HomeMy Public PortalAbout5220 CAMELLIA AVE_Building__ •78A61EA CE*11103 D-87
APPLICATIOi l FOR 1BUILDf G PERM
COUNTY OF LOS AN=ES ulLorNa � O .
I.?EPARTMFNT OF COUNTY ENGINM DDR
BUIWING AND SAFETY DIVISION LOCALITY
JOHN A. LAM91 E, COUNTY ENGINEER N
COLEMAN W. JENKINS, SUP-T OF EARP$TCROSS BUILDING SARI ST.
R AP F IN DISTRICT NO. OR TYPE MP
B
(Print or • onl c CONST.
BUILDING STATISTICAL C FICAT-ION SEWER µAP
ADDRESS CLASS F DWELL,UNITS SK PG
LOT NO. BLOCK ZONE MAP
NO.
TRACT SPECIAL
NO.OF BLDGS. CONPITIONS
SIZE OF LOT NOW ON LOT
E O
XISTINO BLDG, BLDG.SETBACK FROM
TEL / ! FRONT PROP,LINE OF (STREET)
QWNER NO. GSS TYPE OF MUSTING SeTEACK HIOMMAY + YARD' – TOTAL
IGHWAY WIDTH FROM C.L
A D DR ESS
�Z2.2 C)
CITY
ARG ECT.OR TEL. §IDE P O�aL�EO OM (STREET)
ENGINEER NO. �T� OF STING BET BACK HIGHWAY + YARD = TOTAL
A�JPRESS HIGHWAY WFDTH FROM C.L.
CONTRACTOR } NOL O +VvC Op
NO.
CORNER CUTOFF YES ❑ NO E3
DDRESS
CITY V. cll� SEE REVERSE SMf FOR CTA
EL APPROVALS
DESCRI N OF WORK �
C/)NEW ADD ALTER RERAJR DEMOLISH
SQ. FT. NQ. OFNO. OF
SIZE STORIES FAMILIES
L
OFt �KATURE OF
PLICANTLUATION ;
d~
APPROVALS DATE IMS F[CTQR's SIGNATURE
P.C. PMT. 0.w FOUNpATIONI o4- TION
FEES FEE 3 FORMS MATEWAL-S
FRAME: FIRE STOPS,
I HEREDY ACKNOWLKDGK.THAT I HAVE.1KA9 THIs A-priLICATIOH BRACMG BOLTS
AND sTATI THAT THE ABOVE Is coRR[Cr AND AOMM TO tbMPLY FURNACE: LOCAT40N, "
WITHALL COUNTY ORDINANCCs 'AHD STAT[ LAWSREGULATING
WLGAS VENT, DUCTS
ID INO CONaTRUCTION. I CERTIFY THAT IN DOING THE WORK
AV IjORIZM HERESY I WILL NOT EaI'LBY ANY FtRSON IN VIOLA-
non OF THE LA10R cooE OF THE STAT[ OF CALIFORNIA R[LAT- LATH, rNT.
ING TO WORKMEN'/CO SAT'— Ns
LATH, EXT.
SIGNATURE Q HOUSE NUMBER COR-
PERMITTEE RECT AND POSTEO
ADORES/ FINAL 11Q
JOHN F. LEWES. PR CIALST RAL ENGINEER
PLAN CCS VA=ATION. . CK cm.w _ PEWW.VALIDATION M.O. CAs+i
1 2.00,4
PZ'MENT OF BUaMING r,,N-b� O 19 4� APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES ' D
WM. J. FOX. CHIEF ENGINE[]!
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT NO. PLAN OK.ND. P MIT NO.
■UILDIN
ADDR[S!S � �j
LDCAJ-rrY AlRECEIVED KY DAATZ OF APPL DATE ISSUED
N EAR EST CJ.S 5 D v- 1?—
Oa
■UILDINO /
OWN D!
