HomeMy Public PortalAbout5920 CAMELLIA AVE_Building__ I ti
/eAG3aA CK#SOaa•eIAPPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES ABUILDING
DDRESS
DEPARTMENT OF COUNTY ENGINES&
BU ING AND SAFETY DMSION LocALrrY
,JOHN A. LAMBIE, COUNTY EiQINKEIR NEAR F_UT
WILLIAM A. JENSEN. SMr`T OF a CROSS ST.
DISTRICT NO: GROUP T�.rE RR ED BY
FOR APPLICANT TO FILL IN ��.
S U I LD I NO STAT IST I CAL CLA"I F I CATION h AP.
wDDRElB 5920 Camelia CLASS.No LL.�N .L.r K
LOT NO. BLOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE:
TRACT MAP HIGHWAY ly
NO.OF BLDOH,
NO. ICIRCL[> STATE MAJOR SECON LOCAL
SIZE OF LOT. NOW ON LOT USE ZONE SPECIAL
08E OF CONDITIONS "
EXISTING ELDG.
OWNER• b N L. 8E BUILDING
WEx
DYARD HY STREET E r
ADRKPI 1215 E. Norwood Pl. 1=0 WI
FRONT
ARCENGI{NTECTEL'R OR Alhambra. No P. L
SIDE
ADDRESS OV
CONTRACTOR Vir in Roof Co NOLA'I`7 b INSPECTION RECORD
DRESS-600 S.San Gabriel Blvd
DESCRUMON OF WORK S.G. o-
NEW ADD ALTER REPAIR DEMOLISH
SQ.FT. NO.OF NO.OF' "
IZE STORIES FAMILIES
BE OF
STRUCTURE
Rq ear H se
SIGNATURE
APPL 1 CAM
.VALUATION S
AP"OVALS DATE' INSPE 11-3319KATURE
FOUNDATION: LOCATION
14& - F�• 3.00 FORMS MATERIAL? ..
FRAME: FIRE 6TOF6,
I HER[SY ACKNOWLIIDOS'THAT I HAV[R[AD THIS APPLICATION BRACING'SOLT8 -
AND STATL THAT T}{[ ASOV[ 19 CORRLCT AND AOR[[TO COMPLY --------
FURNACE: LOCATION,
WITH ALL COUNTY ORDINANC[1 AND STAT[ LAWS R"LILATINo GAS VKNT,DUCTS
NUI
LOING CONS-MUCTION. I CLRTIFY T T IN DOINo'TH[ WORK
AUTHORIZLD H[R[aY I WI NOT[MP r ANY PQSON IN VIOLA, _
TION OF
TH[ LAaOR CO • TZ OF CCAI.LIFORNIA R[LAT- LATH, IM' -
]No TO WOnk [N•S C INSUMl1dL
LATH EXT.
SI"GNATURE HOU
$g�E NUMBER COR- -
PERMIT' R[CT AND
AODREsrL 60 S San GeOriel Bldd FINAL
• . CLYDE N..DIRLAM, RI cIP,aL STR Rw>..E,NOIN[!Qt
PLAN � VALIDATION: cv- o. cAm �EHMIT V ATION K.O. CASH
LAC0 8 664 ,% FEB 1 1. d 3.0 0
WORKERS'COMPENS,4Tl� DECLARATION
-
hereby affirm that I h¢ve a certtflrAte of Fonsenf'to self A �� A I TOR BUIL- D I N G` P EYtI111IT` v -
Insure, ora certiflcate of Workers t6rnpeasatlon Insurance, ,
t V.' 4
or d certtfled copy,thereof (Sec. 39W;-Jab. C.)
r.• • -COUNTY OF LOS ANGELES I BUILDING-AND.SAFETY
Policy No... Company. . _.
❑ C�+tlfi�d copy as hereby fumisl,ed. _. FOR APPLICANT TO FILL IN ADDRESS
Certlfied'copy.1{'flled with the'cqunfy building Inspec- BUILDING
❑ ` tldn de
epartmnt: - ADDRESS
• -
Date• Appl lcont CITY 7JP LOCALITY
CfRTIFl.CATE C5F EXEMPTION FROM WORI�RS' - NO.-OF BIDGS-- NEAREST -
Sig OF LOT NOW
COMPENSN ATIOINSURANCE' OPhL
(Thli section need riot be'cdm feted Ifahe pgrmlt is fdr one. - - T 't
hundred dollars (5100)or leu, ' TRACT BLOCK LOT NO. . MAP BOOie' a PAGE' PARCL3
certify.that In the performance of the work for which this
01Mt�R USE ZONE ,2
permit Is Issued, I sholl,not employ any person In any m er ADDREg _ -_ _ - . ' �- - _
ONS
so'as to become subject to the Wor mPe Id
Daflt, Appllca' Cry _ .ZIP- - - ;' 0
O .
NOT1C! TO APPLICANT:.If; after'ihaking thli Cerllficat6 of ARCHrTECTR Di.STRICT_ �, TYPE 19RE _ _-- BY ._
ZONE
Fxemptron, you should becdtne subject to'the Workers BJG R NO. T��?
Competlsatlon provisions of the Labor Code, you must forth- ADDRESSwith comply with, suth provisions oc. thts.permit shall be
q AFT.STATtSTTGL QISSIF T10N
dammed revo.ked., .• - •. �. NO 7 � - - - -- .-.-. —
LICENSM CONTRACTORS DECLA"TIONt _ ��
CLASS td0. 'DW9J_ LNITS
I here�y affirm thgt I am licensed urlddr provjslors of Chapter 9 a� / NO.
