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HomeMy Public PortalAbout5760 CAMELLIA AVE_Building__ RKE PENSATIOT� DkIARAfION I� Irm that I Ixlv�,.a crttflcate of consent to Nlf fmure, or p certificate of Worksrrs'CompensgtI n InsuranC6, APPLICATION FOR BUILDING. P E RM I T or a,certtflopd copy thsraof ($ec..3K0,Lab. C.) COUNTY OF L09 ANdELES DUILDIN.G,AND SAFETY Policy No. Company ' Certtflod copy Is hereby furnished.'. -FOR APPLICA W TO ILL IN MLDING ADDRESS Cbrtifl�d copy Is filed with'the coority building lnspec- IWILDING . tion dlpartmeht.. Ll",t �/4 �i r Date Applicant CAY LP ; L LOCALITY CERTIHQATE Cif EXEMPTION,�R6M WORKERS ,NO.OF,BlDGS.' NEAREST . •.ODMPEKSATION INSURANCE sum of LOT' 7 {NOW ST (ThK sectl¢n need not be cam leted if tt».perrnlT Is for one 4;,<4 f gLOp� LOT tJO. MAF PGE PARCEL hundred dollars ($100)or'-less-,� , USE ZONE �. TEL. I'certify #hat In the.performbece of the`'woA for.vfhlch tbl* � / �� NO. r permit Is Issued, I Whall not employ any 7e In'dhy manner. SESST�d �I - so as to became subject to the Wgckers ComlSehs%h Laws.• =Mom 91 data-- AppllCaht t NOTICE TO APPLICANT'. If,'aftbf'making'ihts Certificate of CITY ARCNRECI { ;fir } j J NO. !. DISTRICT GR4)l1P IYP♦* SIRE Exemption, you should become sublets to the' Workers' r Comperba-Ion provisions of the Labor Code, you-must forth.. ADDRESSwith compty with 'such provisions or thir-permit shall be .- - ��yJ ` deemed revoked. i COtJIRAGT 0� TEL 3D STATISTICAL F 7KX� APT.' . LICENSED CONT{2ACTCM2S DECLARATION �f r ��¢ CLASS NO. DWELL UNITS � I hereby affirm that I am Ilcensgd under pfovislons of Chapter 4 ADDt?ESS'3 -�' i7 NO.�-3lf '"•' (commendooqq with Section 7000)'pf DfvWipn 3 of the Buslrtgss and... r SEWER MAF. ProfersloM.Code,'and'my Ilceaie Is In full force and effect. Crit u / PG. V TION. SO. FT.- NO.OF NO. OF a*cx L ll cent.Number LIG Cln> SIS F rt_ Contractor date DESCRIPIlON•OF WORICI VALJIATKW t � D`e-,✓"'r 111 I arrt exempt urK*Sec_ / x Alp . ALTER B.&P.C. for this reason REPAIR S Date! i E�n G I3LOG OF DEMO[ 8 a$.5lA Signature (PRJNT � 0' No. ;P13.Z RiAL' e` # 0.0 •' o.o ll OWNER-BUILDER DECLARA DAA �. q' 'O s# © t 1 hereby.affirm that I am exempt from the Contractors License - ADDRESS f Law for the following reasoh '(Settlors 7031.3, Buslnew and - torts Code): ._ _ - NG 1, as owner of-the property, br my erttployeq wltfl ADDFkJRESS i as their sole cofi rfsatlonr will do the wbrk and - th�r structure Is ngt'Inferxied or offered for dale(Section , 706",-Business and Professlods Code). MOVING, tgr ` I, as owner of the property, am eklualvely.contratting OR NO. ❑ with licensed contractors to construct the project (Sec, ADDRESS - tlon 7044, Business and Profewlans Code}. FROM CCKJSTRUCTION LENDING AGENCY BACK YARD FIWY IRED TOTAL PR UNE I Hereby affirm that there fs cprstrudton lending ggency for FRONT the performance of the for:which this permit Is.Issued (Sec. 3097,Cly.z.).. SIDE r Leaders Nome 8 P.C_ Fie tr Fes TDMA Ref. # Lender's Address TRAC I crtify that I have riad this apptk rtlon and stair that the wsuance:iee � PlC# P gbovq Information Is toned. I agree to-comply with all County Investigarlon Fee oi�tnartces and State kma relating to building corutnxttan, ¢nd hereby authorize cepresehtatives of this County,to enter ToraL Fee IDMA perm # u n the above�n tioried for Inspectbn purposes o t> MM roe EVIAMATORY LANGILCM of Appikoht or Agent D8ri 1 — ' I COUNTY OF L09-?*GELd TEMPLE CITY 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701. WTUNAS ALT WTION/REPAIR {P i BUILDING AND SAFETY / LAND DEVELOPMENT TELEvCITY CA 91780 BL 0508 9904140023 PHONE: (626) 285-0488 EXT: LEGAL ID: 100. OF CONST BUILDING ADDRES-S: TR: 6561 LT: 545 UN: .002 SQ. FT STORIES TYPE 760 CAMELLIA,AV STRUCTURE: 0 VN EMP CA 917802501 ASSESSOR INFOWTION NUMBER: NEAREST CROSS STREET: WORKMAN 8587-022-016 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY TENANT: EMIST BLDG USE: RESID USE ZONE: EXPIRES ON:- EXIST OCC GRP: - 04/14799 UT 1 ISSLJED'O": PROCESSED - 04/14/00 OMERNASCA�JOSEPHINE R (626) 285-9132- 1 5 000 CODE:FINAL DATE FINAL BY:5760 CAMELLIA AV �, — TEMP 917802501 DESCRIPTION TEAR OFF, NEW SHEATHINb INSTALL G STAR 25 YR. COP. FEE DESCRIPTION: QUANTITY: UCM: AMOUNT: SHINGLE - HOUSING RERABILITATION APPLICANT: TEL. kU: 4 NICK'S REMODELING (626) 442-7985- AA BLDG PERMIT ISSUANCE 27.75 9941 HOWLAND DR. AC STRONG MOTION 5000.00 VAL 0.50 . TEMPLE CITY, CA D2 PERMIT W DO VAL 132.60 PNCE LE 160.85 CONTRACiM TEL. 5 Ci s UTE INSPECTOR SIGNATURE NICK'S REMODELING. (626) 442-7985- �� �T�. 9941 HOWLAND DRIVE LIC. NO LOCATION AND SETBACKS TEMPLE CITY, -CA 91780 409663 B SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOLkDATION/TRMfMT7MW_ LIG. NO - 111111 kACWED,�FLOM FVNrgV— 11AP NO: SEWER MAP BOOK: PAGE: FIRE ZONE- FLOOR.fHEATHIN'ff 150HIM9 3 U�L�C W0NO. OF FAN UNITS: APT/COIND: STAT C SCHOOL WITHIN ��� Ito 21 ROUF b�EATHING AIR QUALITY: 1000 FEET MATERIALS ❑ NO NO NO ❑ ___NKlER HANGERS SFE BACK- YARD: HWY: PROP LINE: WIDTH: A4b/%L+ S,er 11at�Ot $ SIDE PL- VIC() ERTER16 LATF- RAT ED *L Mff991rW__ RAR c 4 - LOT DRAINAGE REPORT ID: 0PR261 ROUTE TO: BS0508 i . t