HomeMy Public PortalAbout5239 CAMELLIA AVE_Building__ °''^°'°• APPLICATION FOR BUILDING PERMIT
DMSION OF BUELDING AND .SAFETY pDeparbaw3l of
op 3
rw�--�.{, Em .=*w LOCALITY
JOHN A. LAMBIH, COUNTY ENGIN®t NEAR¢SI.
CASSAIT D.GRIFFIN, furT o�■uiumma
FOR ��� TODISTRICT NO. GROUP Fnl IN .>YPE n HEWER MAP
CONST
CUILDINGMAp ��s,, STATE
ADDRESS NUMBER V HWY YES O
LOT N0. FLOCK I1lyE ZONE SPECIAL
CONDITIONG
TRACT
NO.OF.BLDOS. /
SIZI OF LOT NOW ON LOT BUILDING YARD HWYSTRtrFT NAME EXIST.
D CK WIDTH
USE OF
EXISTING BLDG. zi FRONT
P. L
OWNER HIDE
P. L
MAIL ?
ADDRESS Q O .TRACT DWELL 1 UNIT INDUIITRIAL
Tom' 1 DWELL 1 UNIT
CITY NO. LIC BG
6 PUBLIC
ARCHITECT O TEL, 2 DUPLEX R UNITS 7 ADDN..ALT„ ETC,
ENGINEER NO. 8 APT. UNITS
8 M I;CEL
ADDRESS 4 COMMERCIALr�tonz./.�.r -
TEL. RffW ION RMORD
TR
CONACTOR NO.
ADDRESS
DESCER TION OF WORK
NEW D ALTER REPAIR DEMOLISH
BQ. FT. NO. OF Nqq OF
HIZ STORIES F) ILIES
U�SJEOF YTRUCTURE
SIGNATURE OF
APPLICANT APPROVALS
ADDRESS O DATE INPECTORIS SIGNATURE
FOUNDATION: LOCATION 1
�d P- C. 4 FORMS,MATERIALS I E�
FEE FRAME: FIRE 8TOP8, /1
VALUATION / `� O BRACING.HOLT;!" .1
E FURNACE: LOCATION.
I HREEY ACKNOWLYDGE THAT 1 HAVE READ THIS GA;VENT. DUCTS
E.
APPLICATION AND STATETHAT THE ABOVE IH CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. '
AND STATE LAW; REGULATING BUILDING CONSTRUC-
TION.
LATH. EXT.
SIGNATURE OF HOUSE NUMBER COR--
P EffLiPULMA 1 1
ORPERMITTEE RECT AND POSTED
ADDR Q 1 FINAL (1 Is
JOHN A.LAI SIM. CQuNTY ENGINEER Yh,�MATION CLYDE N. DIRLAM, CHIMF HLDG. INSPYCTOR
NO CASH
L&1 9 5 5 2 HN 1 • 1 8.00 a ��z
r T
APPLICATION FOR BUILDING PERMIT
COUNTY.OF LOS ANGELES BUILDING AND SAFETY
WORKERS COMPENSATION DECLARAnON' FOR APPLICANT TO FILL IN
I hereby afRrm Chet I have a certlHcate a( cormerrt to self Inoue,CAy _LLA� >`I/c
or a certffioate of Workers' CompAhsatbn Inwrance,ora certffled
copy thereof(Seo.-�8W.lab.a) allllat'1 LL . . � 1 [190 .
Policy Na T Corrparly SIZE OF LOT NO,OF BLDGS.NOW ON IAT
❑ Certff1edcopy ie hereby furhbhed. NEAREST CROSS
Slr
❑ CertW copy le Hled with the county butiding Inspection TRACT $LOCI( LOT N(D.
USE ZONE MAP NO.ASSE� .
Date Appk-d P?� PAFICF] / ��CONDrnow
CERTIFICATE OF EXEMPTION FROM.WORKERS' Oyy �-/ Tt1NO
COMPENSATION INSURANCE b W � 53 vee N i°°°FT.of eckaoL?
