HomeMy Public PortalAbout5337 CAMELLIA AVE_Building__ APPLICATION FOR BUILDING PERMIT
FOR APPkANT TO FILL IN (Print or type only)
COUNTY OF LOS ANGELES
BADDRIEII '�� DEPARTMENT OF COUNTY ENGINEER
urY ZIP BUILDING AND SAFETY DIVISION
NO.OF BLDGS. BUILDING
SIZE OF LOT NOW ON LOT ADDRESS (/
TRACT BLOCK LOT NO. LOCALITY
-TEL NEAREST
OWN ERC% f CROSS ST.
ASSESSO
ADDRESS,3 ' MAPMAP BOOKR PACF PARCH
_ �� t DISTRICT GROUP TYPE FIRE ED BY
ARCHITECT OR- ZIP TEL t7 ZON
ENGINEER NO. STATISTICAL CLASSIFICATKNISEWERAIP
ADDRESS TEL ELCLASS NO.�L�DWL LRJTrS K BK
CONTRACTOR N�. lb 9NE MAP
Li C- NO.
ADDRESS NO. SPECIAL
LIC J_ CONDTfIONS
CITY 4-°S ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑
CONSTRUCTION LENDER
NAME AND BRANCH .SETBACK FROM
FRONT PROP.LINE OF ISTREETI
ADS CITY TOTAL SETBACK FROM TYPE OF EXISTING
SQ.FT. NO.OF NO.OF CHECK HIC#iWAY + YARD FRONT Pi�Op UNE HIG WIDTH
SIZE STORI ES FAMILIES ON E
DESCRIPTION OF WORK NEW +
ADD ❑ BLDG.SETBACK FROM oc
SIDE PROP.UNE OF (STREET) O
ALTS ❑ TOT CK FROM TYPEOF EXISTING
H]Gi(WAY + YARD SJ DE LINE HIGHWAY WIDTH
LME OF REPAIR ❑
EXISTING BLDG. DEMOL ❑ +
APPLICANT TEL CORNERQJTOFF YES ❑ NO ❑
(PRI NT) NO.
IN OPEN SPACE YES ❑ NO ❑
BY ISIGNATURD
IN COASTAL PERMIT ZONE YES ❑ NO ❑
VALUATION �
1HERBO
Y AQ40YAJDGE TFIAT I HAVE AD-�Tftb.�RlSLlUlryX `d'bYi{tE - b�
THAT THE ABOVE IS ODMY-7 AND, 70 QQMP�Y WfTH AALLLL O0
AND LAWS LATINO BUILAING CO�TIOf1 I'(�i'11 FY hiAT�LN ZO NCi THE 1, a
vVOR)c AlJTF10R17$3 H r a NOT PERSON IN, TION C
THE LABOR CODE OF THE STATE OF CALJEORNL4 W ,nNG�Q 'S ODW 'c ,!�},��.-�q
PENSATN I .�� 1:�, /��L� C X70 4
IO
SIGNATURE
PBzmrrrEE
ADDRESS
r pNA1' �I/� BY
TE-
CITY..
E
.
CTTY NO.
MAKE dl RFLYA61tt.fO� ` FEE77
$ PMT. $. J
HARVEY T.BRANDT.COUNTY'EN�lWi-tFTt #' ) I$ FEE' , U •n 0
P4AN CHECK VAL16ATION cx W-0., C"WH PERMIT VALIDATION cIc K.o. CASH
,AtL 1
15-00A
es 7eAe3nA CE Ye03 3-73' .
7eGe3e,1� cv.-i Boa v-eT
APPLICATION FOR BUILDING PERMIT
COUNTY .QF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVLSION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, 9UP'T OF BUILDING NEAREST
CROSS ST. ,
FOR APPLICANT T FILL IN DISTRICT NO. GROUP TYPE PROCESSED BY
CONST.
Print or type only)
BUILDING STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS CLASS NO—E—L—DWELL,UNITS BK PG
LOT NO. 7:2 BLOCK USE ZONE MAP
NO.
TRACT _ SPECIAL
NO.OF BLDGS. CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF
EXISTING BLDG. BLDG.SETBACK FROM
TELA FRONT PROP.LINE OF -(STREET)
OWNER G_ TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
A D DR E33
HIGHWAY WIDTH FROM C.L.
CITY / 0 + 2
ARCHITE TEL. BLDG.SETBACK FROM (STREET)
ENGINEER NO SIDE PROP.LINE OF
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
A D D R s HIGHWAY WIDTH FROM C.L.
