HomeMy Public PortalAbout5328 CAMELLIA AVE_Building__ �;76A6 aA CE#8 31.67 APPLICATION FOR BUILDIeGPER
COUNTY•OF LOS ANGELES BUILDING / S--�
DEPARTMENT OF COUNTY ENGINEER ADDRESS _: ✓ s
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS,SUP'T OF BUILDING CROSS ST. l(941-
DIS T$)C NO, GR TYPE R B
PR
OR APPLICANT TO FILL IN V i, CONsr.
BUILDING STATISTICAL I! IFICATION SEWER MAP
L "'1
S CLASS NO. DWELL UNITS BK PG a�
. BLOCK USE ZONE MAP /�j
NO. C
Q SPECIAL
N0. OF BLOGS. CONDITIONS
LOT �Y NOW ON LOT
EXISTING RLMQ_ BLDG. SETBACK FROM
njEL. �� /JLC FRONT PROP. LINE OF (STREET)
��ryry O. CJ TYPE OF EXISTING SETBACK NI OHWAY + YARD = TOTAL
HIGHWAY WIDTH FROM C.L.
�i ECT OR TEL BLDG. SETBACK FROM
ER NO. SIDE PROP. LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L.
TEL. + _
CONTRACTOR NO
LIC CORNER CUTOFF YES NO c-
ADDRESS NO
CITY LICCLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS
CD
DESCRIPTION OF WORK
NEW ADD ✓ ALTER REPAIR DEMOLISH N
Z
SO.FT. NO. OFNO. OF
SIZE STORIES FAMILIES
USE OF
STRUCTURE
SIGNATU E F /le'r, -
APPLICA T
VALUATION$ V' ,C'•�0 APPROVALS DATE` INS'PECTOR'S SIGNATURE
P.C. PMT. i� FOUNDATION, LOCATION
FEE$ FEE$ 17, FORMS, MATERIALS
FRAME, FIRE STOPS, r
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
9UILD I NG CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK _
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA. LATH. INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
I O ORKMEN'S C�11•(PENSATI N INS RANGE.
/ ,S11W//j LATH. EXT.
SI lPt7ROF OUSE NUMBER COR-
PERMITTEE_ REC AND POSTED
ADDRESS- ' Fl NAL ® /Q
JOHN F. LEWIS. PRINCIPAL STR RAL ENGINEER
PLAN CHECK VALIDATION CK. M.D. CASH _ PERMIT VALIDATION CK. M.O CASH
LALlu1502'%Io- 6jai 1 D 17.25— v
r
BUILDING � � 'LD NO
ADDRESS
APPLICATION LOCALITY
NEAREST LSC.
DIVISION OF BUILDING AND SAFETY CROSS ST.
Department of County Engineer DISTRICT NO. RECEIPT NO. PERMIT NO.
County of Los Angeles s
WM. J. FCX, COUNTY ENGINEER GROUP DATE RECEIVED DATE ISSUED
CASSATT D. GRIFFIN, SUPT OF BUILDING ' _
FOR APPLICANT TO FILL IN TYPE CONST. RECEIVED BY V 15SUED BY
OWNER ^ /''
MAIL NUMBER MAPdO tC? SHWYE YES iNO
ADDRESS
USEZONE SPECIAL
TEL. CONDITIONS
CITY t y- NO.
ARCHITECT OR TEL. _
ENGINEER NO' - BUILDINGEXIST.
SETBACK YARD HWY STREET NAME WIDTH
ADDRESS FRONT
TEL. P.L.
CONTRACTOR NO. --
SIDE
ADDRESS P. L.
BUILDING - DATE CORRECTIONS INSPECTOR
ADDRESS
LOT NO. o BLOCK
TRACT 7 a 0
!�
n NO. OF SLOGS.
SIZE OF LOT 5� 0 I NOW ON LOT
USE OF �--_
EXISTING BLDG.
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH Z
SO.FT. NO. OF NO.OF D
_ SIZE j Q , STORIES FAMILIES r
USE OF STRUCTURE
;LI.
NO.OF
EMPLOYEES
1 HEREBY ACKNOWLEDGE THAT IHAVE READ THIS AP- - t. - -- - -
PLICATION AND STATE THAT THE INFORMATION GIVEN IS APPROVALS INSPECTOR'S SIGNATURE DATE
CORRECT.
IAGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS,MATERIALS
FRAME: FIRE STOPS,
SIGNATURE OF BRACING, BOLTS
PERMITTEE 5214
14 �
FURNACE: LOCATION, h
GAS VENT,DUCTS
ADDRESS.— ✓ �C9
LATH, INT.
AUTHORIZED AGT. _
a ,m ' Q O -=`_
�y I'• C•$ HOUSE NUMBER COR-
V/ FEE RECT AND POSTED
VALUATION .•.. :.f -' 7 $
FEE FINAL
76A63BA DBS 3 12-53
79"39.DEW-2 la-"
APPLICATION FOR BUILDING PERMIT 1
DMI3ION OF BUILDING FIND SAFETY BUILDINo
Dep=hmIIt of Co=t7 Enghx*w ADDRESS '
Co> Gf Los A±aolff LOCALITY
WM.J. FOX, COUNTY ENGINK" NEAREST
C''dATT D.GRIFFIN, 8UP-T OF BULL-DING /00
- CR038 ST.
DISTRICT No. GROUP-1TYPE S BK M AP PG
FOR APPLICANT TO FILL IN
15- CONST
BUILDING
ADDRESS M/ STH YEA Nb-
NUMBER r
LOT NO. BLOCK UOE ZONE SPECIAL -
CONDITIONS
TRACT
NO. OF BLDGB.
SIZE OF LOT NOW ON LOT BUILDING YARD FiWY STREET HANE EXIST.
USE OF SETBACK WIDTH
HXISTING BLDG. 1AA FRONT
P. L
OWNER SIDE - -
MAIL
ADDR1<8f - -
TEL 1 DWELL .1 UNIT S INDUSTRIAL
CITY NO -
2 DUPLEX-UNI-r- 6 PUBLIC BLDG
ARCHITECT OR TKI
ENGINEER NO. 3 APT-----UNITS 7 ADDN., ALT., ET .
ADDRESS - - 4 COMMERCIAL 8 F118C pr I
CONTRACTOR .No INSPECTIONS RECORD .
AD D R ESS LL
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH
SQ. FT. NO. OF NO. OF -
SIZEI&e STORIES FAMILIES
USE OF STRUCTURE
SIGNATURE OF
APPLI APPROVALS
ADDRESS DATE INSPECTOR'S SIGNATURE
�] FOUNDATION: LOCATION _
s � �1 P. C. f FORMS MATERIALS
•/ O FRAME: FIRE STOPS,
VALUATION BRACING •BOLTS
FEE FURNACE: LOCATION,
GAS VENT, DUCTS
1 HEREBY ACKNOWLEDGH THAT 1 HAVE R D THIS
APPLICATION AND STATE THAT THE ABOVE 18 CORRECT _
A�1D AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH INT.
AND NTATK LAWS RXGULATING BUILDING CONSTRUC- -
.TION. LATH, EXT.
fLONATURE OF HOUSE NUMBER COR-
rE17MITT09
RECi AND POSTED ^}
ADDRESS FINAL
WM. J. FOX. Couk" ENaLmom VALIDATION
BY LAC0 41 1.31, JM14 . 1 2.02 0
DE>SUTY r DUTY
I�Y BY 1 ✓.
(b DEPUTY DEPUTY
WORKEItS'COhA�T10N DECLARAOON aTGT',A .� _ �- -- �'-1>)+:�' ;•. , t1 'r ^- - - '
kais.a ��f�cath,of consent to w if d rr __ �`. I.
I ( rocertlficate of Worker'Compbruatron Insurpnce, ^ ..a...- ` �� _ � a L T
, ��cerltfl«i.cogy;thereof (Svc 3WO, Lbb.C'.� Y (�OLLNTY'b� LOS'ANGELES BUIL lNdr',*WD'SAF- T ,,
POcy'No.• Corn Pon Y - - ->- _
Cerrtfied'Gopy.Is herby famished: FOR-APPOCAN� O FILL IaF -f�' �DUMNG �G'GX�f�
Cer4ified'coois fifgd with tfre cq,4ntY building Tnspec; BUILDING- / '•''
on gepYr{mint;_
f Yte' f 's' -`Applrtoar d.
CITY /C �t jDp _ LOCALITY t`
.
