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Home My Public Portal About5718 CAMELLIA AVE_Building__ _41 -,AWRKE--F COMPIlNSAVI N DECLARATION hereby affi at I have rk certificate of consent to .elf APPLICATION FOR BUILDING P E RM I T Insure7.or"a caters'e.of WorkCompensation Insurance, or a certified copy tthereof (Ser-.3900, Lab. G) ^j r. C50UNTY OF LOS ANGELES BllImING AND SAFETI( Policy NO.� Company - -- I\ BUILDING' ❑ Certtfled cop�bweby furnished. FOR PLj NT701#11-L,ILL IN _ ADDRESS . P ❑ Certffied.copy is filed wfth 0-a county bulkiWg Inspec- ADDU 1 - tion department. Date Applicant - CITY LOCALITY' NO. NEAREST MIM CERTIFICATE OF DPTiON FROM WORKERS' OF LOT ON LOT - CROSS ST. COMPENSATION I NSU RA14U ASSESSOR (fhli section need not be comleted tf the permit Is for one TRACT BLOCK LOT NO. Map BOOK . PAS PARCEL hundred dollars (;100)or less. ` • 115E ZONE OWNER , I certify that in the performance of the work for c is permit is Issued, I shall not employ any person In nner ADDRESS CO ONS a so as to become subject to the W O CTFY ZIP el,7,00-,00 / U Date AppIIoo ARCHITECT OR TEL DI GROUP TYPE FJRE BY ix NOTICE TO APPLICANT: If, after making fits Certificate of ENGINEE?'a _ NO. ZONE Exemption, you should become subject to the- Workers /��.f _3 ¢ 0 Compensation provisions of the Labor Code, you must forth- ADDS 1116f J with comply with such provisions or this permit shall be . TEL STATISTICAL CLASSIFICATION APT. CONDO. V) deemed revoked. CONTRACTOR NO - a UCENSED CONtRACTORS DECLARATION 1 /0 CLASS NO. UNITS . . I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS / SEWER�yAp - mow (commencing with Section 7000)of Division 3 of the Business q UC �— and Professions Code,and my Iicerue Is In full iorcepnd effect. CITY l S BK . PG VAL DATFON I SQ.FT. NO. OF NO. OF CHECK Hoo a Number ' �DI YR/�� Llc Claes' SIZE STORIES FAIWUES ONE" ON Contractor4-O DESCR(PT1ON OF WORK sAIUATI ' r ADD o Date ❑Iain exempt undet Sec. fMMIL poll- ALTER ❑ BAP.(r..for thls reason' REPAIR ❑ ; USE OF ❑ sco NG BLL)(,'. Signature = APPLICANT NCO FINAL 1 QWNER ILDER DECLARATION DATET A�GT ` I hereby affirm that I am exempt from the Contractors-•Ilcense • Law for the following reason (Section 7031.5, Business and ADDRESS FINAL 3303 125.55 Professloris Code): dY 1 ITEMS El I, as owner of the property, or my' employees with ADD wages as their sole compensation,will do the work and TOTAL 125 - 55 LOCAi the structure Is not Intended or offered for sale(Sectlorr � 7044, Business and Professlons Code.) MOVING TEL. �1. ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contrgct6rs to construct the project (Sec- iDORFfis •�- tion 70.44, Buslneas and Professions Code,) CONSTRUCTION LENDING AGENCY YARD HWY FROM I hereby affirm that there Is a construction lending agency.for FRONT 0000-"1 '' .5/ 5/95 the performance of the work for which this permit Is Issued P• (Sec. 3097,Civ. C� SIDE 5755 1 AMID 13 P.L Lenders Name P.C. Fee Perm n Fee LDAhA Ref. ti Lender's Address ' I certffy that I have read this appllcotlon and state that the Issuance �� LD AA P/C above information Is correct. I ee to comp) with all Coun invests on fee ordinances and State laws rel�atlnfl 10 building construction Total Fee �v t� LDHIA PerrrL / a a o". �&—�sentativee of this County to enterpan thea mpenly for Inspection purposes, lxfr C M WQW-K>R�LANATQRY L kNGUAGi 1' Signature of Applkant or Agent Date A . I WORKERS' COMPENSATION DECLARATION APPLICATION FOR BUILDI�V -P�R1�A1 I hereby affirr4� Shpt I have a certificate of cbruenf'to sbFF ' I here- ora rn4 thQi I -h Worker} compensation Insuragce, T or a certified copy-ther!4f COUNTY OF LOS ANGELES BUILDING AND SAFETY ` Poll No. T— Company � CerrtFigd coy is#tereby{umishbd. FOIA APPLICANT TO'FELL IN Certified copy Is filed.with stip coOrrty bullding lnspea BQILDING- - tion department. . , 6W ` L P rDOTe'--` Applicant ' NO.OF BLDG& tFARESI cEknFICATE.OF EXF,"ON FROM WQRKERS'-- 5 O�LOT NOW ON LOT 3 - COMPfT1SA-MON 1 Nt U RANC E CROSS Sr.. ASSESSOR .(This section need n6t be completed If the permit fs for on1 TRA(T �. OCK OT NO. µop 13('" PAGE PARCEL dollars �$looyor'less:) TELr , :., OW1H2.' _ O► AMP _t1 y / ' I cerfify That In the pefformanoe.of the work for which this permit is Issued, I shallrat emplgyany person In arty annef ADDRESS `-S K— tC 75 - so a}fq become lobled fp.the Y(orkerk Com a.Laws. _ O _ * C1Ty _. r. ZIP DaTp APPucanf ARCHITECT OR TEL oC NOTICE TO 'ApPLJ If; afipr r king thli . cafe bf.•. ElWINEEt - S. Tq' D ROU TYPE ' Exemption, �Y_ O pt you ,shbulo ,beco",sub}e.4l'.ro Workers'• ' CONST. ' ZONE Con; on,provlslorta of fhq i ybor SAOe; ust.forts ADDR£55. _ 3 with comply,with such prov'�lorfs -o[ this It shall lx .. P°fTr' .. STATISTICAL CItSSI TION. AFT.. CONDO.' :Z, ' deemed revoked.. bOM-RACTC7R � - ijc6 SEO 0bNTRAcTORS'DECL'ARATICXJ: } ❑C CLASS 1JNTI5_ hierekry gfft'rm that I am IIcerlsbd under provislonrof Chapter �S NO. (c:ommenclnfl.Mth Section 7000)8f Division 3 of She Business DC- SEINER , and Pfofeislons Code,end my Jicgnse lf,Jr),full force and effe4. _ CLASS, l _ VAl1DATION 1 SQ.FT.. NO. OF NO.-OF. CHECK PG _Llcen6 Number SIZE , STORIES FAMJLIES _ ._ VALN DESCJ7IFTION OF WCQr)trivctorQRIC p NEW Eli.am exempt-under Sem yLj , ALTER B.BP.C. for thLs tealon' l REPAIR 0 r° fie: EXLS11tJG hCDCi. S . . - DEMO. 0 ! r Signa tuTe APPI�C CANT . , Tti _ ! QWNEk-BL) �ER;PEC1ARATION 1 YI C No. 19� r I hereby affirm that I am exempt from the CdnfrociorsTJcense \ DATE ! I_pw ffir the fbllowlri9 r`bason (Seftlon 7031.5, Bualness and ADDRESS R 1 o Ion{Coda): 1, a'sowner.'of the o' - oy w yvlth BUILDi i - peFiy; or my empl qc?D. f' '`T.T - . wades 6s thtiiragloR componsdtioh;wlll do the work bnd. _ the structure Is not Intended or'offered forpate(Sbction, LOCALITY ti}" ." 7 78.� . 