HomeMy Public PortalAbout5842 CAMELLIA AVE_Building__ 76A638ACE08038-64 APPLICATION FOR BUI DING PERMIT
COUNTY OF LOS ANGELES
BUILDING �
DEPARTMENT OF COUNTY ENGINEER ADDRESS rj g Z_ CC9� c
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS,SUP'T OF BUILDING CROSS ST.
DISTRICT NO. GROUPTYPE . P SSED BY
FOR APPLICANT TO FILL IN CONST. ' r,.
BUILDING STA ISTICAL CLASSIFICATION SE 4ER MAP
ADDRESS S�jyZ La CLASS NO.d DWELL UNITS BIfz::�G
LOT NO. .�„ fiC-/$-Lj8,LOCK USEZONE MAP
NO.
TRACT SPECIAL
F.D. OF BLDG.. CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF 0.a
NG BLDG, C BLDG. SETBACK FROM /
_+ l
TEL FRONT PROP. LINE OF (STREET)
OWNER T \t O.Z _2 TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HI HWAY WIDTH rmom C.L.
r _
CITY DG. 9 BACK FROM
ARCHITECT OR TEL, SIDE PROP. LINE OF (STREET)
ENGINEER NO.Z� O TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS 1
HIGHWAY WIDTH FROM C.L. O Cl-
TE
L. + = 0
CONTRACTOR �Q s t - NO kli C15 U
ADDRESSCORNER CUTOFF YES NO{ �Q'C4� �L NO O Z 0
O
IC
CITY Ir 9 LL C--Z SEE REVERSE SIDE FOR SPECIAL APPROVALS w
DESCRIPTION OF WORK z
NEW ADD ALTER REPAIR DEMOLISH
SQ.FT. ,NO. OF NO. OF
SIZE STORIES FAMILIES
USE OF
STRUCTURE
SIGNATURE OF
APPLICANT A
VALUATION$ APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. - PMT. FOUNDATION, LOCATION
FEE$ C��' FEE$ FORMS, MATERIALS
FRAME, FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
9UILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT.
ING TO WORKMEN'S COMPENSATION INSURANCE. LATH. EXT.
SIGNATURE ' � V HOUSE NUMBER COR-
PERMITTEE /' t / RECT.AND POSTED
ADDRESS SS E I NAL
JOHN F. LEWIS. PRINCIPAL ST CTURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O CASH
�7 4 2 WS NOV 18 1 D 4.0