HomeMy Public PortalAbout5826 CAMELLIA AVE_Building__ 7SAaSOAC=#eoa_S-t7 APPLICATION FOR BUILDING PE=RMIT
C.`OUNi'Y. OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVWON LOCALITY `
JOHN A.LAMBIE.COUNTY ENGINrrue NEAREST
CA98ATT D.GRIFFIN EUT'T OF DUILDIH• C
DISTRICT NO; GROUP TYPE HEWER NAP
FOR APPLICANT TO FILL IN �aK
. CO
BUILDING STATISTICAL CLABBIFICATION -
ADDRESS
CLASS.NO 1
LOT NO. BLOCK MAP STATE
` NUMBER HWY. YES O
TRACT doomv SfoUBE ZQNE SPECIAL
NO.OF BLDGS. 1 CONDITIONS
SIZE OF LAT O NOW ON LOT
USE OF
MUTING Q BUILDING YARD HWY- STREET HAMS DIST'
SETBACK WIDTH
OWNER Aw FRQNT
MAIL P.L'
ADDRESS /N BIDE
TFL P.L
CI NO nr.�V
iL�a7.�J..C'TION RECORD
ARCHITECT OR TEL 11��
ENGINEER NO.
DR
CONTRACTOR PQ1V NO — G
APPRF�" 91 t I i r
DFSCRUMON OF WORK
NEW D ALTEK REPAIR DEMOLISH
SQ.FT. NO.OR NO:OF
SIZE STORIES FAMILIES -
UBE OF STRUCTURE
SIGNATURE OF APPROVALS
APPL I CAM
� DATE 1H9P R'd DIO RE
ADDRESS FOUNDATION: LOCATION
FORMS,MATERIALS
P.C. , ; — FRAME: FIRE STOPS,
FHE BRACING,BOLTS /
VALUATION Q FURNACE. LOCATION.
E GAS VENT DUCTS
1 HEREBY ACKN0 EDGE THAT I HAVE READ THIS AP- LATH,INT
PLICATION AND STA TH OVE CORRECT AND
AGREE TO COMPLY 1 U INA AND
STATE LAWS RS TI N CON CTIOtL LATN EXT. I'V
SIGNATURE OF H UBE NUMBER COR-
PER M I R ECT AN D PO RTED
AD FqNAT,
JOHN A.LAMBIE.COUNTY INFER. CLYDE N.DIRLAM PRINCIPAL STRUCTURAL ENPI
PUN CE =V % Tl02f ctt M.G. CASH PEDM VAlMIMOR hLo. cwsa
�.
2.5 ER X30 1. -A 6.00
es 7GAE78A
C■(Goa(A1<V.
APPLICATION FOR- BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BAUI
LDINGDDRESS
BUILDING r `
ADDRESS LOCALITY
N REST
CI ZJ P CROSS ST.
NO.OF BLD-GS. ASSESSOR
SIZE OF LOT `J P40W ON LOT ;3- MAP BOOK PAGE PARCg
DI CTP TYPE FIRE ED BY
TRACT B-LLOT NO. COf1ST. ZONE
OWN NO
STATISTICAL CLASSIFI TI ER
ADDRESS CLASS NO DWELL UNITS BK PG
CITY ZIP .
ARCHITECT OT VALUATION
ENGINEER NO. ,2
ADDRESS FROM
TEL FRONT PROP.LINE OF (STRE TI
CONTRACTOR NO. TOTAL SETBACK FROM TYPE OF EXISTING
LIC HIG}�NAY + YARD. FRONT PROP.UNE HIGHWAY WIDTH
ADDRESS NO.
LIG +
CITY CLASS
CONSTRUCT( N ER BLDG..SETBACK FROM
SIDE PROP.LINE OF (STREET)
NAME�,ND CH
HIGHWAY + YARD TOTAL SETBACK FROM TYPE EXISTING
ADDRESS CITY SIDE PROP.L NE HIGHWAY .WIDTH
SQ FT. NO.OF NO.OF CHECK +
SIZE STORIES FAMILIES CMIE
DESCRIPTION OF WORK NEW P.C. Fee S Permit Fee
ADO Issuance Fee
ALTER
REPAIR Total Fee
USE OF
EXISTING BLDG. DEMOL
AP PU CANT TEL
(PRINT( 1}O ri
BY(SIGNATURE) 7
I HBdMY A0040WLIDGE T}(AT I MA t READ THIS APP-kCATK)N AND STATE Y
THAT THE ADOVE IS.CORRECT AND'AGRSE TO COMPLY WTTH All ORDNANZES
AIA LAWS REGUJLATING'BtALDING COf•ATRVCf10N.I CE RTIFI'.THAT IN DOING THE
WORK AUTFIOR)ZED HEREBY I WILL NOT EMPLOY,W1'-?EiSOF�IN VKxATKIN OF I
THE LABOR CODE OHNE STATEOF CALIFORNIA IN161ATING TO WORKMEN'S COM- _ I :2.CJ 6 1.1 A
PENSATKXJ INSURANCE.. t .
