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Home My Public Portal About5200 CAMELLIA AVE_Building__ DEPABTME, T OF BUILDING AND SAFETY APPLICATION FOB PEBMIT COUNTY OF LOS ANGELES �'VB ®� WM. J. FOX, CHIEF ENGINEER NG FOR APPLICANT TO FILL 1PK FOR OFFICE USE ONLY pp�� DISTRICT NO. CK. NO. PERMIT NO. ADDRMM ,S.2 0 "' t '13 O a LOCALITY .•1 f7w I ' RE IV DAT[OF APPL- DAT=ISSUED NKAREBT CROSS ST. ! BUILDING ' ADDRESS s OWNER LOCALITY MAIL ADDRif; NEAREST yj / CROSS ST. CITY i•� NO. S� IR[ NO. OF —ITYP GROUP ARCH CT OR TKI N[ PLANS ENGINEER NO., i BLDG. N SETBACK LIN[ ADDRESS APPROVED ' TEL 13Y DATE CONTRACTOR NO. USE APPRED OV ZONE BY I DATE ADDRESS HOUR[ NUMBERING LEGAL '} DESCRIPTION LOT NO. SLOCK ]NO. MAP NUMBER 6' 146 RIQ.D CHECK BY TRACT ASSIGNED MY-6v---,ATK- 7 NO. OF BLD GB. CORRECTIONS BIZ[OF LOT NOW ON UB[OF NO. OF f EXISTING BLDG, FAM IU[S DESCRIPTION OF WORK NEW ALTERATION ADDITION 1 X_r REPAIR DEMOLITION IQ Q. FT. �'{/ NO. OF SIZE / ROObtS STORIES EXT. WALL ROOF COVERING COVERING USE OF STRUCTURE d - -- APPROVALS INSP R'S SIGNATURE DAT[ 1 HERESY ACKNOWLEDGE THAT 1 HAV[ READ THI]AFP� FOUNDATION, LOCATION PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS CORRECT. I AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME, FIRE STOPS, tr��•ii EREON• AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS ' vl% REGULATING BUILDING CONSTRUCTION. FURNAC[i LOCATION, �(4 a a"VENT, DUCTS 4 r 111IGNATURZ OF PERMI LAT-H, INP. ADD RUS LATH, EXT. Q AUTHOR171D AGT. / PLAST[R, INT. 7aA SsaA Dim" to-OO S 7 �a F. C. f FEE c�- PLASTER, EXT. ONFEEt s r 4 WORKERS##COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to self APPLICATION FOR BUILDING P E RM I T Infu� or a certificate of Workers'Compenstlon Insurance, or a certified copy thereof (Sec. 3800, lab. C.) \1. COUNTY OF LOS_ANGES BUILDING AND SAFETY Policy No. Company Certified copy Is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS C 19 Cart Ifled copy Is filed with the county building Inspec- BUILDING tlon department. ADDRESS / LOCALITY C Date Applicant CITY I ZIP b CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' ~ '"tom•OF Kms• ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed If the permit Is for one ZON huhdreA d dollars (;100)or less.). TCT Sd C 0 h LTD r10 � �l CL I certify that In the performance of the work for which this OWNER NO CONDITIONS O permit Is.Issued, I shall not employ any person In any manner ICT GROIJP TYPE FIRE BY W l to as to become sublect to the Workers'Compensation Lows. ADDRESS y r D be Date Applicant CITY / ZIP / �� STATISTICAL CATION CONDO. NOTICE TO APPLICANT: If, after making this Certificateof A��T OR TEL w Exemption, you should become sublect to the Worker' ENGINEER C»NO. DWELL UNrIS W Compensation provisions of the Labor Cbde, you must forth- ADDRESS SEWER MAP _ Z 'with comply with such provisions or this permit shall be TEL deemed reyoked. CONTRACT NO. BK. PG, VALIDATION LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am-licensed under provisions of Chapter 9 ADDRESS NO. VALUATION (comrnendng with Section 7000)of Division 3 of the Business and LIC. Professions Code, and my license Is In full force and effect. CITY CLASS f SQ. NO. OF NO. OF CHECK License Number LIc.Class SIZEFf. STORIES FAMILIES ONE Contractor Date DESCRIPTION OF WORK — NEW rl f am exempt from the licensing requirements as I am a ADD Ilcensed architect or a registered professional engineer ALTER FINAL acting In my professlonal capbclty (Section 7051, sA0 REPAIR