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HomeMy Public PortalAbout5227 CAMELLIA AVE_Building__r ± 1 T6ASa6A seoa a Se APPLICATION FOR BU ILDI G PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST COLEMAN W. JENKINS,SUP•T OF BUILDING CROSS.T. DIf TRICT 0 T E P BY FOR APPLICANT TO FILL IN I CONST. *UILDINO ;,77l STATISTICAL C FICATION SE E AP ADDRESSt1l / CLASS NO. DWELL UNITS 8K PO LOT NO. BLOCK USE ZONE MAP O. TRACT / SPECIAL NO. OF ■CBIs. SIZE OF LOT NOW ONLOT CONDITIONS USE OF 41 ■CDG. SETBACK FROM TEL. FIIOMT PROP. LINE OF (STR[tT) OWNOWNjjR NO. TYPE OP [IISTI M• SETBACKHIGHWAY YARD = TOTAL ADDRESS S C L. + _ CITY ■LDS. SETBACK FROM A,RCHIT EC T OR 001 SIDE PROP. LINE OF STREET ENGINEER TYPE OF EXISTING SETBACK . HUHWAY_ + YAMq = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. TEL + _ CONTRACTOR % l LIC CORNER CUTOFF YESEl NO ADDRH NO CITY LIc SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK NEW ADD A----ALTER REPAIR DEMOLISH Sp.FT.' NO. OF NO. OF SIZE 10 N STORIES FAMILIES USE OF 11p STRUCTURE - el SIGNATURE OF oll APPLICANT r VALUATIZ)N$ j1,041 ld l •00 APPROVALS bATE INSPECT !SIGNATURE P.C. PMT. FOUNDATION, LOCATION — FEE$i FEE$ 4f, FORMS MATERIALS RA H, FIRE STOPS,RES 1 HEY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING DOL AND STATE THAT THE ASOY[ 10 CORRECT AND AGREE TO COMPLY FURNACEI LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GA ENT. DUC ♦UILDING CO1t1TR UCTION. I CSJrfIFY THAT IN DOING THE WORK AUT}i OR MM HERESY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. TOM OF THELASOR OF THE R AT[ OF CA FONIA RELAT. [NO TO WORKM[/l'0 CO 1 U LATH. [XT. SIGNATURE OF r HOUSE NUMBER COR- ' PERMITTEETEl ADDRESS FINAL � JOHN F. LEWIS. PRINCIPAL ST RAL ENGINEER PLAN CHECK VALIDATION cK. M.O. CASH - PERMIT VALIDATION CK. M.O CASH 7 5 4 I� MAR 1 © - �� 13 8.0 0 PF 7GA93.A Q: 03"J APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELBUILDING DEPARTMENT OF COUNTY ENGINEER ADDREss BUILDING AND SAFETY DIVISION LOCALITY < JOHN A. LAMBIE, Cou NTY ENGINEER NEAREST WILLIAM A. JENBEN, SUPT Or BUILDING CROSS ST. DISTRICT NO. G:10 UP TYPE ESSED DY FOR APPLICANT TO FILL IN .1 ONST. BUILDING STATISTICAL CLASSIFICATION S4WER P ADDRESS 5227 Camelia ' T. C. _ K PG CLASS. NO. DWELL. UNITS LOT NO. BLOCK WATER NOT REQUIRED RECEIVED . CERTIFICATE: TRACT MAP / HIGHWAY S-f.ATE MAJOR SECOND LOGA NO.OF BLDGS. NO. /' (CIRCL[) SIZF OF LOT NOW-ON LOT USEZONE SPECIAL USE OF CON ITIONS EXISTING BLDG. UY TEL L OWNER NO. BUILDING YARD HWY STREET E FXIST- 5 BACK WIDTH ADDRESS 5227 Camelia T.C. FRONT ARCH ITEdT OR TEL P. L_ ENGINEERNO. SIDE P. L ADDRESS CL CONTRACTOR Virgin Roof C o.NoAT 705 u GC ADDREss600 S. San Gabrjol. Blvd, 0 DESCRIPTION OF WORKSan Gab CL NEW ADD ALTER REPAIR DEMOLISH SQ. FT. N NO. OF SIZE STORIES FAMILIES USE OF STRUCTURE Re-roof House & Garage. SIGNATURE OF APPLICANT VALUATION $421.00 APPROVALS DAT INsr[ctow•s sIGNATupm C FOUNDATIONI LOCATION FEE $ FEE $6•00 FORMS, MATERIALS FRAME: FIRE STOPS, I HEt�Y ACKNOWL[DG[ THAT I HAV[ RiAD THIS APPLICATION B CIN LYS AND 9TATK THAT THE ASOVC IS COAA[CT AND AGR[[ TO COMPLY FURNACE: LOCATION, I WrrH ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATING GAS VENT. DUCTS l BUILDING Cc STA 10 I CEAT FY THAT IN DOING TH[ WORK AUTHORIZm H[RI I ILL NOT E Y ANY P[RSON IN VIOLA- LATH. INT. TON OF TH[ LADO DE OF. RIL.AT- ING TO WORKM[N LATH, EXT. _ SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS 600 S anabrie "B1V FINAL en an a r e JOHN F. LEWIS. PE6NCIFVAL ST RAENGIFAER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMT VALIDATION CK. M.O. CASH L o5586�Z NOV 1 D 6.00~ •.A WORKERS' COMPENSATION DECLARATION' PPI AT� PERMIT , sur , o affirm thatfica I have a certificate ru cbnaent.to agff C O FOR . �U 11 D I N G P E RM I T Insure, or a certlficatei of Workers, Corfipensoflon Inaurortce, ' _ _ � ` or a certified copy thereof ($ec 380gb,-Lob. ��)c ZOU TY OF LC�S ANQ�LE� dIJILDING AHD'.SAFETY Policy NoCompartyi� IiZs� Certified-cgpy•ls heroby'fuinlahed. - FOR APPLI TO fJLL IN ego I �ZZ CertfRed copy Is filed with thecounty building Inspec- mss tion department. jA llcar+�l�d-► •�•• ZIPDate AppLOG�IJTY � -� — T i NO QF �7 t�sS i CEIIFfGATE OF fA�P�ION FROM WORD' _ Sig OF L9T NOw ON LOT s+ p OD PENSATION INSURANCE / (This sectron need.not be ram let�d if the permit la for one TRACT f3LOCx LOT NO. !' �� '" PAGE P " huhdmd dollars (;1.00) or'lq*L). I certify.that In The perfo nlonce%of the wbdc-for whlrh this SPECIAL •. permit Is luued;I.sholl of,gmploy'ahy per}oR In arty manner, cox Din O so as to becomA subleto.the Wrs orkeComlSbrtsaw tlort•LaL zjP Date;.. 4 '. ApOlgdnt ITECTOR TEL NOflI i TO APPUC.111JT If; after. makln ''fhls ,GW ficate of B,IGIN�t NO. ISTRKr GROUP TYPE FIRE-. BY O. Exem Ion, u hould ¢ CONSY., ZONE' _ gt yb become. aublect,to.:the VVorkeri' Comptinsatlon provisions Qf the Labpr e,'•you mint forttr AL)61iFSs �/ O �- - N with.comply with such provlsrons (:k•thrs.permlt shall be TEL STAT1sTic LCLAS51 TR5!R.._'. Z �kmmed revoke: NO. LICENSED COPfTRACTORS DECWRg11CxJ = LIC flASS NQ• tjlNris J hero by affirm that G am 11cer4ed under pmvlalons bf(a r 9. - -. ADbi�ss �' i (opmmencing with Sectlon'7000)of DlyWgn 3 of the$uslness - ! t �' C � and Professlons(:ode,-end my Ilagnse:is jn full forcaancl .. CrTy CLASS B� VALIDATION Allb4 5a7: NO. QF NO. Of CHECK -' • Ucense Nur&eT c"ClarMi STORIES FAMIUFS ONE Y4UATION LJ F Contractor pie Di 5CR1PT10N 4 wqw ' 0 I am-exempt und;r Sec ASD B•BP:C:, for thli reason ; REPAI RUSE OF _ [krtwt T fJ(15fING BLDGL.0r ✓ DEAhOI Signature - ' ' - APPUC'ANT .TEL .- OWNER-BI;ILDER DECLARATION NO. -C 1Z ; I hereby affirm that'I am exempt�­r6m the Contractces Ucense 2•�C ct i` Law fbr`the"fbJlowlrS�'teaaon_(SectYon•7Q31.5,18uslnes� and - ADDRESS �~ FWAL Profeulons Code):' Fld� ,,; - :F ThJL T I, as owner of the property, or my a ployees with p�p�� a ~ �n ti i. wage asthelr sola cbmpensatloh will do the work and tffe structure la not Intended or offered for sale{SecHbn LOCALITY 7044, Etal'neu- end Profertys,on! Code.)' TITU O, E • I, as owr�r-ofthgprop epm exclusively nontrading CONTRACTOR NO' T{7T# 4a;. 75 with 114ensedtQhtracfonr fq,conatNct the pcolaKt (Seo- _ _ lion AM4i Business and Ido?esslons.�ode.). ADDRf s CONSTRUCT}ON_LENDING AGENCY YARD FIwY FROM PR I hereby affirm that them!aa conV7ructlon iendrng n for the pexformance•of the'work forwhlch3hls'pa+rmth•Isaied P L _. (set_3097, Cfv..C:.} SIDS t Lenders iJd'me LDMA Ref. / � � I Am 9{l�!'. Lenders Addroea P:C Permit I' ' I certify that I have read this application and state that tt» Iauarxe LDMA P/C I .' J above Irifprtnaflonit corte�t.i dgree to comply with al l County lnvdllOationfee 60'1 T t'"ordindn6n and Stade laws relating to building conrttvcflon, To4al Eee LDMA Perm" 1. 