HomeMy Public PortalAbout6026 CAMELLIA AVE_Building__ fi� 1
I�hPLIC�► IC �IFeR= ILDING PERMIT
' - COUNTY OF LOS ANG" : N
UIL XNQ AND SAFETY
fWXHU09re CO PENSATION DECL RATIOIiAP*1JGw�TO RL�!I Aeby AM that I here a cMtificale of oweent to ow h mxa' MXIPQ or a on Mats,of MbrimW Compsrritlon Inarvice,or aCopy thanof(Sea 3900,l.eb.C:). aP
Pofioy No, company. erg of LOT No of BLDCad .LOT
❑
Cwtoopy w d.hereby hm*haT
ar
TRACT BLOCK `
❑ Cwrttfsid copy w ffied WAtlr the oour" bu&ft apeotbn
(a rsyl 114
USE zorE 141P Na ,� \
Dais /lpplkierd BOOK PARCEL . SPBMA \
COMPOMATION[NSURAMM 1&011311NO '^
moo Fr.of ecHiooL?
(rh*aeotion need not be oompMied If the pmn*w for cm h undred 0 DDfBTRICT CROUP DOm By
ttertf m
doles Crrr P
I prCfy thatt h,n le
ths.psrfirnwtca d the work Cor wttioh tr,t.Psrrtrtt �
Y waled I shag not snVloy arty Person In any mbt mr eb as to
be=. atjeCt to the Vft km. Comperratlon L ws. 5p p�s 8MKn Wrro6L cFat c ampt APT r `
Dais Appal" 4Na " Dw91 UN" j
►{M�OTfCF TO APPLFCAtYf: tf, after rn*khHp this Certlficete of REOUFTa) TOUT BETTiACK FROM
Ex o,n, you should beoome subject to the Workers' t 91. BEt BACK YARD HWY PROP LIE WIDTH
rn
ComP!rmation prwbioDf the Labor Code,you must forttrnfth W B'u I L� -g_
oompfy with aioh prwhlom or this permit shad be deemed Tw oked ADDFIM LW_NO. FFKAff '
PL
I.KNOO®CONTRACTORS DECIJIRATIOM CITY Lr—CLAW S 23 ,
I hereby of rm thmt I em Ibensed under promord d Chopbr B WERAMP .T
(Corrdr naft with 88otbn 7000)of DMal n 3 of the Bt#tew and NEW
N0.OF BTOt NO.OF FAILJ�. BEtr
ProleeelornV fkstnw Is In ful tome and eNeot Q NEI(H eK Po
ta Co*code. 3307 491.93
ertae
UoNumber L
to.Cts. of ADD ❑ , 1 ITE11S
f Contractor Date ALTER 25
t El I am ewempt Lm Kim sea REMR ❑ $ .,//�, ao TOTAL 4r 1_ t
6 M$ �;440 D CK 491.93
B-4P.C.for No reason USE OF DCBTNO BLDGDEMOL 11L36AA P�-_i a
s •0(1i
Q �.... DoW _ �r , URAA, ❑ _ T
Ma"�e I TEL LLMM Penh I
❑ l, m owner of the propmr*-or.mee.y employwtih wages j,- 6M4r
.their sols oompentmation,will do the work and the struoY,rs w 1 W'l.
not inUndedoffered for @We (section 7044, Busilrom and FWAL . :
1419.[t
C
) r1m�FE RLDHo LULAMMT F LANDLL A F W.AFDOUB MAMIAL �` i
==-Intractore
of the OR A LEXTLWE COff01MlQ A FMZAFDOIX YRaLAL eoriAL TO OR GFEUM TK" "' WL 14Y9.l5 ICY, am Y T G wkh rTFIR�❑ M ❑ ON THE FFArAFpaw�i ra-oraLAMN QMV Pam rir to oorubvot the pr*ot:(Seeders 7044,1 No
Buinimm and Prubseiom Code.)
WILL THE WHAM)uCi Or THR W• M N THE OR RIMMy• X M
COAST AM FEousaA ala rCR r DW TTLfonow oR"mor THi eourFF 1 � ��
CONSTRWTION�M AGCY carr Ar ouALm rrwAor�rt CreTrsar aaosot ser FfferrTeFs•aFs9a�r
rCR d.,o..,.
F hweby af}Ym that there w k col Nib led K& agency for ym❑ iso❑ 0-
ttre perlorrrrerHoaof the work forwhioh this permit Is walled(>#so AN 9:41
3087,Ctv. I FMT FsiAC rrE RAZAFDOI�WOL11
iLe lFOF1WVIOM auaE AFD TIM soAao
r.en-r.,o oHrc+aE>:I uroetawn w uDeA TI-i�. Los Arro>v
� n,-_OounTrcoos.TTrus OFEPORTis iTfFouoFf:risecarcrssa+Q J(J t,
Lerrdar'a NaRne Fw.Aioor�s rwWLALe FEFroRrno AND PPR oeTasan A Fserr rRosr THE soAono. Z
LsndErs Addrew a�aAMWff7ryQy�P77
I oerttfy that I heme read this application fid stab that the aboveQ�
hrformation Is correct. I sprat to owM* with`all oounty PC ` P6e�rF� /� ,
ondineinbw"state laws mWlnp to Ix"Irrp axis uaft%arid._. FEFOJ J
Aeby aintrorfte repreaentatty d Ws County t-6.UPon; / �e MUANCr'FES a /• 7
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atorl FEE ! TOUL Fff
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fM FEYfai>tE POR EM MATORY LAMQUAGE