7b.", I3uslne dnxl Professlons-Cbde.J- tJG Tt . I, as bwner of She.pro perky,,am exclu&we)y contracting. , CONTRACTOR NO. k 1 ITM -.With I1cens6d tontractq.q to coprtnut.the prolpd (Sec- ADORfss r. , TOTAL 7 f OO tion 7044; Badness apd Professlona:C,od�e.) . OOt4MQCTION LENbINQ AGR4CY YARD. HWY TOTAL _ 781QQ I hereby affirm that thbre 1s d constNctlor}lendlnq agency for FRONT F _ .t.. �. (Avery, the performance of-the Work fOr whlch this permit Is illk!ed -P:L 1 ' L r'... . Ave 1 ..- (Sec. 3047, d v.,C_}. 5i CE r P.L' l Lender;-Name LDMA Jef. ,t WOHM I 7/2X89 - P t'Feo- Perm n fe. 4b9$ 1 All 8:42 Lenderi Address //�► I'certffy that I have-reed this appllcatlon and state that the r ♦sworce V LDMA P/C f+ 4. above fnformcrfion-is correct.I aflrbd to'compty with aIrcouoty ,' Investrganon Fee ordinances and State Laws relating to building construdlon,. Total Fee V. MMA Perm.' and hereby authorize presenfafivea pf this Couhty to enter the'above- •n ned prbp*fy fordrupet-tlbn pUrpom _ SM 111111VIIIIIIIIS11 FQir oQ, LMTORY Ia,NGUAGN SigrKrNre of II oaW or Apenf- Date - z . COUNTY OF LAOS ANGELES TF?@LE CITY 9 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/RE-PA-IR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0901080023 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 6561 IT: 549 SQ. FT STORIES TYPE 5718 CAMELLIA AV 9TRUC'=: V-B TEMP CA 917802501 859E-9OR INFORMATIONNUMBER: NEAREST CROSS STREET: LIVE OAAL 8587-022-024 TI-ROM91.9 PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, C T EXIST BLDG USE: REBID USE ZONE: R-1• ISSUED ON: PROCESSED BY: EZTgT OCC GRP: 01/08/09 SR OWNER: TEL. NO: BLDGS. NOM ON LOT: VALUATION: FINAL F Y: GOD& J MCAULEY KEITH DIRDSRANNE (626) 286-7948- 10,000 5718 CAMEIZA AV TE31P 917802501 FEES PAID D CRI OF wcRK REPLACE 19 WINDOWS W= WINDOWS, REPLACE (E) FRENCH APPLICANT: TEL. NO: FES DESCRIPTION: QUANTI'L'Y: UOM: AMOUNT: DOOR X/SLIDING VINYL AND INSTALL A.DD=019DIN AL SLIG DOOR IN SAME AS OifNER - AA BLDG PERMIT ISSUANCE 27.75 AB STATS GREEN BLDG FEE 10000.00 VAL 1.50 SPECIAL CONDITIONS: AC STRONG POTION REBID 10000.00 VAL 1.00 D2 PERMIT W/O EN-HC 10000.00 VAL 216.60 TOTAL FEES 246.85 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR 92GNATIIRE SAME A9 OWNER _ LSC. NO Locaxlac AND srzTA.rra � SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOONDATION/TRENCH FORMS LSC. NO: SLAB UNDER FLOOR RAISED FLOOR FRAMING ' MAP NO: SEWER MAP BOOL: PAGE: FIRE ZONE: CMP: 150H269 3 00 LIDIDSRF'LOOR INSULATION NO. OF FAMILIES: DWRIJ-I G UNITS: AFT GOND: STAT CIAS9: FLOOR.9HEATI-17NG NO 21 ROOF 1gHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QOALST7: 1000 FEET MAXE4IALS PO AO NO FRAME INSP=ON REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINIUM HANGERS SET BACK YARD: HWY: PROP LINE: W17JTH: FRONT PL- SIDE PL- 7NSUWION WRATBER STRIP INTERIOR LATH/DRYMAL.L FrRRIOR LATH RATED FIGO CE II.. AssII4. RATED ►01LL ASSEMBI,T}'i9 RATED SHAFTS OPENINGS T-BAR CEILINGS + ADDITIONAL DATA ON FILE LOT DRAINAGE REPORT ID: DPR261 ROOTS TO: B80508