CERTIFICATE OF FXEIVIpTFOItI FR07N WORKERS'T
bF L07 NOW QN LST ST. L /� :- �,r +tel/
COMf�1SATION.INSUR)4lJCE "�' _
�Th section.peed rpt be rom eta4 if thespet�mlt'ls for,one _. _ _ _ _ __. __ a - �.'. ' `I�{'
TRACT Kocx LOT tJd�.,_.__..,_ IV�AA '� AO '• PARCQ
kt�+ndred fjolkirsl(�100j Or l¢fe t� } .,' ___ T- _ ZONE
mApr
I certify SL
th4f Iq e`j rfPfTrW��4 ° Wpric fqr w�t`IGh this �' tr V t y-- -- t�f
permlf ri l*Wid,' sroR r)df¢mPloy.ahYp�! rt In a,IN r ADDirf55,
#d'as'to b'ei'6me'tbbJ,ect to the W
.722._ - - r -•I�__f--r.-_ _t.�:.y',ii..... ;� ,,. -�
CITY,
e y--4- �PPI11 . ARCHITECT QR T� _9JSJRIGT. GRO.I --49� --PRDqESSED BY._
NO;cC -Tb.APPLf�ANtf:,If''afiPr`rr akln'd'this.-Certi#icate of - NO: r ZOtJE
Exemptlb7r,,yoV ahoilld tieootne Oblect',td+4he' -wodceri' - r i �OrST.
ou^must forth- F - - - -- -
Compepsallon•provlstonsrof the:{.ak}br Code;sy, ,�p�� -
with comply wlth'.wch proVclslona or•t}lPbrmll shall be _ - - - -- - - -• —� L' STAT15T1CA1 FtCf1TK3N '
deefned,royoke�, t =: p , : •s,rr CONTRACTOR Q e%�. ' NO. - L_ -
LigNw CONTRACTORs waARATt)w,.a
1-be(eby.pffirrTl that,lam I�ce�under pro�islons of Chapter 9 ADDS NO. ' - t,
mrn with SecNq� }of Dly ior�3 of{ a kWhess and SEWER AAAA Y� 1
Pro#«slorls Code, dnd-'myIIcerbb Is Jn full force 4pd,effeft. Cfty CLAM BK �_/A DATION 7.
LJC CIS FAMILIIES - O 1f�. :i' ,...n;i. r, r. -•
NEW-
4ys - V.•,+..`i a.a,•u-t; ,L.' t .'.f a'. c a OF - l jL/ - ��•.�� -
ConfrCMOr
QI.am exempt under Sec -, 9 7(k 7 A -
'B.3P.0 for ihTER
ls regbn �r NR•_
z J
USE OF } '
_ P ►i:- E>asrrNG BLDG, *4¢$5-0 ,I
Slgna#11re` -JH- INT _�,C�./T_ n�
OWNER-BUILDfRbECL ATION _� _ CJI, C - _ - -e, a..�.Q Q-5+y c�.
Vh&reby<rffirm•that I am.e)(tmpt fr6 i Contractoe4-Ucanse
raw for the follo�l6gi recfoh CSeitlop-703i.5, Business and ADDt 55 =
''i�rofeesf•6►ti'Cgde7'- �^-"--r _'-_ - • - .- �`,:-`�'•�'rs-Q���'A.8$;- ,
1
BUILDING
I, as owner of.the p4oper4y,;of myer�sployees.wlti]' ADDS 't ' 1���; � �'' •` r
wages ai th-aIr•sole compeneatforr,w111 do the work and L � ✓Jf J nr
thtstrurture Ii not InMndid or offered for sale.(Section
7049,$yslness and�fofessrons Coded MOVING
I' am owner of the pr -drd exclusively contractlhp
with Ilcgrtsed controto rArratryct The{?rojecr;(S.c- ,
tion 704t,'"Ine and Professions Code},. _
'CONSTRUCTK)N LENDI AGENCY— : - SET.BAcx �! -FtWY - PROP. LItE MDTFI
I hereby.afflrm that.thefi b a cor4&Vctlon Iendrng agency for' Tthe performanccbf the-work-for-whlch'tHlrpefrmlt-b Iswed {• - - - - _ - - ���l�. a l x
(Ser- 3097,.CIv. C_} P
Leaders Name ~' r-
1a - - FermIt
.. _. P.0 Fee .'�• �'�='=•. -�- -_
lbndW�-Address
1_certtfy hat I hav*L.read:thb-c'ppllccttion_and.slvter that the _._- _ _.._ _ -- - hauancs Fer - - �?