DATE Business and Professions Code). USE QF Business C �� FINAL (� EXISTING BLDG. C� By 1 Llc.or Rep. No. Date APPLIG4fJT .TEL. 1 OWNER-BUILDER DECLARATION PRI I hereby afflrm that I am exempt from the Contractors License �'a Lck for the following reason (Section 7031.5, Business and ADDRESS Prgfeulons Code): BUILDING 1,1, as owner of the property, or my employees with ADDRESS .wages as their sole compensation,will do the work and ,the structure Is not Intended or offered forsole(Section LOCALri-Y 7044, Business and Professions Code). MOVING TEL I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and.Professlons Code). 226 RE-QQ 1 A CONSTRUCTION I ENDING AGENCY uBARE YARD T� WIDTH , o 0,0 0 • 1 hereby affirm that there Is a construction lending agency for FRp{IT the performance of the work for which this permit Is Issued P.L 2 0.� 2 0 (Sec. 3097, Cly. C.). SIDE I P.L o ° 1 24,00 Lender's Name $_ Lender's Address P.C. Fee f Permit F•• I Q 2 0 8 0 I certify that I have read_this application and state that the Issuance F•• above Information Is correct. I agree to comply with all.County Investlgatlon Fee / ordinances and State laws relating to building construction, Toal Feel and hereby authorize representatives of this County to enter n the above-m i ad roperty for lnspectlon purposes. f!i RiY0tSi FOR lXrLAfiATORY LANf3UA6! ) Signature of Applicant or Agent Dote 1 APPLICATION FOFf BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BLC-DM ADDRESS . I hereby affirm that I have a certificate of consent to self Irnelra, BULDNO ADD�,O or a oerttftcete of Workers' Compeneaffon Insurance,or a certlfled copy thereof(Sec.3800,Lab.C.) („� LOGU_ffY Polley No. CompeRy SIZE OF NO.OF BLD0.3 NOW ON LOT ❑ Certified copy 18 hereby fumlehed. 4c, X, // NEAREST CROSS ST. 47 ❑ Certified copy Is filed with the ¢ormty bu5dN Inepectioo TRACT BLOCK LOT 40. 118E miJE MAP NO. Dete Appkant +SSE 9 MAP BQOF( FARE D (� SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' ER Na YES NO COMPENSATION INSURANCE / — � W1TNW 100-0 FT.OF SC✓-TOOL? ADDRESS I (This eectlon need not be completed If the permft Is for one hulndred // r 6/�� qy�l QFKAJR TYPE CONST. Fid�!E PROCESSED BY dofiarn ($100)or less.) A lA�l I certify that In the performance of the work for which ti>fe permit /� 7JP Ie laaued, I shall not employ anyer pson n any manner so as , ARCtGTE OR EN6W NO. become 8ub)act to the Workers'CompaneaHon Laws. SV,TISTICAL CLASSIFICATION APT CONDO Date AppilceM ADDRESS � CLASS NO. , DWELL UMTS NOTICE TO APPL rA T.- If, after maklnp this Certfflcate 'of REOUFED TOW SETBACK FROM E)3ST Exemption, you Should become subJect to the Wbrkere' CONTRAu%TOR .// TEL NO. SET BACK � )AM Hwy PROP P LVMTH Compensation provislons of the Labor Code, you moat forthwith WAA2 r� !�([ Lp FRONT Cornpiy with such prWlelons Or this pa-rmft shall be deemed roroked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION SIDE CITY LIC.CLASS P L I,hereby afftrm that I am Iioerleed UoJwl7rov Ions of Chapter 9 XWER IIA&P (comn)ndnq with Section 7000)d Dhvl 3 of the Business and SOL FT. NO.OF 8 Na OF FAMILIES Pro(esslons Code,and my fber�e Ie In full force and effect .s 8 NEW BK PO , } LJcerlse Number Lfc Claes DESORPTION CF ADD ❑ MLuIQK)N d Contractor. Date8 U LD ,errC ALTER .