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Home My Public Portal About5327 CAMELLIA AVE_Building__ i DMSION OF Bv1LDING AND SAFETY BUILDING Department of County Engineer County of Loa Angeles WM. J. FOX, COUNTY ENGINEER APPLICATION BUILDING e FOR APPLICANT TO FILL IN ADDRESS 1--d I;e BUILDINGLOCALITY ' ADDRESS :0 f NEAREST - LOCALITY e-C 7-i ft .{ CROSS ST. _ DISTRICT NO. PLAN CK. OR Rec. No. PERMIT NO. NEAREST CROSS ST. i OWNER RECEIVED BY DATE OF APPL. DATE ISSUED MAIL ADDRESS , AjCa USE ZONE I NO. OF TYPE GROUP I FIRE ZONE CITY r+`��.. /l. l - �'� NO. 1T ARCHITECT OR TEL. ZONING ZONING .�r�/-f� Dw7e9d, ENGINEER NO. - APPROVED BY-J BUILDING ORD.ADDRESS SETBACK LINE: TEL. APPROVED 'r ' DATE CONTRACTOR NO. BYa HOUSE NUMBERING ADDRESS j LEGAL MAP NUMBER �0/f7 NO. ASSIGNED BY DESCRIPTION LOT NO. 5 BLOCK TRACT DATE CORRECTIONS I INSPECTOR NO. OF BLDG SIZE OF LOT J �. `J J�-Z. I NOW ON LOT S r �.� I e./ ZAZIV 20FQ/ USE OF - I NO. OF I - .� / /" ..._ EXISTING BLDG. "�� FAMILIES � O DESCRIPTION OF WORE �.Ae . a z NEW ALTERATION REPAIR__I DEMO(TION ADDITION r � SQ - / / 1 S ZEFT / - / ROOMS 6 STORIESEXT. WAL / _C_OVERINGL U I COVERING Vim ' USE OF STRUCTURE 1( +® �,� APPROV INSPECTOR' SIGNATURE TE FOUNDATION: LOCATION 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS pp. FORMS, MATERIALS /l PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME: FIRE STOPS, _ CORRECT. BRACING, BOLTS I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION, AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT, DUCTS SIGNATURE OF0r'i. LATH, INT. f, - PERMITTEr ADDRESSLATH. EXT. r` f - -� PLASTER, INT. AUTHORIZED AGT. PLASTER. EXT. FEP.B HOUSE NUMBER COR- = P✓'1 RECT AND POSTED J. VALUATION FEE *306- FINAL 76AS38A DBS 8 2- APPLICATION FOR BUILDING PERMIT �. DIVISION OF BUILDING AND SAFETY '� , '�,"a . 3 a Q - � of Lps Aug LocALITY C wM.J. FOX.couNrr ENaiNxER NEAREST Jr L CASSATT D.GRIFFIN,tur•T OF SUMMING D197 NO, a TYPE SEWER NAP FOR APPLICANT TO F l IN 447 ADDpRtfl s'3 a 1I r I ` -ummAmplIR v `aTY19 YES O IAT NO. BLOCK Uf[ZONE CO•N "II OWNS TRACT ]� o / a V n �� NOW ON LOTS SUILDING YARD HWY STREET NAZI IDT SIZE OF LOT 0/� ■RTGACK �D� USE OF Q Z I I� FRONT f(D OWNER I nn S I r" SID, MAR . .Z l- , , O TRACT DVMJ- 1 UNIT INDUSTRIAL . ADDRESS l15 Cm QvT ` TEL I DWI I 1 UNIT d PUBLIC WLDa. ARCHITECT OR Tn- ALT..` Z DUPLEx 1 UNIT ADDN., LT.. ITC. INGIN13IR NO. 8 AFT. UNITS miscm- ADDRESS 4 COMMERCIAL CONTRACTOR A eyTla r 'J�1Y INSPECTION RECORD AppKESS /311 S, W AJ n t-r - �-aba-Eta L - DESCCRIPTION OF WORE NEW ADD r ALTR R1QA1R DEMOLISH So. Fr. 3 t SNTo. o r FAoia r,, slzE US F UCTURt A- SIGNATURE OF V APPROVALS APPLICANT DATIESF Q'S SMIATUEE ADDRESS E s FOUNDATION: LOCAT`ON D D ir�r F.0 # FORMS tiATE]IIALS PRAl.III FIRE STOPS. ■RACINo.MOLTS ti ` VALUATIONFURNACE: LOCATION. GM VERT DUCTS t HIIILSY ACKNOWLEDGE THAT 1 HAVE READ THIS _ APPLICATION AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO AND STATE LAWSN REGULATING SULDINO CONSTRUUNTY C' LATH INT. LL 4 TION. LATH ECT. SIGNATURE OF HOUSE NUNS !00 PERM RtCT ANDEIPOTTED ADDRESS FINAL vvm.J. FOX.CouNTY mNOINEE.R VALIDATION C. N. DIRLAM. CHIM7 BLDG. INSPECTOR -a07r' KC 2 1 .12.0 0 a _ 850519 LA WORKERS'COMPENSATION DECL, ATICKJ = 'z hereby affirm ;bat ) havera•_grtFfIcats of can}ent1a self APPLICATI�I� FCSR �IILD�NC-PERMIT Insure, or a certificate of Workers' Compensation Insurance, orQcertffiecopy cothereof �Se I. ': .,j. ; Lab. C:) . COUNTY OF LOS ANGELES BUILDING .ANfJ SAFEYY J Policy No.I UR,5,-72,5 15*mpa+rrufrant L ndenn 1 t V - - Certfflatdcopy.Ishereby;furniihed. `. FOR APPLICANT TO FILL IN BUIL°I14c ADDRESS V U CertIfled copy Is filed wlfh th4-eouMy-bolldln9 Imo- BUILDING tion departrA'ent. - ADDRESS 5327 Camellia Datil 110/16,/$5-" licantVIrg1.R.