ADD
RISi
MAIL LODAIJTY �/T
ADDRESS v�5'ZIKIP
r NEAREST
t I4 TEL OROeB XT i L N C-IG
C1
ARCHIT[OT OR f TE0.L ZONES / PLAN■ �' TYPE ORD r
[NOINE[R -� ►�--n=s N '
eLDA. � � N
A D - - ■[TRACK LIN[
__ APPROVED
TEL BY �' "�`"L DATE
CONTRACTOR T.0.
_ USE APPRw[D
DR91" Qr ZONE 14 NY DAT[
LEGAL CORRECTIONS' Zp
DEEORIFTION LOT NR ■LOOK �1
TRACT �k� 9
r a NO.OF ILDMIL
RIZE OF LOTt!J- 68 o'a OI NOW ON LCT .C'
UB[OF 0 NO.OF NO.OF
I OO
DESCRIPTION OF WORK
NEW ALTERATION I I ADDITION
O
p
REPAIR MOVING DEMOLISH p
Bq.FT. NO.OF Z
■IZE ROOMS STCRIM >
WALL yyyrrrryll� ROOF r'
COV[RINA ���c.y �/iB DOV[RINO�
USE OF NEW
Bu ILDINO
I HERCeY AOKNOWLLDO[ THAT 1 HAVE READ THIN APPROVALS
APPLICATION AND CTAT[ THAT THE ADOVE 10 CORRECT FOUNDATICNI LOCATION INSPECTOR DATE
AND AOR[[ TD COMPLY WITH ALL DOUNTY ORDINANCER FORMS,MAT[RIALt
AND RTATE LAWS REOULATINO ■UI INC DONSTIlUOTION. A
n ! FRAMEs SRADIN IaSOLTO
SIGNATURE OF G
PERMITT[ f�ZLLATH, INT.I
i
AUTHORIZED AAT �/' LATH,IXT.i
DMB-3 sari erre 1-4a -yJ O P.O.8 PLAST KR,INT.
FEE P LAST E a.IXT.
•
VALUATION FEE FINAL
Y
I
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES BUILDING
WM. J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDING
DISTRICT NO. PLAN CK. NO. �RMIT NO.
d!!
ADDRESS
LOCALITY / - RECEIVF�D. DATE OF A DATSUED
NEAREST
CROSS ST. BUILDING /
ADDRESS
OWNER
MAIL ' LOCALITY
ADDRESS Q �,.�, - � ��<<' r:. (' NEAREST
TEL.e/I, CROSS ST. d', L,,. 10
CITY e,0. C- . i'rl � NOG�4 ! FIRE NO. OFP GROUP
ARCHITECT OF� TEL. ZONE PLANS
ENGINEER NO. BLDG. ^Ir
SETBACK LINE NO.
ADDRESS APPROVED -
TEL. BY I I DATE
CONTRACTOR NO. USE PPROVED
ZONE r Y DATE
ADDRESS
I 'HOUSE NUMBERING
LEGALBLOCK -FIELD CH
ECK BYDESCRIPTION LOTNO.
MAP NUMBER
TRACT Jr(�j � NO. ASSIGNED BY DATE
NO. OF BLDGS. CORRECTIONS
SIZE OF LOT { G NOW ON LOT
KX STOING BLDG.j,j t`�jpS��p �1 F MILLIIES
DESCRIPTION OF WORK
NEW L_:. I ALTERATION I I ADDITION
REPAIR I I DEMOLITION
SQ. FT. f NO. OF D
SIZE / ROOMS STORIES / Z
EXT. WALL / ROOF t'
.��� f
COVERING L+d,GI, I COYERIN
USE OF STRUCTURE
Q G✓ GL_C
I
APPROVALS
INSPECTOR'S SIGNATURE DATE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FOUNDATION: LOCATION
PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS
CORRECT.
1 AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE STOPS,
HEREON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS
LAWS REGULATING WJILDI G CONS RUCTION. FURNACE: LOCATION,
SIGNATURE OF GAS VENT, DUCTS
PERMITTE -e
�-.. LATH, INT.
ADDRESS
LATH, EXT.
AUTHORIZED AGT.
PLASTER, INT.
7EAS28A, Desi to-bo ` P• C. It
v v FEE PLASTER, EXT.
VALUATION !6 11"q?FEE i FINAL �C "
I