(Thfe eecfion need not be oorrpieted If the permit le for one hundred ADDRESS
doibrp ($100) or leas.) &J AVC- xsrFncT oRouP TYPE coN3T. RZO�JE PRocEs3rA BY
I certtfy.�fn d* performance of the work for whbb thb pgrniltul�o ttZIP
le kasued, I shall not.employ arry,porson In arty manner ao ea toAPc�rrECCir `./ �(� `
beccens sub)ect to the Vvbkam'Cornpermation Lewin. EER TEL9P,TISTICAL APT CONDO
Data, Ap~ .. ADpREg3 CLA33 NO. Qz I DWELL UNITS
N.OPCE TO APPLCANT. q, atter maktnq thb Certificate of REWRED TO CIL SETBACK FROM EXIST
Exemption, you ehbuld bebome sub)ect to the Yvbrkers' CONTRACTOR TEL NO. SET BACK 'Ok m -Hwy PROP LINE WUTH .
Compensation provision.of the Labor Code, you mast foritwtth FRONT
comply with e<ich provbbns or thIt permit ehWI be deemed revoked. ADDRESS LIC.NO.' P L.
LICENSED CONTRACTORS DECLARATION Sam
pTY• LIC.CL0.3.9 P L
hereby affirm that I am Ilcer a underprovlelone of Chapter Q Ar-y MAP
(cornmendng with Section 7000)of DMelon 3 of the Brminebs and. SQ FT. NO.OF STORIES 40.OF FAAaJES
Profeas"Code,and rry Ilcenoe Is In furl force and effect, NEW El sic PG
1Jcenee N4mber Qc- CrBBS" bESCRIFrION OF Ylow ADD ❑ WUMM10N
Contractor Date !•!�cW' ALTER $ CO-
❑ I am exempt under,Seo REPAIR .fl
BAP.C.for thb reeeon DEMOL ❑ LDMA R/C•
Date: USE OF EMT NO BL-Da URM ❑
Signature1
APPLICANT(PFMVT) TEL K%a LDW Perm• w
), 1, as.owner of the prpperty, or my enployees with wepee as O ACCT.Ir
their Sole =npeneabon, will do the Work and the stnx;hue b ADDRESS
not Intended or offered fOr sale (SeoHon 7044, Buatnam and FINAL DATE 3303 67.20
Professions Code.) Y&L THE APPLICANT oR axrm or1x"#cr FNroLE A FVZNCC08 wArBuL1 ITEMS
El 1, as owner of.the prpp", am exdueWy contracting wIth oHT��caraaa+o A FWAADOLM MAJ194 L EQUAL TO OR E1 THIW.THE
nceneed contradxxr to construct the project (Section 7044, oM T}f wzArmous uaanALe or►wior+o nes FQ+� TOTAL 67 . 20.
B*neas and.Pro(esslorm Code_) vas❑ No❑
waL THE NTF.o L9E of THr ewLm ar THE APPucANT ora FLYn-w eL oC o CWCK 67.20
oAar AlH CAWCONSTRUCTION LENDING AGENCY cI*K' i C8OF"0cT aOR FFY7M TFE BOUTHI
T t .
f.UQ Wa
I hereby afnrrn that thele Ida oonst ugdon lending agency for vEs ElmD 1:1o the periormahoe d the work for vvh lct thle peen ft Is faacled(Sec. i rwE r£nb ATCACW TM
3007;Civ.C.) CECKL"Tr_A_olWQ DoL09 AKOS GOWN CCel '
.. L�LMJ LRRJ t - 8/ V93 Z Cl1020 SECT201OQ TFRUt2-M 140 OOMM-44 WAFDOUB .
Lenders Nane - M TD46-Le FE OMNG AND FOR 06P!!4e A PS44T FR061 THE 8CAGMa
I_ehders Address 1079 1 AM*.19
O a.ii M AOfi
I certlry tha#"I have read this appllcatlon and State uxier penalty P.0 SEE PEAT YT FEE
of pwr my that the above Intamatir b correct I agree to corrpfy p p0
w(th alI county ordktarK>W and State laws rotating to buldng u
conetrucfion, and hereby authorlte repreeentaHves of U* County tssUANCE FEE
1mentbrled property for[rep-tion V
m .may,..{,' - r-3-93 rrvEstxiFlT50N FEF MOIL FEE O
Aq{ v App �.