•Roof .Co. CITY ZIP - LOCALITY ..CE=RTIFICATE OF EXEMPTION FROM WORKERS' - NO;OF$LDGS--- tEA.REST - COMPENSATION INSURANCE SIZE OF LOT - NOW ON LOT - ST - - ' (fhrs•section nebd not be-completed If the permit Is:for one TRACT BLOCK LOT NO S R hur)dred dpllgrs ($LOQ)or leas.) MAP BOOK PAGE PARCa TEL UgZ04 "MAP hcerflfy that In"tFle perfprnjance of.the war for whilch this OWNER NO.- permlt Is Issued,.]shbll not employ any person 1n any mdnner -' 1V0. SPECIAL tZ to as-To become kublect to the Workers'Compeniatlon Laws. - Axgmas- above CONDm6ns 8 CITY- - ZIP - -TIE T(� O APPLICANT:-'If; after"Makln9 this Cerifflcate of �� TEL DISTRICT GRpIR TYPE ._. RRL- 9Y CONST. ZONE E�tenS'ptlon; you should becdm6'subject to the Workers , b ,I/ CompensaHoh provisions of the L_aboriCode, you must forth- ADDRESS _ with compfy with-such provisions or this.permit shall be - T� - - STATISTICAL CLASSIF T10N AFT. deemed revoked. CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION. - -- - -- CLASS NO. DWEI I UNITS I hgreby affirm that I am Ilcertsed-under-proytsions of Chapter 9 ADDRESS'P.O. BOX .1 NO LIC- �6o1;5O (p6mmen8ng with Section 7000)of DlvWon 3 of the B*ftess and SEWER MAP San Gabriel CA 9177 Profes�lons Code, aril rry license Is In full force;arl�effect. CITY a t r.•, Sp. FI. NO.OF [JQ.-OF CH BK PG. Licen'W Number i oO6r]O Llc Class C39 SIZE STOOE$ FAAAILIE� ONE VALJJATIQN- . oEscl moN OF off and re-roof NEW Contractor U i re I n Roof Co,Dare 10/.16;/85 - i 6690.00 - • ❑ lam exempt under sec ith Class A composition :shingl . _ 3] squares AIrER f T B.BP.0 for this reason _ REPAIR USE OF Datb: EXISTING BLDG. �� --- .. -Sig6aturp _. Vlrjjn Roof Co. NO. 287-0507 MAL _ OWNER-8UIIDER DECLARATION DATE I hereby affirm that I am exam pt-fro m the Confractor!s License ADDRESS POBOX J San Gabriel 9177 :a. ;132 4.2 A Law for the following'redson (Settibn 703 . . 1.5, Business and _ -Profeaslorts,Cbde): - o o i - ❑ BUILDING - - - - - I, as owner of the property, or my employees with ADDRESS o o wage4 as their sole compensation,will do'the work dnd the structure Is not Intended or offered for sale Section LOCALITY - 7044, Business and Professions Code}. ( MOVING _ TTL a - _ NO I, rn owner of the property, am exclusively contracting with Ilcensed contractors to construct the proldct (Sec- tion 7044, Business and Professions Code). ADDRESS _ - CONSTRUCTION LENDING AGENCY SET BACK YARD. HWY TOTAL PROP. LII,E WIDTH I hereby affirm that there Is a cons dlon lending agency for FRONT the performance of the work for which this perm Lt Is Issued - P.L. (Sec 3097, Civ. C.). SIDE 8 - -- - - P.L. Lender's Name LDMA W. i Lenders Address P.-C. Fee f Permit Fee ..86.25- I.certify that I have read this appHcatlon and state that.the _ .. �. .