above Information is correct. I agree to comply,wrt6 all County Inver110atlan Foe
oar ncg3 pr S.tatQ lav++�rrrlatig0 t bull�lnb�pnslru-rHon, Total fee LDAAA-Perm: i -
., qqgg '
arx)'h,eieby;oath tall of thfa.County to enter .
ooc Inspection pUrpos(M.
-r.
$111111!eiAM e041 EMAHATCWY t-A)OGUAGa
R SlprwtYrr ar Agent Dah -a -- - - r
COUITT OF LOS ANGELES 7EXPLE CITT f 0508 BUILDING PERMIT
DIPARTM3ZT OF PUBLIC WORKS 9701 LAB TRIS ALTZRATION/REPAIR
BUILDING AND SA.FVTT / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0605310023
PHONY: (616) 185-0488 =XT.
LEGAL ID: 190. OF CONST BU-=IIG ADDRESS. -
TRt 17780 LT. 11 SQ. TT STORIES TYPE 5378 CAMXLLLA AV
STRUCTURE, 3000 VI TZKP CA 917803144
ASSESSOR INFORMATION NUMBZRi r ARX9T CROSS STREET: BLAC=L!Y
8589-007-019 THOIAB PAGZ� 597 QYID: A4 LACIL=t TZMPLN CITY, C
TZNAITEAST BLDG USE: RYSID USE EONli R-1 IBSUXD ON: PROCESSED BTS E3LPIRYS ON:
EXIST OCC XPi 05/31/06 J7C 05/76/07
OWIRR: TIL. NO: BLDGS. NOW ON LAT: VALUATIONi 7 IXAL FINAL By, - CODR:
AIffi RAXaLIL• DICA.ROL L (676) 785-6711- 7,000 ��O
5378 C11�I1 AV
TEMP 917803744 FZYS P>ID D=—S 'RID�T OI OF WORX
TZAR Olt AND RYROOF D7S5lWTIAL 40 YR COMPOSITION SHINGLES
FEE DESCRIPTION: QUANTITYI UOMt AMOUNT
APPLICANTi TEL. NO-
SAME AS OMQZR - AA BLDG PERMIT ISSURNCE 77.75
AC STRONG MOTION REBID 7000.00 VAL 0.70 SPECIAL CONDITIONS:
D7 PERMIT W/O ZN-HC 7000.00 V]L 166.70
TOTAL 73M 194.65
CONTRACTOR: TEL. IOC APPROVALS DAT➢ INSPECTOR SI®170RE
SAME AS OM3YR -
LIC. NO LOCATION ASID SETBACKS - - -
SOILS ZOG3SOM 1PPROVAL
ARCHITECT OR YNGIYXKt: TEL. NO: FOUNIIxrION TR=CH FORMS
LIC. NO, SLAB UNDER FLOOR
RAISED FLOOR FRAMING
MAP NO: BVWXR MAP BOOLi PAGH: FIRE SONY: (30 1 UNDZRTLOOR 31SULATIOff
147H769 3 01
' FIAOR HHRAl'H lYG
NO. OF FAMILIES. TELLING UNITS. APT COED: STAT CLASS
NO 71 ROOF HIMTE-IIG
SCHOOL WITHIN HOLZARDOUS SHEAR PANELS
AIR QUILLI:TY. 1000 FEET M&TIMTALS
NO NO NO FRAME INSPECTION -
RYQU RIM TOTAL SVTEACL FROM ZZIST FIRE SPRTXPUiXR HANGERS
SET BACX YARDS ENTI PROP LINE: WIDTH.
FRONT PL- INSULITION THZR STRIP
BIDE PL-
INTYYIOR LATH/DRYWALL
ZZTRRIOR LATH
RATED FLOOR CYIL ASSBK.
RNID 13LL ASEW01IYB
RATED SELFT8 OPYYINC38
T-BAR CYIL-TNGS
LOT DoiIKAav
REPORT ID, DPR761 ROUTE TO: BS0508