(cgmmend.n.g with Section 7000)4f, W n 9 of the Busingw and LIG_ SPAIER AMP ;
Prof"I6ris Code, and my license Is fn full force and effect. CTfY C / CLA55VALbAT}ON i
` *Q..FT. NO.OF _ NO.OF.. - -y « { T
ucenie Number,'T'Z '7/3— Llc CI — Sul STORES FANNIES ONE
i�OLGI f/�sY ;AlUAT10N
Contractor DESCRIP11ON OF WORK
ADD
I am exempt under Sec ALTER -
B.BP.C_ for this reason - 5 —/ 7 REPAIR ;USE OF
Dater EXISTING BLDG. DEMOL
Signature APPLICANT NO. FINAL U_6 7 a
OWNER-BUILDER DECLA ZAT1ON - - - - - -. --._ DATE - .r
I herebyaffirm that I am exempt from the Contractor's License _ _- r ? # o. °.4.oto
Law for the followlil9 feasoh (Section 7031.5, Business and ADDRESS _� -
Profesilorfs Code):"
BUrLDiNG I ° ° 5 9,.2 5
erty
Q I, as owner of the prop , or my employees with ADDRE5,S .r: :.
wages as their sole compensation,will do the work and Loc��LfrY -0 o 0 5 9.25
the structure Is not Intended or offered for sale(Section
704,t, Businessand Professions Code). MOVING OR - - - - TEL" - ' - ,- - -
1, as owner of the prop" am exclusively coniracting Q 5 2'�L 8 b '
❑ with`licensed contractors to cohittuci the project (S...-
tion
Seo- _ _ _._., .--- __. . _ . .. -. _ -- . _ _-. _- • - _
tion 7044, Business and Professions Code). ADDRESS
REQUIMCONSTRUCTION LENDRJG AGENCY SET B� YARD HWY PROP. uta wIDTI� - --
I hereby affirm that there Is a construction lending agency for �T
the performance of the work for which this permit Is tssued - P.L - -- - - - - ',
(Set. 3097, Ov. C.). SIDE
P L - - - -
Lenders Name -
$ LDMA Ref.7 -
Lender's Address P C F°°s H Fee :.
I c.ffy that I have reod this applfcatlon and state that the - — - hsaance Fee--- 0 tIS0 I LDM4 P/C i
_ — t
abgve Information is correct. I agree to comply with all County Invevr4atton Fee' Too -- -
ordlydncss p'nd.State laWp,rolating to building construction, l Fee LDMA #
and authorize rop"man of this County to enter
u the ve-mentlo rty for Inspection p
SH MWW$&POR D�LANATOCY 4MlGUAGi
Slpnature of APel nt or Agent _ .Dal• _. _.
N ,
I
COUNTY OF LOS ANGELES T7LE CITY -0 D588 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTEtATION/REPAIR
BUILDING AND SAFETY / LAUD DEVELOPMENT TEMPLE CITY CA 91780 BL D508 0006230014
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
TR: 6561 LT: 143 S0. FT STORIES TYPE 5920 CAMELLIA AV
STRUCTURE: 0 VN TEMP CA 917802001
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS
8587-020-028 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY
: R-3 ISSUED ON: PROCESSED BY: E)(PIRES ON:
EXIST OCC GRP: 06/23/00 UT 12/20/0.0
FINAL 1Y
06PNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: MAE DAIE CODE:
WALTHER JOSEPH A;BETTY J - 2 1,500
6833 SULTANA AV
SGAS 917751526 FEES PAID DESCRIPTION OF WORK
TEARIOFF EXISTING GARAGE ROOF, REPLACE WITH FIBERGLASS
FEE DESCRIPTION: QUANTITY: LION: AMDUIT: SHINGLES
APPLICANT: TEL. NO:
CAMPAGt1A ROOFING (626) 398-1302- AA BLDG PERMIT ISSUANCE 27.75
1625 DEL MAR AC STRONG MOTION RE_S� 1500.00 VAL 0.50 .
SAN MARINO, CA D2 PERMIT W/9,.Elf�'HC-- --4500.00 VAL 82.20
T.6-- 110.45
CONTRACTOR: TEL. NO: io- err;;tiAPPROVALS DATE INSPECTOR SIGNATURE
CAMPAGNA ROOFING (626) 398-1302-
1625 DEL MAR AVE LIC. NO � LOCATION AND SETBACKS
SAN MARINO CA 91108 518327 C39'
SOILS ENGINEERARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS
LIC. :� - -- SLABAINDER FLOOR
MAP
150H269 3 _,� I� r1' ���� n
ZONE:NO: SEWER MAP BOOK: PAGE: FIRE
KDL
— ----- — —
NO 21 i r r i � jROOF SHEATHING
SHEAR PANELS
SCHOOL WITHIN
f U ' ,
AIR QUALITY: 1000 FEET MATERIALS ��' !� Q -f 1trl
NO NO MO Y` -, r -� j� TUNE 7rm
REQUIRED TOTAL SETBACK FRNF--MUTr—
SET
FROMBACK- YARD: HYY: PROP LINE: WIDTH: Sery Ce-(h IL
SIDE PL- -- "-
INTERIOR LATH/DRYWALL
I
REPORT ID: DPR261 ROUTE TO: 8S0508