7 t a 34 ond,hpreby authorize representatives of the County to enter 2Q, T " u o-m for Inspect) pLrpgsea. i - ' 422 3 1 _ . •-n 1^ITRIS si UVWU roe VMLA AT l,l►ri6l^i*. y CL sig Imnt a: Die _+ : . . TI-3t� 42:;2- * C`�: ` 422.34_ `.'`WORKERS' COMPENSATION DECLARATION �I nsherecertificate reby'affirm that I have a certificate of consent to APPLICATION F R BUILDING PERM Iu , or a certificate of Workers' Compensation Insurancece,, IT or a certlfled copy thereof 3 , ) _ 800COUNTY OF LOS ANGELES BUILDING AND SAF PG{I ny Certified copy Is hereby furnished. R-APPLICA TO FILL I BUILDING f �. ADDRESS rl Certified copy Is filed with the county building Inspec- BUILDING Lj tion department. ADORE55 ODNDMCtA fl Datv Appllcant ZIP LOCALITY RTIFICATE OF EXEMPTION FROM WORKERS'' NEAREST COAAPENSADON INSURANCE 312E OF LOT NOW Si. (Thld section rr not be completed If the permit u for one TLtACT ASSESSOR hunired dollars (;100)or less.) IOT�' MAP BOOK PAGE PARCS Ta. I cWlify that In this performance of the.work for which this OWNER �' luE NO. pernilt is Issued, h shall not employ any n In any mannerWECIAL so a to become subject to the Workers�to pe Ion Laws ADDRESS Date Applicant , RESS CITY ZIP ARCHTTECT OR T9 TO APPLICANT: If, after making this Cert DISTRICT P TYPE FIRE BY O Exe ptlon, you should become subject to the orkers 5, 0 CONST• �j Com nsatlon provisions of the Labor Code, you must fprf(a ADDRESS ✓` 0 with comply with such prbvlalons or this permit shall be �� TEL. / STAn3T1CA1 C1AS31FICAnON APi. Z dee ed revoked. CON / LICENSED CONTRACTORS DECLARATION LIC CLASS NO.�DWHL UNITS I affirm that I am licensed under provisions of Chapter9 ADDRESS NO. ( rrx"JN with Section 7000)of DlvlsJ 3 of the Busineand Loa SESEWERss MAP Pro eslons Code, and my license Is In full force and effect. CITY aA55 BIC VALIDATK>N PG. _ 'W. Ff NO.OF NO.OF CHEC X LI ense Number Llc Clas SLZE 6V STORIES FAMILIES ONE • - _ DEVALI}A Ar SCRI NEWCJ ntroctor ; , I am exempt under Sec. B.BP.C. for this reason REPAIR DUSE OF Date: DEMOL IX tSTI tJG Signature 's'WUCANT Ta FBiAIL ✓� OWNER-BUILDER DECLARATION DATIs — 9 4 9,5�A I hereby afflrm that I am exempt from the Con!.actpr's License Law for the following reason (Section 7031.5, Business and # o.e o 0 0'.� Professions Code): PRESENT ❑ BUILDING 10 o59,25 I, as owner of the property, or my employees with ADDRESS wo"as their sole compensation,will do the work and ' the structure Is not Intended or offered for sale(Section -LOCALITY '2 5 7044, Business and Profeplpns Coded MOVING TEL o e,0 5,9, r, as owner of the property, am exclwively contracting NO. with licensed contractors to construct the project (Sec- ADDRESS O 5 2 2`8 8 tion 7044; Business and Professions Code). CONSTRUCTION LENDING AGENCYYARD FiVV^I Ute TM FROM I hereby affirm that there Is a construction lending a¢ency for FRONT the performance of the work for which this permit Is Issued (Sec. 3097, Civ. C. SIDE P.L. Lenders Name LDAAA Ref. 1 Lenders Address P.0 Fee S Permit Fee I certify that I have read this application and state nkat the Lwuance Fee LDMA Pk f oil. above Infonmatlon Is correct. I ogee to comply with all County Investigation Fee ordinances and State laws relating to buildin corsttwtlon, 7ata1 Fey S LDMM Perm, and h re authorize repsentatives of this County to enter b upo aabov property for Inspection purposes. 