HomeMy Public PortalAbout6104 CAMELLIA AVE_Building__ APPLICATION FOR' BUILDING "PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING
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BUILDING
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I HEREBY THAT I HAVE READ LS Z;JCATCN-AND STATE 7�
THAT THE ABOV IS AND AGREE TO COMPLY WITH All ORDINANCES D-/,2 C'H
AND LAWS RfGLTI BU LDlNG CON$TIZIJCTION.(CERTIFY THAT IN'
DOING THE - -
W'ORK ALM-IORIZED I WILL NbY EMALOY ANY PERSON IN VI OLATIOfa OF - - G `+ •. °
THE LABOR CODE E STATE OF RN CAU FOLA IN RE ATI NG TO WORKMEN S COM- d Qr• L '/ ' -2
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APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
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OR APPLICANT TO FILLJN B�Ef /
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S L�+</ LOCALITY / f
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APPLIC�
BY(54GNATUREI AdgL-�fi► (� '
I HER0Y THAT I HAVE READ THIS AMIJCATK)N AND STATI! ;R I 6 7.7 A 1
THAT THE ABOVE t5 AND AGREE TO COMPLY WTTH All ORDINANCES _
ANDLAWS REGlAAT1NG SUILpNG CC)WFRUCT10f1 I CERTIFY THAT IN DOING THE # o o e o 0 1
WORK AUTHORIZED HERHY I WILL NOT EMPLOY ANY PERSON W VIOLATION OF
TH ELABOR CODE OF THE STATE FORMA I N Rt3AT1NG M Y?OR MEN•5 COM, '
PENS
ATK)N INSURlJ . 2 ° 22 0 p
SIGNATURE —22006
PERMITTEE
ADDRESS
CITY L,,q y o G3
P.C.Fee$ Perm ft Fee l' r 3
J A
Is$uarxa Fee
Total Fee
COUNTY OF LOS ANGELES TILE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT ` TEMPLE CITY CA 1 BL 0508 9610090039
I PHOME: (818) 285-0488 EXT:
ADDRESS:
TR: 13277 LT: 14 SO. FT STORIES TYPE 6104 CAMELLIA AV
STRUCTURE: 0 V TEMP G 917801733
ASSESSOR INFORMATION NLMER: NEAREST CROSS STREET:
5385-017-020 THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY
EXIST OCC GRP: 10/09 TC 10/09/97
MMER: TEL. NO: LDGS. NOW ON LOT: VALUATION: FIkA F I NAL BY CODE:
VU STEVE S TR STEVE S HU TRUST - 4 1,600 l/`T../�
91 SADDLE DR / y
LBCH 908154740 FEES PAID IDESCRIP7ION OF WORK
RECOVER WITH COMPOSITION SHINGLE
FEE DESCRIPTION: �G�ANT& , !o AMOUNT:
APPLICANT: TEL. NO:
MITCHELL WADE CONSTRUCTION (714) 840-9437- AA BLDG PERMIT ISSUAN W 27.75
6312 SHAYlNE DR. AC STRONG MOTION � 0 .
HTINGTON BEACH, G PERMIT W/O
UNOENj iQO �VA 0
FECNTPACTOR: TEL. MO, I
0 �Xpoks DATE INSPECTOR SIGNATURE
MITCHELL WARE CONSTRUCTION (714) 840-9437- 0
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6312 SHAYNE DR. LIQ NO (/� 0 . 1p 1
HUNTINGTON BEACH, G 92647 5//33777
LIC. N0: , SLAB/�MDER FLOOR
MAP NO: SEWER MAP BOOK: - PAGE- FIRE ZONE: '700 DERF NSULArMW
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STAT CLASS:
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NO � 21
AIR QUALITY: 1000 FEET MATERIALS
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