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Home My Public Portal About5215 CAMELLIA AVE_Building__ M603 4/7APPLICATI N FOR I D 4 LING PERMIT COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAOE PARCEL BUILDING AND SAFETY DIVISION BUILDING MAKE CHECKS PAYABLE TO: ADDRESS i HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY L F NEAREST CROSS ST. DISTRICT NO. GROUP TR E BY BUILDING COY T. ADDRH35 G LOT NO. BLOCK STATISTICAL CLASSIFICATION SEWER � CLASS NO.p7/--DWELL•UNITS BK PG TRACT � USE ZONE: MAP NO.OF BLDGS. NO. 52017- SIZE OF LOT /7t NOW ON LOT / SPECIAL USE OF CONDITIONS EXISTING BLDG. �7 /�eE TEL OWNER NO. BLDG.SETBACK FROM fq ADDRESS /rf /;I FRONT PROP.LINE OF (STREET) TYPE OF IBTING SETBACK HIGHWAY + YARD = TOTAL CITY Hl%"AY WIDTH FROM C.L. ARCHITECT OR TEL. I + ENGINEER NO. BLDG.SETACKFROM ADDRESS SIDE PRO .LINE OF (STREET) / TEL. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CONTRACTOR .ANO. 6 HIGHWAY WIDTH FR(*A C.L. ADDRESS O + _ CITY T (fi�/L� CIL.ASS / CORNER CUTOFF YEs ❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH PEF ERSE SIDE FO SPECIAL APPROVALS ADDRESS SQ. FT NO. QF NO. OF NEW SIZE STORIES FAMILIES USE OF ADD STRUCTUREK'i•G ALTER REPAIR SIGNATURE F APPLICANT DEMOL ON VALUATION 5 U qOVALS ATE IN■PMT. Ton's ■1 NATU R[ FEE !p� ! /�Jr FEE f �/ �� ATERIALS ON Z �! E STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIOBOLTS AND STATE THAT THE ABOVE I• CORRECT AND AGREE TO COMPLLOCATION, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS N 17 STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR CODE OF THE TATE OF 'CALIFORNIA IN RELATING TO WORKMEN'S COMPEN T N INSURANCE. n LATH, EXT. SIGNATURE OF J �� / PERMIT-PEE C HOUSE NUMBER COR- RECT AND POSTED ADDRESSFINAL 77 S PLAN CHECK VALIDATI K . cwaH _ PERMIT VALID ON C".) N. M.O. CATH ! 3(', 08 73 ' 23 D 29.25L � f' 1 1 8x373 MAY 1 2 3 D 1 2.1 �~ �r 1 1 8 973 MAY 17 1 D 6 9.0 0- J DIVISION OF BUILDING AND SAFETY � ' ® ' Depzr&oeut of Oo>mty E�eer Oounty of Los Angeles WM, J. FOX, COUNTY ENBINEER APPLICATION FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING / 7_ 1 DI.TRIOT N0. _ PLw OK. on Rin.NO. PERMIT MO. , ADDR13M a /r / 1' � 0 �- a LOCALITY OCA ITY R EfVEP BY DATE:OF AFfn- DAT=I0&LJED OR13MFI a BUILDIND ADDRKM S OWNER M RO ee�� LOALITY ADD l7. s-O' Hk.ARKNT TELL OR CUM 6T. fid Mr6 FIREM0.OF [ BROUP� AROHITEOT OR TEL, ZONE PLANS [MBINEER 0. MILDS. fir., Q 1 Ma lriT7AOK LIN[ L� ADD [Jti USE —/APPRIIV[D `r[L ZDN[ BY DATE OOMT77AOTDR Or HOUSE HUMBERIM13 ADQRJOW MAP NUMB R+ v NO. Afo1BN[D oY '�� D[80RIrTIOM LOT N0. 3 1..LOOK CORRECTIONS TKAOT Q NO. OF HLDBL .JZ[ OF LOT NOW OK LOT U21E OF NO. OF EXISTING BLDB. FAMI LIEN DESCRIPTION OF WORK ° p O NEW ALTLtATIDM I ADDITION X = RIIPAIR �--DIMETLITIOM .4 IFT. 11 N 0.OF / OIZV ROAM■ fTORIp ECT.WALL ROOF OOV[RINB OOA•[RINB Ua[or mTRUDTUR[ INOPVDTION FDR APPROVALS 0013UPAN13YAI INBPEOTOR'B■IBNATURIC DATE FOUMDATIDHI L 12ATIE M 1 H[R[fY AD KMOM/I.iDB[ THAT 1 HAV[ AJ P36 THIN A - FDRM.. MATT RLALE PLIOATIOM AND KTAT[ THAT THE INFORMATIOM BIV[N IN FRAiIEI F1REOTOA6 OORREOT. ■RACINB, BOLT. 1 R[[ TO OOMrLY WITH ALL COUNTY ORDINAMDp FURHAD[I LOOATIOM AND BTATI LAWO R[0 T7N0 .UILDINB ETRUOTIOM. i BAo V[MT DUOT. ■IGMATUR[ OF LATH, IMT. PERMIT' /S ADDR LATH, EXT. 4, PL ASTER. I HT. AUTHORIZ ADT- P.0.