HomeMy Public PortalAbout6030 CAMELLIA AVE_Building__ APPLICATION FOR: BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
Q KM APPLiG1NT TO H.1.M BUILDING ADDRESIB
WORI�i"a.001pFI�lBATION DECLARATION' ,
I hereby-aflk'm that I h"a certtfloats at opnMnt b sett hK ��
or■ow Cl$9 of WbikasCompensation bmrwxo,or a osrttfisd
Dopy thereof(Sea 3800,4b.C.) -- •
Posoy No- Company of LATflk
ND.of eLDGa DN LOT
❑ CK#Msd copy Is hereby hrnli a NEAREST CROW ST.
O'Certtfled oopy Is fled wtfh the county bukkQ frrpeoOm BLOCK LAT NO. USE ZONE rfrw NO
«�
D� APP�rrt SPeMAL COPDtTIOHe
COn-MCATE OF TION FROM WOR 033OWU YES No
CONF19 AT1ON L48MANCE ' wlTFON 1ODD FT.OF SCHOOL? ..
ADDFEee
(This*WOW need not be compbted If the pane t Is for one hurl*W DteTFWT GFlDUP mrE
dofars(#100)or Iasi) P --`9
I csrUf #W In t o performanos d the work for whklh U*permk� LL bid. r �-3
Y Wooed, I shall not employ say person In arryrlkwo f+o.r b OR
I bworns KMect io the V"kens CompW=dkn Lissa. BUTWelxu L fin APT
pay App/prrt CLA98Ma MULL LINWTS
NoncL- m-Aj3s-uC.Awr tf, ~ maww•ti-da Certtfica* Qf AEOUFIED TOv,I_SETBACK FROM EXIST
Exemption,- you should become sub)eot to the Wbrkm' 1 ANO' SETBACK )%M HW PROP.LIE MVIDrFI
Comp'erw prov4iorr of tM Labor Code, you muet.fortt.M FRONT
��y Mfh euoh provisions or tide permft WW be deemed TriokscL L)a NO. RL
WENSM DEC.WATION CITY LIC,CLASS PDE
.t hereby aNtrn that I am Downed under-provWorr of Chepl r B NQ,OF S'tQRE8 NO.OF Ruaukz
(oonrn i N wfth.8ecdon 7000)of DMWon 3 of the BLxkma w4 NEW BK . PG M7 491.9'
PnAselors Code,end my Ilcenee IsIn-fuEform end aflsot
Lkaerve Number . Lkl.Cuss ADD -❑ r , 1 ITEM
ConbMcbr tae' AUTER ❑ TOTAL 491_ 91
1 am axmnpt Inger sea RE1'AlR ❑ �/ L OD• � OWE
OF
491.94
B 8P C for this,*=* D EMOL ❑ LONA PSC e 1 fa�a E
DriK USE ea ❑
(PROm TES LOMA PwM e _ (..I. 1 b1 X 19-0I,r '
❑ I, r owner of the proper{A or my empivypes v fth wages r 4
their wie oompw*03oc> wtll do the work end the*uohue Is Pw►L GATX! .Ir 1 Am .. 17
root'k,t rKW or othred for sale (eecdon 7044, 131,**= endUna -
> waLTT3ApR!wTaAn mmmwDXo=".rrfw mLeAmzaumwry WLM.`` 1419.
I, as owner fi
d the OR A romlw OW"MJO A tw.AroMM r MWL#L aouAL TO OR eMasn 7niw.
Ixop", — W-knivr♦ry.aontraott►a wfth T}C Aaoixre�M ON TTE HAZAMOUS WWWO.L.s.otiutrM acv t�AL� r S 1 I TE IS
ioerred oontraotors to oonstniot the projed.(seodon 7044, Q la❑ ` t�
t3uetr»w end Prole.eloin Code) ym rrrwssn Lab DF THE Ml•DING arTre APPLKI.W nmrae sus Dew �-1T! 1417.
oa.r Ari«�"�'ter�arm i rrro CHER a�OUWr #0?31419.1]
CONBIRUCTION LDIDING AGE`HCY Fon a.ti,...
I herby affb'm dud then Is a 6onsW-%c8on ktndkV spy Yra❑ NO fl
Ow pwWmwwe of the work for which this pwmft Is Mued(Sea 1 rws rrAD Tre MWIDOue iwRsALS DrOR vaN aide AND T FE
g 9067,Civ.CJ. IolwDra�e L T uo�ewo w r+musssrrrLoe
5 Lsrder'r+Phrne ir�Dw A o ri�ooe axre AT=M
` � lr]Qfl-OLS]1 2/ 4/92
leildar.Aldim o�ai,rrr l�D�� 1•ti 1 AM 9:41
' I owft that I have raid thlsappboatlon end stria that the above
hfomvLdm Is caTsot. I agree to comply wfth ell oounty P FRS PgRurr FEE . .90
ordlnwmee aid&bass Ian rehttn0 to bus M corriruot►on,.r,d rry
hwdby authortze rep"wentatfyes of this Canty to enter upon rBBXrArrcE FEE
U,. fDr i76
,,' / TO-ML FEE
M REV'EM POR EXPLANATORY r AJfQ M.