- 10 O - above Informatlon Is correct. I agree to comply with all County Inveatlpatlon Fe* prdlraro-State laws relating to.bylldl.n9 construcH9n, Total Few96.75LDhb4 Perm. i _ and he by authorize representatives of this County to enter upo a above ment)oned pro fc, Ion purposes. m n A ��6 fH WMN�DaLANATOIN LANGUAGI _ I - SIp of AppAcont or Apnt Dots n 'CIZ� ISATRA IOAI DECLATION nt lf InsureeboracertlflcateooffWorkers' C mtpensatonnrnurar to e, APPLICATION FOR BUILDING PERMIT or.0 certified copy thereof (Set. 3800, Lab. C.) � Ni7 COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No./Company [�4/rGertlfled copy Is hereby fumished. FOR APPLICANT TO FILL IN AWRESG ADDRESS I`I Certified copy Is filed with the county building Intpec, BUILDING - p LJ tiogr deportment. ��J� / ) V Date Appllcant +/", IST� /7M'�-' CITYTe/.Xf• C1ZIP ! 210 ly LOCALITY CERTIFICATE OF DO MPTION FROM WORKERS' OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE Of LOT NOW L ST. (This section need not be completed If the permit is for orleASSESSOR hundred dollars ($100)or less.) TRACT BLOOC LOT NO. MAP BOOK PAGE PARCH TEL Z29— urt I certify that in the perforinance of the work for which thisowrlu eAy NO. }' AL permit is Issued, I Shall not employ any person In any manner ADDRESS 2 1 A AW NO 1) (TONS Ll. so as to became subject to the Workers'Compensation Laws. 8 Date Appllca � �nf CaTY � ZIP v ARCHITECT TLC DISTRJCT P I TYPE ARE BY O NOTICE TO APPLICANT: If, after making this Certiflc`ate of NO. ZC Cts Exemption, you should become subject to the Workers Compensaflon provisions of the Labor Code, you must forth- ADS with comply with such provisions or this permit shall be TEL STATISTICAL TION' AFT. rDO. Cf) deemed revoked. CpNTRACTOR Ni `//I Z LICENSH):CONTRACTCIk$DFCI.ARATION � L}C. ,,``nn CLASS NO. DWELL UNITS I hereby afflrn that I am licensed under provisions of Chapter 9 ADDRESS Q NO 'T`f SEWER MAP (commendng with Section 7000)of Div Won 3 of the Bus]nees and UC_ Proteeslons Cbde, and my license Is In full force and effect. CITY A CLASS BK. PG. VALFDAMN SQ. FT. NO.OF OF CHECK License Number Lic.CI SIZE STORIES FAAN LIES " ONE ��// JDate EI VALIIATFON`„O Contractor""a461 te6. rid-I& C- DEsatIFTION of WORK _ /ADD El I am exempt under Sec ALTE4 , r B.BP.C. for this reason REPAIR USE OF Date: EXISTING BLDG. DEMOL s - 171.756 Slgnature -CLAPPLICANT NO. F9NAL n _ OWNER-BUILDER DECLARATION (PRINT) DA T4� 0.1.21 8 8, 1 hereby affirm that I am exempt from=the Contractors Ucense Law for the following reason (Section 7031.5, Business and ADDRESS ;nL. Professions Code): BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the-work and ' the structure Is not Intended or offered for sale(Section 7041, Business and Professions Code). MOVING TEL EJI, as owner of the property, am exclusively contracting ACTCR NO. with Ilcersed contractors to construct the project (Sec- ADDRESS - tion 7044, Business and Professions Code). CONSTRUCT}ON"LENDING AGENCY YAC IfWY TOTAL SETBACK FROM PROP. CAPE I hereby affirm that there Is a construction lending agency for 7DE the performance of the work forwhich this permit Is Issued(Sec.,3097, Civ. C.� Lendees Name LDMA Ref. I P.0 f Permit Fee Lenders Address - I certify that I have read this application and.state that the lsuar,ce Fee 1 -' v LDMA P/C• above Information Is correct. I agree to comply with all County - Investigation Fee / ordinoncee and State laws relating to building construction, Total Fee ( LDMA Perm. f and hereby authorize representatives of this County to enter upon t�npr4ab for Inapecilon u�/ WMR PPR EGIANATORY LVXWAGa Date