* PLASTER. ECT. FIE HOUOE NUMBER DOR- REOT AND POSTED VALUATION FIDE FINAL 7AAAMRA4 DEW a I-M f DEQAP,TMCENOUNTY OFLLOS ANGELES RING � 195 APPLICATION FOR PERMIT ` WM. J. FOX. CHIEF ENGINEER 13 U ' L D ' N G FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLAN CK.NO. PERMIT NO. BUILDING �'' 1�. N�T��IN� ST ADDREHH '-" •�T - 7 p LOCALITY TEM y RECEIVED MY DATE OF APPL. DATE ISSUED �i�., �•,� i...�C� ''' NEAREST CROSH ST. ADDREBUILDSS Cl-, NG S �✓ OWNER ^�Qy 9 U'� L /�.115,+` . MAIL ADORERS "Z, - - A6 of t/'J�f"+" LOCALITY / C ?� NEAREST CITY CAD��" NG•00 7 6� �- CROSS ST. FIRE NO.OF TYPE OROyP •- ARCHITECT OR TEL. ZONE PLAN■ ENGINEER NO. BLDG. ORD.NO. ADDRESS SETBACK LINE ,1, APPROVED CONTRACTOR 0 IAI/V L TEL. BY &ATE USE APPROVED ADDRESS ZONE BY DATE LEGAL ® � COEMMONS DESCRIPTION LOT NO. /LOCK TRACT J NO.OF SLOGS. SIZE OF LOT ✓• fp / NOW ON LOT USE OF ND.OF Q- NO.OF EXISTING BLI FAMILIES I ROOMS DESCRIPTION OF WORK NEW ALTERATION ADDITION A REPAIR I MOVING I DEMOLISH Sq.FT. NO.OF �. Z SIZE ROOMS STORIEH L � ,1Y-,i>r �'1"- r WALL - ROOF COVERING I COVERING W� a •_ - �,�p USE NEW DI BUILDING -t A e I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE 18 CORRECT INSPECTOR DATE FOLOCATION AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMSORMS,,MATERIALS ` • AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS. SIGNATURE OF BRACING,BOLTS PERMITTEE LATH, INT. AUTHORIZED AOT 1 / / - LATH, EXT. 76A63BA-3 2-5057$ / •• • PLASTER,INT. P.C. FEE _ PLASTER,EXT. !p VALUATIONFEE ? FINAL �c - r 'APPLICATION FOS y $UILDING PERMIT BUILDING FOR APPLICANT TO FILL IN �� BUILDING ADDRESS LOCAIJTY � / � NEAREST CITY e ZIP 1 X55 ST. .OF BLDG& ASSESSOR SIZE OF LOT N ON LOT MAP BOOK GE PARCEL TRACT / BLOCK LOT NO.(9-3 DISTRICTQ G12011P TYPE HIRE ED BY OWNER LA00, NO.C.% ' I �j � ]) STATISTICALCLASMO SIFICATN SEWER MAP ADDRESS�✓� S /�/' CLASS NO. _DWELL UNITS BK PG CITY ZIP fr7NE ARCHITECT OR TEL PEC]AL ENGINEER NO. V75scM.A.P ONDITIONS AI>DRESS ROADDEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CONTRACTOR NO.Z-tt 2r BLDG.SETBACK FROM LIC FRONT PROP.LINE OF t�J ISTREETI ADDRESS TOTAL SETBACK FROM I TYPE OF EXISTING LIC HIGHWAY + YARD- FRONT PROP.UNE HIGHWAY WIDTH CITY CLASS r CONSTRUCTION LENDER + J NAME AND BRANCH O BLDG.SETBACK FROM U ADDRESS QTY SIDE PROP.UNE OF ISTREETI SQ.FT. NO.OF NO.OF CHECK HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING 51ZF STORIES FAMILIES ONE SIDE PROP.LINE HIGHWAY WIDTH vva� + Z D ESCR I PTTO N NEW ADD CORNER CUTOFF YES ❑ NO ❑ ALTER IN OPEN SPACE YES ❑ NO ❑ REPAIR USE OFDEQ IN COASTAL PERMIT ZONE YES ❑ NO El EXIST I N G APPLICANT TEL ^J (PRINT) NO.G BY C5IGNATUREI I HEREBY AOQJOWLEDGE THA HAVE READ THIS APKKATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WFFH ALL ORD04ANCES AND LAWS REGILATWG BUILDWG LYON.I CERTIFY THAT IN DOING THE WORK AUTHOOZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR COOP OF THE STATE OF CAU FORMA IN RELATING TO WORKM -S COM- RBSATK)N INSURANCE SIGNATURE OF FINAL V/2 BY PERMITTEE 4vo DATE ADDRESS MEW2 4 j TEL�� P.C. Fee$ J Permit Fee 8 CITY `�-�/�Q'✓. NO. J luuance Fee / VALUATION$ �L os-e� Total Fee PLAN CHECK-YANJD L�T'1 I I FiZf CABH T PERMIT VALIDATION Y.O. CASH v � 38 41I-�Y 10 8 8.00 ��' . 