The URL can be used to link to this page

Home My Public Portal About5712 CAMELLIA AVE_Building__ 7GAOSDA Ci iW7IIa7 APPLICATION FOR UILDING PERMIT �. COUNTY OF IAS ANGELES BUILDING t DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A.LAMBIE,COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN Gur'T of Bun-DIMa CROSS _ DISTR1 NO. GROUP Ty-pr- SEWER AP R M FOR APPLICANT TO FILL COIN - �C_raK ; BUILDING177/ STATISTICAL IFICATION ADDRE88 may- - . LOT NO. J. BLOCK CLASS.NO LL.UNIT - MAP STATE YES NUMBER D HWY. TRACT r U8 O H SPECIAL �/ NO.OF BLD GB CONDITIONS siza OF LOT O O NOW ON LOT 'd it 6 USE OF TUILDING EXIST. T=I YARD HWY STREET NAM WIDTH OWNER FRONT -MAIL _ P.L t ADDRESSCITY glpE ARCHITECT OR TEL INSPF. 'CYTON RECORD ENGINEER NO. _ TEL CONTRACTOR NO. ADDRESS 0 . DESCRIPTION OF WORK Ir NEW A-' ADD ALTER REPAIR DEMOLISH SQ.FT. NO.OF NO.OF SIZE - STORIES FAMILIES USE OF 2TROCTURR - SIGNATURE OF APPROVALS APPLICANT CLATE INSPE 'E SJONATURE ADDRESS FOUNDATIONi LOCATION FORME MATERIALS A 6-0 d a P.C. ; (J FRAMES FIRE STOPS. - ,U FEE BRACING, BOLTS VALUATION Q 111 FURNACEi LOCATION. E GAS VENT.D U CTS 1 HERHSY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH INT PLICATION AND STATE TI-AT-THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS RSGULATINO UILDING C.ONSTR LATH,EXT. SIGNATURE OF HOUSE NUMBER COR. PIERMITTEEr RECTAND POSTED ADDRESS FINAL CLYDE N.DIRLAM PRINCIPAL STRU RAL ENGINEER PL&K CE=VATMLTION CK. WO. CATH P13HHI'f VALUATION CK Y.O. CATH, m. Lgo 3066,R XL21 1 43.50 � i .. � APPLICATION FOR BUILDING PERMIT Z COUNTY OF LOS ANGELES SUILD,NG DEPARTMENT OF COUNTY ENGINEER AD BUILDING AMID SAFETY DIVISION LOCAL] JOHN A.LAM BIE.COUNTY ENammxft NEAREST CAMATT D.GRIF71H,*upwT or D182NO. GROUP COPS F:DRX8S OR APPLICANT TO FILL IN CONST. ol STATISTICA IFICATION HEW R MAP CLASS.NO UNID7.Q STATS NUMBER fryyYYES NO USEZ.ONS SPECIALNO.OF BLDGS. CONDITIONS NOW ON LOT SE F ElUILDI K AM Wim' YARD HWY STREET NE • CK WIDTH NT Ir A[AIL P.t. ADDRESS HIDE CITYP. INSPECTION RECORD ENGINEER O. ADDREW TEL- CONTRACTOR ELCONTRACTOR NO. — / � DESCHUMON OF WORK r N ADD ALTER REPAIR DEMOLISH f .FT. NO.QF NO.OF SIZE STORIES FAMILIES USl OF HTRU RE 1 J QIQNATU-RS OF APPROVALS APPLICANT DATE IN3PECTOW3 SIGNATURE ADDR FOUNDA ION. LOCATION s FORMS,MATERIALS P.C. sI FRAMES FIRE STOPS, Cn FEE BRACING BOLTS VALUATION 4d j FURNACE: LOCATION. FEE GAH�VEM DUCTS 1 HER BY ACKNOWI=GE THAT h HAVE READ THIS AP- LATH INT PLICATI N AND STATE THAT THEE ABOVE IS RRECT AND AGREE TO COMP TH ALL COUNTY ORD NCNB ND LATH,�� STATE LAWN TING SUI O ON. g1ONN,A�TURS HOUSE NUMBER COR- P$RMI RECT AND POSTED DD FINAL C CLYDE N.DIRLAM PRINCIPAL L ENGINEER ,- Y.O. CAjai VAIMATION Y.O. CASH 7 6 5 4Ln JUN g 2 3 A 6.0 0 r� L7656 sA 8 1 A 12.0 o- WORKERS' COMPENSATION DEaARAnON 1 hereby affirm that1 have a cartCo,p ns tion Inf to self , ° APPLICATION FOR. BUILDING PERMIT Insure, or a certtflcate of Workers: Compensation Insurance, cr a certified copy thereof.