HomeMy Public PortalAbout5238 CAMELLIA AVE_Building__ A ROAD DEPT. PL"?.•,7 IS RE U.'fT
FOR AWhlA y':,=,L 1�;:�. )RK
DONE Ud TV,E.• ROAD RIO,-iT OF 'vVAY.
APPLICATION-;. rOR -BUILDING PERMIT T . �.
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER AD REHH
BUILDING AND SAFETY DIVISION LOCA'-IT'`�
JOHN A. LAMSIE, COUNTY ENa1NRE1! NST
TT D. GRIFFIN • T o Buy iNo CROBH 8T
DISTRICT O:. GROU TYPE
FOR APPLICANT TO FILL IN 1. CoNs••
BUILDING STA lSTICAL C IFICATION B IAP
ADDRESS �� BK. 150
C1AHH.NO ELL{JN
LOT NO. F BLOCK _ MAP STATE -
NUMBER
TATE -NUMBER D' HiNY. YES
TRACT lJr46 .5 - USE ZONE SPECIAL
NO.OF BLDGS. CONDITIONS
SIZE OF LOT NOW ON LOT-
USE OF
EXISTING BLDG. BUILDINGYARD FiWY $"IRE$7' NAME EXIST.
SETBACK WIDTH
OWNER i FRONT /
MAIL n + P.L.
ADDRESS SID@
L P. /
crTY . No. I INSPECTION RECORD
ARCHITECT OV TEL
ENGINEER NO.
ADDRESS
TEL
CONTRACTOR G/ NO.
ADDRESS •
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH
SQ. FT. NO. OF ►►••11 O. OF
SIZE STORIES F*AMILIEB
.USE OF
STRUCTURE 'r
SIGNATURE OF
APPLICANT-
APPROVALS DATE INSPE R'9 BIGNATURE
ADDRESS FOUNDATION: LOCATION
FORMS MATERIALS -
VALUATION -�_� - FRAME:FIRE STOPS,
BRACING BOLT6
P.C. PMT. FURNACE:LOCATION, -
FEE FEE GAS vatrr,-Duc7s -
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND IINT.
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND ,
STATE LAWS REGjl)LATIt4G BPILDICONSTR4CTION. BATH �T•
SIGNATURE OF HOUHH NUMB r-OR-
PEtRurrrFv RECT AND POSTED
ADDR NAL
CLYDE N. DIRLAM, PRINCIPALS RAL ENGINEER
PLAN CHECK VALIDATION � -0- �A.fl PERMIT VALIDATION � CAWi
-7 o-7 1 Ii W 1 A. 2:o 0.