1 .1(-Y HOLDER: - - �s �eAese■c■Iaoa■ern /v �[ �7 l'C', ICY JqiJmBTR: I APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUl-DM ADDRESS I hereby affhm that I have a certificate of correerd to wif Insure, or a certificate of Vkrkam' Compenaafbn Insurance,or a certlfled COPY ( 3 0 a) LOCALITY ��Pdloy NO CrTperTY S>g OF LOT Na OF BL .R DONOW ON LOT T tlfled Copy is hereby fumfehed. NE.APEST CA038 ST. L/J Certified Is Mod withInspection TRACT BLOCK LOT Na USE a-xE MAP Na k�rrt ASSESSOR AMP BOOK PAGE PAFiCEl SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' R TEL Na YES / — NO COMPENSATION INSURANCE VUHN 1000 ter•of Sc4-aoL7 (This&action need no(be oorrpleted If the permit Is for One hundred Dt8TR1Cf OROiJP TYPE CONST. FfiE DDfE PROCESSED BY ddiam ($100)or le&&.) I certify that in the performerm performance Df )he work for wtrloh this pit �o p —9 Is leaned, I &hell not employ arty person In any manner so aa to �;Nlo Al I 'k,a� t- TE1 NO. O become subject to the Workers'Compensation Laws S-pKrIS-I)C,,,L CLAS q .-T CONDO Debs Applicant ,,DDFESS CLASS Na DWELL UMTS NOTICE TO APIRUCANT. If, after mokfrnp thle CerUflmte of REOURED TCU4L SETBACK FROM EXIST ExHmptbn, you ahould become wboIct to the Worker&' SET BACK YLFO H Y PROP LNE WDTH Compensation proviaionle of the Labor Code, you mLwt iorthwfth FRONT oonpfy with auoh provision or thb permit&hail be deemed rewired. LJC t4o. PL LICENSED CONTRACTORS DECLARATION P L C�L`,� LIC.CLA8.9 P L I hereby affirm that I am licensed underprovie" of Chapter 8 66U SEWER VkP (commanotg with Section 7000)of DlAslon 3 of the ajoinaw and NO.OF STORtE9 NO.OF B44LES E�2m h fLll forceNEW ❑ Bic POLb.Ciaee MLSE ADD -❑ DKK+ �� Q Data ALTER ❑ U ❑ 1 am exempt under Sec REPAIR ❑ $ BAP.C.for thle reeeon DEMOL ❑ LDMA P/C r Date LDG URM ❑ i Signature APPLICANT(PRMT) TEL NO. LDIM Perm f 1 ❑ 1, as owner o( the property, or my eapbyee& whh wage& as z ACCT." tl,afr sole compensation, will do the worts and the structure b ADDRESS ) 172.65 Trot Intended or offered for ease (Section 704-4, Business andL Profession&co(ie_) Y&L TFE APPLICANT OR FU UAE auLDnrs OCCUPANT HANDL&A HAzApDous mxrs:AL Z1 ITEMS El es owner of tfne property, em axcknafvefy contreofing with OR A"U:C CCtTM&n A RVAMaM rAaasti EU-VL To OR oFEATER TFM THE to construct rreed contractors uct the project (Section 7044, A40LNT8 ON THE KVARDOLE MU8%AL8 NOR 447M GIM-V Mal- licensed rum and Profee&lone Code.) vF�El No El. TOTAL 1. r YLL THE WENDED UBE OF THE eWLM BY TFE APALr.WT OR FUT'UI! !1■nwa ((yyam� -{y1 i'7�'y L OCCURMNT WE A F AFT PCR CO1187AJCTION OR WCCMAT"FROM THE SOUTH 4 CK, 1/i.¢5 CONSTRUCTION LENDING AGENCY COAST AIR alALnnY►V CELENT DrsTRCT fe ACMM&M PET#tfTTNO a-ECKLWT wit ��yy��yy--�� a r1a1 NE 4f7 YTb .00 I hereby affirm that there is a cormtructlon lending agency for Yee❑ HO❑ the perfomiarpe of the work for whloh thb parmft fe laeued(Sec 3097, Civ.C.) CHEQU.ffiT.I U wNDERSVIO FC-0UFE10ns HOER THE _ _LOB ANGELM COON Y CODE, � I TmL 2 04PTEH 220 SECTION&220.1010 TH FICUG-I 220140 CONCERNM F42AFDOUe Lenders Nam NqM%-,Le F$'ORTNO AND FOR OBV20 0 A P IVAT FTIOM THEBCOAO. 955 Larders Address ° 1 AM 10:05 o Q0 I certify theft I have read this applScation and sante �a�r Under penalty Pa F1� PERAff FEF ci ry that the tion Is conned I agree to ow#y O!� all Canty State Tawe mikattng bulldhng /} Qp v an a repreeerrtENM of PBSUANCE FEE o NVE9T k]-ION FEE TOW FEE �. d .b.. SEE REVEfiSE FOR EXPLANATORY LANGUAGE