{Sec"3800,'Lab.,C.) COUNTY OF LOS ANGELES WILDING AND SAFETY Policy No. Company BUILDING ❑ Certified copy u hereby furnished. FOR APPLICANT TO FILL IN ADDRESS -��/'t. ❑ Certified copy is filed with the county building Inspec- BUILDING' tion department. ADORE SS Date Applicant MY ZIP �� NO. OF BLDGS, CERTIFICATE OF D EYJMON FROM WORKERS' SUE OF LOT NOW ON LOT NEAREST CRO55 ST. COMPENSATION I NSU RANCE (This section need not be completed if the permit Is for one TRI CT O(X LOT NO. BOCK PAGE PARCL hundred dollars (;100) or leis:) ftAM r, MAP owrIER I cortlfy that In the performance.of the.work for which>1s NQ, permit Is Issued, I shall not employ an _In.an nor. ADDRESS CONDMCX-4S so as to'become subled to or Ars O My ZIP [ () Applicant ARCHITKTOR TEL D GROUP TYPE FIRE= BY Q NO TO-APPLICANT: If, after making Is Cert f ENGINEER NO. OD ZONE 0 Exemption, you should become subject .to the, Workers Compensation provision; of the Labor Code, you must forth- . ADDRESS Da 3 with comply with such provlslons or.this'permlt shall be TEL STATu�AL��yTK)N APT. OONDO, deemed revoked. OONTRACTOR NO. Z UCENSED,CO ICTORS DECLARAnON7 LIG i , CLASS NO.�'/ rnvlat UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. �cgmmencln9 with Section 7000)of.Division 3 of the Business G ��MAP =salons Code,and my licerse Is In full force nd effect. CRY BK PG VAUDAnON SQ. FT. NO. OF NO. OF CHECY Ucense Number-' I ,�� Lic. CICM SIZE STORIES FAAAILIES ONE — VAL ON �bntroctor �• 1 + Dc p-n OF RK NEW :. �r _ ❑1 am exempt.under Sec ADO ❑ ► AL 10:11 B.BP.C, .for this reason pp—if AIR ❑ ; Date USE OF IV EXISTING DEAAOL ❑ Signature, APPLICANT MAL OWNER-BUILDER DECLAR4n0N .DATE r I hereby affirm that lam exempt from the Contractors Ucerse Law for'the following reason (Section 7031.5, Business and WAIAL Ptofssslons Code):.. BY ACCT.i El 1, as owner-of the propbrty, or my employees with ADDRESS BU 3303 142.20 wages as their sole compensation,will do the work and LOGIITY , the structure Is not Intended br offered for'sale(Section 1 ITEMS. 70441 Business and Professions Code.) tAOVlNG ACTOR t 0 TOTAL j. r? � ❑ I, as owner of the property, am excluslveLy contracting with licensed contractors to.construct the project (Sec- AbDR . CWCK tion 7044, Buiinew and Professions Code.) 142.20 TOTAI CONSTRUCTION LENDING AGENCY REQRm YARD HWY FROM I hereby affirm that them Is a construction lending agency fol FRONT .the performance of the work for which this permit Is Issued' P.L. (sec 3o97, ay. C.). SIDE. 0 -010 1 6/19/96 _SIDE Lenders Name 7002 1 AM 9:07 . 9t� LDMA Rrf. i . P. I" Perm it Fye Lenders Address Icertify that I have read this appllcatic and state that the lasuanc LDiM4 P/C i above Inf .rmatlon.ls c . I agree ro comp y'wlfh-aII County Investigation Fsy' _ ordinances and State I relating to building construction, Total-Fee LDAAA Perm. / and hereby a I this County to enter v n or Irspectl n — fit RFaM POR LMANATORY LANGUAO� Signature Applkant or Agent Date . I WORKERS' COMPENSATION DECLARATION to sel insure, oraa certificate of Workers' Comtpensation ent Insuran of APPLICATION FOR BUILDING PERMIT or a certified )copy 9'}hereof (Sec. 3800, Lab. C.) j,_ 11 COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No .J�'4- Vmpany %rf.' s: ] ,.:',, f BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING 1 f tion department. ADDRESS 71LOCALITY r t ( r` ,, ;i .