SEE REVERSE FOR EXPLANATORY LANGUAGE
6 �
OOUNTTY OF LAB AKGXLZZ.? Tz"LY CITY # 0508 BUILDI21G PSYIQT
DEPkRTl=T OF PUBLIC WORT.B 9701 LAB TUXJLS RESIDENTIAL ADD
BUILDING AND SAFETY / LAID DEVELOPMENT TZMPLE CITY CA 91780 BL 0508 0602090014
PHOWZ: (626) 285-0488 EXT.
LDGAL TDA NO. OF CONST NEW BUILDING ADDR388i
TRS 15683 LT: 79 8Q. FT STORIES TYPE OCCUP GROUP 5239 CAMELLIA AV
SPRUCTURRI 499 1 VI R3 TRMP CA 917003658
ASSESSOR INFORMATION NUDMXR: GARAGE NEAREST CROSS STRI=:
8589-013-001 OTBSR. THOMAB PAGE: 597 GRID A4 LOCALITY. TKMPLR CITY, C
TZMANTi EXIST BLDG USE. USE LCIN'xI ISSUED ON. PROCESSED BY: EZPSRZB ON:
EXIST OCC dR.P: 03/03/06 JZ 02/26/07
OWNER. TEL. NO: BLDGS. 301 ON IAT: VALUATIOiN, FIFKL A.1TRBY, CODE:
COEVAS RAYMOND J;LIUR.A L (626) 309-0653- 50,000
5239 CANNIJIA AV ��}(.�f �'
TEMP 917803858 FZEB ➢lID DESCRIPTION OF WORK
ADD IDBTZR BEDROOM, BATHROOM, r.invn,y ROOM 499 B.P.
FE3 DZSCRIPTION: QUANTITYI UOK: AMOUNT
APPLIC3NTTEL. IOC
GARCIA (626) 825-7544- B1 PLAICHYCK W/ZIZRGY 50000.00 VAL 745.83
5239 CAMELLIA AVE 1A BLDG PERMIT I88DANCZ 27.75 SPZCIIL COZDITIONS.
TEMPLE CITY C& 91780 AC STRONG MOTION REBID 50000.00 VAL 5.00
B2 PERMIT 1/HXRRGY 50000.00 VAL 877.47
TOTAL FEES 1,656.05
CONTRACTOR, TIL. 10: 1PPROVALS DATA INSPECTOR SIGNATUR3
RAYMOND CUEVAB (626) 309-0653-
5239 CAMELLIA AVE LIC. NO , LACATIOE MID BATB1CLS
TRMPLE CITY, CA 91700 LORE
SOILS 3ZGI>•BZS APPROVAL
ARCHITECT OR EIGINEZRt TEL. IOi IOUYDITION TRENCH FORMS 'n
LIC. *Ox SLAB ZR FLUOR
RAIBZL FLOOR 1RIMIYG
MAP NO BZMFXR MAP BOOK PAGE, FIRE LONE. CMP: UNDERFLOOR IIBULATION
3 01
1ST LZVRL FLOOR BHZ,TH
10. OF FAMILIES: DWZLL ING UNITBi APT COLD: STAT CLABB:
NO 21 �{[ `5 210 LEVEL FLOOR BHEITH
SCHOOL WITHIN HAEIH.DOUS ROOF SHEATHING
ASR QUILITY: 1000 FER'T MATZRIALS rte
NO MIO NO �N'b FIRE DEPT. FRANZ INS
RIQUIR111) TOTXL SZTBACS FROM ZXIBT j/i, pL BLDG DEPT. FRAME INSPECT r`
SZT BACK YARDS Rlf7: PROP LINE: WIDTH: O
FRONT PL- - SHEAR PANZL8
81-DI PL- _
TNSOLITION MEATHYR STRIP /Q �-
b��
TmQDTOR LATH DR71Ai.L
I
13[=OR LATH
LAT DRAPDGE
SMOMS DZTICi`ION DIVICR.B
FIRE D]PARTMXUT APPROVAL
REPORT ID. DPR261 ROUTE TOi DS0506