EL. + _
CONTRACT NO.
ADDRL, O. CORNER CUTOFF YES ❑ NO ❑
LIC. C)
CITY CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS
DESC PTION OF WORK N
z
E ADD ALTER REPAIR DEMOLISH t
FT. NO. OF NO. OF
SIZE STORIES FAMILIES
USE OF
STRUCTURE C�
SIGNATU E OF "--
APPLICANT
VALUATION S
APPROVALS DATE 'INSPECTOR-8 e1/MATURE
P.C. r3 PMT. S� FOUNDATION: LOCATION
FEE7-12--4 .
n, f c,
FEE,%-'5-,-_6.3 FEE S FORMS MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEOG[ THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE A/OVE 1/ CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
WrTH ALL CoUNTY ORDINANCES AND eTATE LAW/ REGULATING GAS VENT, DUCTS
BUILDI
NO CONSTRUCTION. I CERTIFY THAT IN G THE WORK
AUTHORIZED ILL NOT EMPLOY ANY N IN VIOLA.
TION OF THE OR CO E O E STA }. ORNIA RELAT• LATH, INT.
IND I WORKM '/C IN NCZ
LATH, EXT. { l
SIGNATUREHOUSE NUMBER CDR-
PERMITTEE '
AND POSTED
ADDRESS FINAL
JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION �.D. cASH _ PERMIT VALIDATION(:o M.O. CASH
LSO:S 5 2 2's ml 82 3 D 5W,5 F 1 9 G Ja l 8 1 D 2 2P50-
���
S-, 63 �l�
.DMSIQN
OF nty AND SAFETY
Department of County
2 BUILDING
°°`m` , Lm Angeles 2 195 APPLICATION
WM. J. FOX, COUNTY ENOIN[ER
FOR APPLICANT TO FILL IN FOR OFFIC$ USE ONLY
_ I DHFMIOT MO. Pw+Ott. OR RED.NO. PERMIT NO.
ADD R10�ILDINO
■ 1 �I O 6 3 7 5
D v�
LOOALITY 1 I.r Rvqo'�!N DATE0%ArPL. DATE IMUS
NLAlIQ1' j�'�
O � `� T1V ■UIL
ADD=
OWNER
MAUL /y I'�+U�
ADDRESS `�•- - f NEAREST
SS
A /5 OR OTT.
FIRE NO.OF [ OROUP
AROH OR TKL IO~[ PLANE
ENGINEER NO. TLDR NO.
TETIADIL LINEADDRESS d r
Uzi AI?ROVLD
T=L, ZONE IY DATE
OONTRAOT'OR NO. HOLT[ NUMTERIND
ADPRXM MAR NUMHKR No. ANSIONED IY
LAMML
DEmOON LOT No. ■LOOK �QRRRCTTONS
Q Na CW ■LDOi e e,
■Ia OF LOT NOW ON LOT
UTI of NO. CW /,-3
IXITTIND■LDO. t'� FAMt o
DESCRIPTION OF WOKS f o�
NEW ALTDIAnDN ADDITION z
REPAIR DEMOLITION
TQ.FT. NO.OF
01331 .WALLC�'` ROOMS TTORIE7 An
RW
C"7.FX aNO V 1 N ODOWMNI 1�
UT[OF oTRUOTURE i
INI PEOTION FOR APPROVARS
OODUPANOYAM IHOP[OTOR'GeIONATUR[ DAT[
FORIMT. MAT10t1ALITION
4
1 H[RITY AC KNOWI.EDQE THAT 1 HAVE READ THIS AP-
PLIOATION AND STATE THAT THE INFORMATION GIVEN 10 MAN EI FI WE WrOPT.
OORRtaT. ■RAD1N0. ■OLTT
1 �p R!E TO OOM14.Y WITH ALL COUNTY flRDINANO[T F1IRNAOE� LOOATION,
AND STATE LAWS REUULA NO IUILDIND OONITRIJOTIDN. py VENT DUGTE
1
■IINATUR[ � �� LATH. INT.
PKIRMITTIEK4r
ADD LATH, EXT.
PLAXTIM INT.
AUTH OA I .MT. -
J PLATTER. EXT.
I ! t S.'� HOURK NUMBER GOR-
J'Q D REOTAND POTTED
• D
VALUATION Fa FINAL -13
D6M 2 7-119