#i0'O I'O O O 1
SIGNATURE
PERMITTEE 2 o
ADD
CITY
• 3 0 7,2'0 -7 9
ZONE -
NO 2---Z:7. >
9ONDITIOM
FINAL
Y
DATE r3 t
- I 1� nvrv. ,COMPBN.SA_"�D'E�1 A IT1C I
1 I heb`y` rffrrm. I�qve a•certif{cate,of corasgni to wff � F O R-„�'"I L DI N G - E RM�
Idiuro, or ctcertf of Workers' Compenwtlon Iruorance, - - - -
or.a certtfIad'copy tMtirebf'(Se,_ 3800:Lb b. C:, 7
COUNTY OF LOS ANGELES BUILDING AND SAFER -
-
41
policy No.; Company_. ^
.Certtfied,coPy Is hereby furn(she¢.• -FOR APPLICANT TO FILL I �D� 00.
CertfAi0j' 'c8py Is fjfed with the.c�unty L ding'l,ns - BUiDING.
''tbn,departnaent:' ADDRESS
Date• Appllcant' _ + OTa �Z1P Lf CAMY
CE RMF FATE OFEXEAAf+TIQf f�Rf)Al1 WORK RS' i NEAREST
COMPBJSIATION INSURANCE OF LO7 ON tAT'
(thisiiefbd-sa;aon not be`completed If the pirmlt for one - — --r= -- - ___ T
hurac(red dollprs.(:100)pr legis ) n. 1,- TRACT Btoac Lor tJO. AMS-gdpl( PI GE PARS
TF1 115E
l certify.thg�In {he perfPrmaiic� o the w.prlc,for wklchi,this . owt�r tNU No.
permttAs Issue, tsholl not empldy ad'y per�gn In any rricamn ADDRIESS - COND -
ib ai to become iublect tis the W 'Compsp -ONS I_
• Dat:d i�'pplh •
NOTICE TO"APPLICANT: ff; fi3 CertARIH _STRICr : GROUP. TYPE __ FIRE- BY_
-Exemption, yov 'should becbtniv iub to;the Workers: _` ' NO• MST: ZONE
Compdr►satlort.provi lons.. ftthe iabor'Cods,'you must forth ADDRESS
"ACL _
with compy'.wlth•such�provWc;ns:•or.thla perrlilt .shall; be ---
STATLSThG,L•C1I.SSFlG,TION AAT.. CONDfl.)'- �1
do mad.evoked. • - ',-• � CONTRACTOR TOR- ;., . _
.L. _ ___ / _ ._ .
LICENSED CONTRACTORS DtCLARATION - - -- - - - - LLC- O155 Nb �l I Dw�L UNffS
I hereby affirm that I am Ikerned u.oder,Prgv)}{4rn Chapter 9 ADORE NO. SEWER AW
(cornrnter?dng With' ,�)of Div”3 of{tfie' npw and
Prgfeosl Code, nd my llcaruA ts.ln full force.tad CTrY L - w ,
CLASS Bic -}-- VALMT{ON l
` +v Llc_CI .1 ,• ;:,.: " $Q.,FT. STORf£5- - - FlaNU�6- - - bt•E - ;_ �".. 7-177,
TT
LlSenseiNtimber VALUATFOM_
�on}ratior ° DESCRIPTION O Q
4 I am exempt under Sec
B.8 P.C, for this rdoson AIR.-. - r
_ USE OF
Data; EJQSIING BLDG.
Srgnahuro ' ' ,pplxC•a,r .ANAL
OWN1rR BUILDER#CLARATION' _ _ �-DAib
I heteby affltin that l-am exempt from the Contrgbrors:-cense -Ja
Law for the following'reawn (Section 7031.5, Business and
I'Yo#eesloni Code):
I, as Daher -fthe property, of my-emprgyees wlth BUILDING .-.-
woges as their sole compensation,will do.tfae work and -
the structure Is.not Intended or offered for sale(Section LOCALITY f 4 8 9,-7
7044;Businam and'Profeubns-Code).-' - - - MOVING
#10 _
i, as Daher of the property, arts pxduslvely 4ontractlrtg - - -- .- - -- _-_ .. ._..�.._, 'o 0 o-e
-_
with-Ildbnaed cgntrat'rdrs to..cormruct the prdleLY(Sea
Non 7044, Bwlness and PrgfasJoru Coded• - ;
r � 07 $ 0
LSEMACK FROM
CONSTRUCTK),N LENDING AGENCY - - YAIRD FIVMY PROP. UNE WWTH' _. - - _ - _-• -i•'
t hereblraffirm thatthere Iia construction lending ogency for PRpNT 7 a,0.0
the performance of the work for whish thlspermlt isinued - - - -- - - _. _ _ -
(se�: 3097, civ.c) SIDE 0 b�C 6--;8,¢+ ,
_ P.L
Lender`s Name - -
- - - TDMA Ref.
P-C fee Itfee" V
Lenders Address
1. certify that-I have read this appllcaHon avid state-that-t-he -- - iwirance Fee---- - V � LDMA P/C
above Information Is corned. I ogreb to corm witf3oll County Invemsgation Fee
.-acdlnans and S" Ea+w)_rolatlRg.to b4lbin
ug-Poral Kilon. --- total Fee-' - V LDht/rPerm t
orad hereby authorize rW"mehtatives of this County to tinter -
u the above-lnentio Iru xoctbn purpcsgs. -
- >�INV111111M KM DMAMI TORY UUMAW w