3 01 FLOOR SHEITHIEG NO. OF FAMILIEBs DAII.LING UHITBi APT COIID: STAT CL1H8: NO 71 ROOF SHIATHffiG SCHOOL WITHIN HAZARDOUS BHYAR PANELS AIR QtALITY: 1000 FINT MATIMMLLB NO EO NO FRAME INSPECTION REQUMUM TOTAL BETBA(3 FROM EXIST FIR. spRimiaim HAIIKaZRB SET BACK YARD: HAYS PROP LIYEt WIDTH. FRONT PL- INSOLATIOII WRATHER STRIP 83-DR PL- rnrewrOR LATH DRYKALL EXTERIOR LITH RATED FLOOR CEIL ASSEM. RATED HALL ABSEMBLIE8 RATED SHAFTS OPBNERGS T-BFR CEILINGS LOT IIRAINAGN REPORT IDS DPR761 ROUTE TOi 880508 (pl� OF LOS ANGELES TEMPLE CITY # 0508 BULLDING PERMIT DE'PAFTMM OF PUBLIC WORKS 9701 LAE TUTAS RESIDENTIAL ADD/4T/REP BIJUDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91750 BL 0508 0205010046 PHONE: (626) 285-OM EXT: LEGAJL ID: NO. OF Ccw NEW BUILDING ADDRM TR: 15683 LT: 86 S0. FT STORIES TYPE OCCLIP GROUP 5145 CAIELLIA AV: STRUCTURE: 362 1 VN R3 TEMP CA 917503856 GARAGE: NEAREST CROEE STREET: LA ROSA 8589-013-008 OTHER: b THOMAS PAGE: 597 ARID: A4 -LOCJILITY: TEMPLE CITY EXIST OCC GRP: 04/20/05 JK 04/15/06 am ;I--. TEL. W: BLD0, N0W LiDT: VALUATION: FI T FINAL BY: CODE: UTAR JOE i PAULINE 4626) 257-5725- 29,990 5145 CAMEL L I A AV I!ln TEMP 917503556 FEES PXTF DESCRIPTPM DF WOW ADD BEDROOM L 3/413ATH 362 SF, FEE DESCRIPTION: QUANTITY: UOM: AMOULT: SAME AS 9MER - M BLDG PERMIT ISSUANCE 27.75 AC .4TRONG MOTION RESID00 VAL 3.00 ; 81 PLANCHECX W/ENERGY 2990.00 VAL 501.50 B2 PERMIT Y/ENEROY 29990.00 VAL 590.37 TOTAL -FEES 1,121.92 SAME AS 06NER - - - —�--- - - - , T�-- LIC.-MO LIC. N0: SLAB/LJNDER FLOOR RAISED FLOOR FRJWTNU— lW - 91 00. OF FAMILIES: D61ELLING UNITS: APT/CCN - IST LEVEL FLOOR SHEATH No _ 21 . SCHOOL WITHIN RODF SHEATHING AIR QUkLITY: 1000 FEET MATERIALS ND.. NO NO FIRE DEPT. FM I MPECT BLDG DEPT. FRAME I TOTAL SETBACK FROM EXIST SET BACK, YARD: 'WY: PROP LINE: : WIDTH: y FRONT Pl,- SIDE PL INWLATION/WEATHER MIP EZM I 13R LATH 943M DETECTION' DEVICES REPORTA D: DPR261... ROUTE TO: Bf0505