0 5�, M tI�N�H KHR KXPLAILIATORY LI NGUAW a Agent Datey-`VV-- O V_ . - _WORKERS,C¢ PENSATIOK DKtAkATION ' Ensure bor o certificaffirm ate of W a icrts' C mperm consent r ce, APP L I CATION F©R BUILDING PE RMI T : Worker' Com nsa{lon Inwrance,- qy acert f''lerrd copybbthereof(Sec. 3800,�Lab. �C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY'PoIIcy,NiY�s{o Company T� r`� BUILWNG Certified topy4s hereby furnished. R APPLICANT TO FFLL"IN ,,,ppm a Certified copy is filed with the county,buHding Inspec- BuIPING� Z / :' t l o Trude pa rtm 6 n t. 4J`t l�ppllcQnt CITY P -Cr{ ZIPW. Q - LOGLiTY CERTIRCATE OF EW PTI FROM WORKERS' NO-OF NDG5, T QOM NSAT I ON I NSU RA13CE SIZE'OF,L NOW ST. (7hly +taction nead;not;he c6mpleted if the permit Is for ono- BtC)�C LOT iJO: fNAp DOAK PAGE PARCPL hundred dgI4ars.($K0j or Jess.) MAP Oma` . D b TEL :l Ug I certify that In the performance of the work for which this �_ pernilt ItI suid;'I-shall nor employ arty penton In dry manner � so as'to T�corrte subject t6 the Workerc'Cornpensbtlon L."'.2.. Data, - App[lcant Di51RI(T P TYPE. . BY Q NOTICE TO AMICANT: If, after mdklIV Ahls Cettiflcate of ARCNlTECf OR TEL 7 ..`'-G CONST, Exemption,. you should .be_come 'wblect. tQ the Werkers' ! ��''OOJ�U Compensation prbvislocm of the Labor Code,you must forth, ADbRE55Ak with comply with'suchprovlsigns qr, this 'Permit shdlG- be ' ' TEL STA STiCAi TK)tJ CONDO. deemed rwokid. CONTRACT SM-kkr :NO. LFCI CONTRACTORS T"sl . I - cms Na.. fJMIEiL UNIT$, I hbreby"affirm fFW 4 prh 1"nsed under prayhloris of chapter9 3- NO. 10 (c& merml waft Sectton 7000)Of'Qlvfsion 3 of the Bu}iness an LIC. Profeisldha Coder on0:my IIcK b in full force 8nd rffoct. CITY CLASS V/1L�A 2 p SQ. FF. OF NOi OF Lice7lae'Nomber. / L,Lit�,.`Cllar-- r SIIF STORM*, ONE VALUATION Goni,CKI r�'C.l 1x �'E[i� ' Date 1 i r�� DESQ21 OF WDd/R1f ; ADD L am exempt under Sea. "" ALTF� : .. t . BAP.G for-lily reusdp REPAIR _ Date;-= E�a NG'-.bG. aE""oL 2 9 7.2 A 4 -y^� SI rtdturs OYVNER BUILDER'D�CLARATIOh} PRI SQ1J — NO. ( f DAlat'�I� 1 •' I hereby,afhrm that[,am ixtmpt from Aho Conti optrfor's Elt_" - l Law for the followlog reason (Seatldn 743,.5, euskou and ADDRESS T 1 ;• • �:�i}�5 profseslons'Code): I, as.owner of tfre property, or my employees wltI1 BUILDING �� Q: -1. �­'$S wagescifthelr sole Compensatlon,wlll.do thework and the sfrLcture Is not 14tendeo Cr offered for sale(Sectlon ' 7044, "nese and Professlonq Code} ,- MOVING .. TEL L f,as owner of.the property, am exclusively conttbdIng - - with Ilcgnsed conttoctorw to construct toe ptol6ct (S6c- a tion 7WA,Business and ProfesslornLode}. <, �..� � � '-.y • ' �:�`,' x'_ :. . QDN�TRL)CTION LENDING.AGIRSKY YARD ElVV1 TOTALPROP.JiTE DTii ^. _ . :r., �• I hereby-affirm that there is a cpnrrtmu ion lending agency for FAL '. the performance,of the work for which thlspdrm.It is ipued ($ec. 3097, Civ. C.� �� •� �? P.L. 4_'. '4 1. 'r... "f ��• 1l Lertder�Name- ±� '•>r _ ` a='�'�.';� "�•�� �q�^_�� -- ,. Address _ P. Iter PsvnM '4rkder's r I c*d fy that I hgve recd this application and �• that the houance Fee LDMA P/C# Q above Irtfoinoal on b correct. I agree to comply with all County InvestiQatfon Fee brdlndrlcee prod Slate laws relating to building construction, Tov L No LDMA Perm. # a ' hereby authohis repree6ntbt)vw of this Courlty.M enter vpQ ffi*bbove-mentlaaed for].WIWIIan purposes _hl—g M FrAM,lQR DMAKATORY tANGU^Oa of App*lcmt or Agftr t Da+.