❑ $ • IZ ElI am exempt under Sec. REPAIR 1-1 RAP.O.for this reason DEMOL ❑ LDMA P/C,r LU Date: USE of EXISIW3 BLM URM ❑ f1 APP, TEL ❑DMA Paan• LG I ae Skzasture owner d the Prop", a my employees with wapee as • A 1 s -04 Z y their sole compensation, will do the work and the stuchve is ADDRESS. Al, fi��4�1 0-303 . . not Intended or offered for eels (Section 7044, Buelrlees and J!" -50 �1 �ild�7r r FINAL D1UE o AC:�T. Profesalole Code) vru THE APPLICANT OR FUTURE etloM OCCLFWT HANDLE A HAZARDOUS NkEFWAL ❑1, as owner of the property, am exchielvefy contwt:bV withA aANTe SIE A HAZAFCOUMAAN 9 MATERIAL EQUAL TO oR OFEER THAN THE _ 1 ficenaed contractors to oor� tijct the protect (Sectlarr_7044, ❑ No f HAZAFC(xle I1A7HirLe rFORMATI)N ol.�eaFCULB7 i �T�i BUehleas and Profeeslorla Code.) Y&L T-E NTEICG� USE OF THE EJUMM BY THE AI'PUCA T CR FUTURE ax-Dpb �'�'} OCCURANT REQU1:E A PERIAT FOR CONBTFA CTION OR MOOFIC.10 N FROM THE SOUTH ' 1S.IL I CONSTRUCTION LENDING AGENCY ouw�Tr►wY1�61T DWRICT MCAQ of SEF PER&C71W3 C EC LOT FOR 2 ITEhkS I hereby affirm ttiet there is a cornatruaion lendfrp epeo4y for rEa❑ No l� N the pact mance of the work for which dda Permit le leeued(Sec. I HOWE FEAR THE HAZARDOUS MCER AL8 DFOR,AUION OUCE AND Z-E S.-"�U PEFMTrIW TOTAL 152- 80 3087, Civ.C-) c EcK-jsT.I U►OER8wO MY uW En T-e LOB ANioE3_Ee COUNTY COOS j+L�'/'y/ p{} N TILE Z CHAPTER 2-20 SECTKM 24(1100 2 20.140 CONCERNM HAZAFCOC 4TC1:Iti 152.C!V ❑Enders Name MAT RPL8 FEPORTNO AIC FOR 01311+1!10 A PERMT FROM T-E ec o. ❑Enders Address Ca00COW . 5Q� I certify ttlat I have read this application and shite under pSnaly P.0 FEE PERMIT FEE { of PNJury that the above hfomaffon 18 correct.I awiSo to cw#y X11 / Q with ell county ordinances and State hR" relstW to bukinp OQ0��001 b/1�/93 corbtrudlon, and hereby authorize repra&wtativee of tfds County ISSUANCE FEE / 01 1 1 AM $:O1 to the above- ned for fo m / STnATKJN FEE T01 kl-FEE �y �. 1 . C/ J SEE REVERSE FOR EXPLANATORY LANGUAGE i COUNTY OF LOS ANGELES TEMPLE CITY 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA j- �- BL 0508 9611200016 PHONE: (818) 285-0488 EXT: LEGAL ID: OF CONST BUILDING ADDRESS: TR: 15683 LT: 72 SQ. FT STORIES TYPE 5200 CAMELLIA AV STRUCTURE: 0 V TEMP CA 917803857 ASSESSOR NEAREST CROSS STREET: 8589-012-013 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY 1 T9990-w-- PROCESSED- BY: EXPIRES ON: EXIST OCC GRP: - 11/20/96 TC 11/20/97 MER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FIW DATE FINAC CODE: MOLILTON JOYCE F;GERMAIN FLORENCE I (818) 286=6363- 1 1,600 IZ_ // /1/ z 5 5200 CAMELLIA AV f {' Zf� TEMP 917803857 FEES PAID DESCRIPTION OF WORK I REMOYE/RECOVER WITH 25 YR. COMP. SHINGLE FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: FREEDOM CONSTRUCTION (310) 943-9574- AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RE I 600.00 VAL 0.50 SPEC�AL CONDITIONS: D2 PERMIT W/O �tZ0 VAL 82.20 0 ds 110.45 CONTRACTOR: TEL. NO: APPROVALS DATE Iwsp FREEDOM GENERAL CONSTRUCTION (310) 943-9574- r LIC. NO ec-n l� ��' IN AND SETBACKS 13472 TRUMBALL ST. 667055 WHITTIER, CA 90605 ARCHITECT TEL. NO: FOUNDATION/TR9XFT05K- LIC. NO: �l — =I" 1" SLAB/LINDER FLOOR RAISED FLOOR MWIffZONE:MAP NO: SEWER MAP BOOK: PAGE: FIRE CMP:147H269 301 J y ' �� a 9f�µ� FLOOR SHEATHING NO. OF FAMILINF-MEMNG UNITS: APT/COND: STAT CLASS� -A kj ROOF SHEATHINr NO 21 �/'A / eSHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS MO N0 NO ��;� 1-L --� ;' , FRAME INSPECTION REQUIRED TOTAL ------- FIRE SPRINKM-M9MMW-- SET BACK YARD: HYY: PROP LINE: WIDTH: k")L'-) FRONT PL- t , 9 + INSU(-ATION[WEATHER STRIP SIDE PL- INTERIOR LATUMUCU— PAT WALL ASSEMBLIES RATED SHAFTS/5FaUW99'— T-BAR CEILINGS * ADDITIONAL DATA ON FILE LOT DPAI NAGE REPORT ID: DPR261 ROUTE TO: RS0508 -a