��, ,� tCITY r, i � ZIP Date,yl-ij Applicant NO. OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. COMPENSATION INSURANCE ASSESSOR (This section need not be completed if The permit is for one TRACT I BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100) or less.) ! r ) TEL. 1 ZONE USE MAP OWNER I ro t r 1 NO. x�, al I 1 NO. I certify that in the performance of the work for which this ) T 1 SPECIAL permit is issued, I shall not employ any person in any manner ADDRESS ? ! , / r .k , , J CONDITIONS so as to become subject to the Workers' Compensation Laws. z } CITY• ] ZIP Date Applicant ARCHITECT O TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY OU NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CONST. ZONE w Exemption, you should become subject to the Workers' � Compensation provisions of the Labor Code, you must forth- ADDRESS LL_ comply with such provisions or this permit shall be / TEL. �- CONTRACTOR `,I f 'f f { ! NO. 3 STATISTICAL CLASSIFICATION APT. deemed revoked. CONDO. a, LICENSED CONTRACTORS DECLARATION LIC. `` CLASS NO. DWELL. UNITS < ADDRESS ' (r''- l, !U ''- i'. NO. I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP 2 (commencing with Section 7000)of Division 3 of the Business LIC. and Professions Code,and my license is in full force and effect. CITY CLASS BK PG VALIDATION w SQ. FT. NO. OF NO. OF CHECK >1 III License Number[' ? Lic. Class SIZE STORIES FAMILIES ONE VALUATION Contractor=' ` )''" Date ai > C� DESCRIPTION OF WORK NEWJ - ADD [I $ ❑I am exempt under Sec. t�t' v' t'~ ' ALTER IE]B.&P.C. for this reason REPAIR ❑ $ Date: USE OF EXISTING BLDG. DEMO' ❑ Signature APPLICANT,. I TEL. ;x FINAL (PRINT)`, / N't r l" NO:' ? DATE OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FINAL e Professions Code): PRESENT By ElBUILDING 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 LOCALITY 7044, Business and Professions Code.) MOVING TEL. I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code.) REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK PROP, LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name. VLDMA ef. # Lender's Address P.C. Fee$ Permit Fee , � 0 1 certify that I have read this application and state that the Issuance Fee /C# above information is correct. I agree to comply with all County Investigation Fee 6 ordinances and State Laws relating to building construction, Total Fee LDMA Perm. # a and hereby authori�e representatives of this County to enter ugpn'the above-f property for inspection purposes. f/ SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date Y RS' COMPY4' AT1QN DECLARATIQN tr +re or aficeerrtl tate of Workers' Coi-h �on nt�ro AP PL I CAT IO NIT O R S U I L D I N. PERMIT R�1A T. or n certtFled copy thereof (Sec:3800,'lob• � ) �• 16601 1F OF LOS AINGBJW i --SWLpl f4G AND SAFETY , Pbllcy No: ��fiompany.: .�r�. caroified'co,py ls.hefY ieky . rDESS ,nlshed. FOR PLICANT TO FILL IN ADDRESS Certified coopy Is filed wftfi the cou,t,ty bullding Inspec--` BUILDING y�� f tlon dep&-tmenti / _ Date l� App1 h nt zip - LOCALITY y HtTIF}G4Tt'bF' No.of NEAREST d EXEMP-tQ F FtkbM RS" SIZE O -IOT- NOW QN LOT CFQ55 } COMPRJ,SATiON INSURANCE c _ is @action need not im cor6pleted1f 4a jf ri'fvr one -. Pe[rh OCX t0T NO. BOCK- TEL OOM _ P PARCH hundred dollars{;1'00)yr Jess ' ' OWNER r aCf ►/1� ��,�' - NO. vYv� I y that.in the-perfgrmgnce•of the-work-for whltfi tfilf peimli Is IssuQd, I,shall-oot e' I Qrty.pmon In any:manngr. ADDRESS t -Y. SPE(I"p7AL po cls,tq becote sublopt to th@-Wor}cers'Cbrhpensatlon Laws _ m O ^ ,r.i" - -ZIP •APpjlwnt _,;z,; A. _r ARCHrfEGi OR T6 3 R TYPE RE BY NOTICE TO APPLI(ANf:.lf :after=maklriy this.Gerttficpte.pf E _ NO. �' OOtST. E Ekemptlon;•you co should beme.,subject to. thd.fWbrkd*,.1 �J Compensation provisions of the-Labof Code, you,mus;'forrh : ADDRESSI. v)^ wMh•comply wlth.sUcj� provisions or;ifils pemilt ingll �.- �`'. TEL deemed revoked: " .. Her! NO $TATI5TIC11LCLASSIFtGTION. 7 QQNDO. U CQNTRACTOf#S•D50 ARATFOf I'! CRSS No. 7 nwa I ,UNITS ! I hereby affirm thatl'a fn ilceitsed urdef provlslons.f Oxoter9'. _ �ommpncing with Secflon900E)yof D1,VIilofr.3 of the Business LG /. .r $�MAP abd ProfeslQrn,Code,and - Jlcerue M fijllforce and effed.- f �. ALiDAT] CITY,' SQ: r o o� r�o. QE o-lEac PG. J�T�A _ �b Ltc�nse Numbef' 7y �,iT�' Clads ZE o sroklLS F uEs oNE .'• _ • �. Till r VAl4A "WORK ElC.nttPTOO - $ {# 4Cv�Er ,.. it'f,■.aryW{}I r� 'ab'e/ AJ I �1 am exempt'undef 6ec `- .ALTER, ❑ - �;' ��ryr•�� r•�r�t�i i�y,�. B,&P:C_foc'thls,ro*n �' a REPAIR ❑ ; t lPJl1V�JLSJ1 _' �;3/L3A-37, [3ritw USE OF... v. - Cy t i ` EXISTING IKVG' ' /� l DEJN�L IJ 2070 1 AM :�4 58 $rgno rture NO. FIS C6A NER BUILDER DECLARATION . TDA 1 � ' I'hweby affirm t*1 ani eketript from the'ContfaGots LJcense Ldw-for the fbllowlhg'rfsasQn and sD0 5 Z Fl I professions Eode�: ❑ I •as owner,of the drop",-or'.my bmploy wMh BUILDINGADDRESS � �t~T�i i-w¢4es as their sole compen*c tlorl,w1H do+4 work.dngf - }�. the atruMrs Isnot Intended 4f offered for sale(Sbctlba 'sL�` 3��. �F��{:i yU4, lk*I ess and,ProfeUlons C-6de.) Mo'YING Ta- as gas owner of the property, din,dxcluslvely tontmctlnq NO. l AD with-licensed oontractaq to construct the a proved (SeDRESS' - ` Tli l tion 70",.Bu*Iness qn�V)Ofes'lons_Codc:j_ CONgTRLfI OfJ LfN01 P}G'AGENCYYARD FfEIM VYY I hereby affirmthat there is b.conatructrgn lending agency for FRONT C 00 the pgrformance.bfAi-A work fok which thlsi p&rmlt Is lasued.' RL J r ■ (Sec 3b971 Cly. Gh. r; SIDE Lander'iNome� J 1 S/17 /a �-,1 g LW�M Rsf. x' 111.1 tender$Address' P.0 FM `� Psrmlt Fse J 2071 1 A i 9:55 I Certify that'll lrjave rood,thit oppllcatloa and state that the . - Lawrance Fee ` �•� LdN1A P/C# _above Infbrmatlon Is correct. I ogreeto.comply with bll County tnve4tl¢att2n dee _ ordinances and State laws relatlnfl to bullding construction Tonal Fee I U31iAA Perm. and hereby,authorize.repro"ntatives of thli.Couri nty.to eAr - upon thb above-mentt ed prtrperty'for Ingdlon purposes, t -7" finVill POR an-wf9"LA1#gv1 .. rwturs of Ak lkant or Agent" iJat� t;