HomeMy Public PortalAbout6109 CAMELLIA AVE_Building__ QTY OF TSL$ CITY
70A638A C"803 8-84APPLICATION FOR (BUILDING PERMIT _
COUNTY OF LOS ANGELES !)UILDINO
DEPARTMENT OF COUNTY ENGINEER DDRESS
BUILDING AND SAFETY DIVISION LOCALITY
.JOHN A. LAMBIE. COUNTY ENGINEER NEAREST I
COLEMAN W. JENKINSXUP•T.OF BUILDING CROSS ST.
-
DIFCT NO. d-Ptr I TYPE. PR nY
FOR APPLICANT TO FILL IN coNSr.
BUILDING 57ATISTICAL SIFICATION SEWER M'AP +�
ADDRESS CLAS9.N0: DWELL UNITS BK 14 FSO iJ
LOT NO. BLOCK USE ZONE 14AP. 2 C) D
O.
TRACT 9PECIA '
MO. OF ■LDGs. CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF
BLDG. SETBACK FR M -
A.,�
TEL FRONT PROP. LIN[ OF (STREET)
OWN9R Albert Ans ach NO. TYPE OF RXI/TIN/ G[TBAFK. HIGHWAY YMD = TOTAL
C.L.
ADDRESS 6109 Qgm6lia
CITY Temple Ci + _
ECT OR TEL. ■LOG. q[ ACR FROM
ARCHITECT -
RCHIER NE. SIDE PROF. LIN[ OF STREET
_ _ TYPE OF [XI/TIN/ /[TBACR HIGHWAY + YARD = TOTAL
ADDRIZSS HIGHWAY WIDTH FROM C.L. /�
CONTRACT gld ,.,g. �a�" + - 8
ADDR EES337 S. Woods APe. No 159 9 CORNER CUTOFF YHs No Ll
oc
a
CjTyLos An les LLASS
IC C39 SEE REVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTION OF WORK y
Z
NEW ADD ALTER REPAIRX DEMOLISH
9a FT. NO. OFNO. OF .
SIZI! StORIE5 - FAMILIHS
USE OF
STRUCTURE
SIGNATURE OF
APPLICANT
VALUATION$ 450.00
' AFPROVA LB - DATE IN/P[CT011'//IGNATl1R[
P.C. PMT. FOUNDATION, LOCATIO
FEE$ FEE$ 9.00 FORMS MATERIAL _
FRAME, FIRE STOPS,
I HG]tOOE
Y ACKNWLXDGTHAT I HAVE ROADA
THIS AIPPLICTION ERACI NU BOLT
AND SEAT[ THAT THA ASOV[ IS CORRECT AND AGREE TO-COMPLY FURNACEL LOCATION
WIT-HALL COUNTY ORDINANCES AND STATE LAWS REGULATING OAS VIZNT. DUCT
GUILDI NO CONWMUCTION. I CERTIFY THAT. IN DOING THE WORK
*ADDRESS
n[RESY I WILL NOT EMPLOY ANY PARSON IN VIOLA- LATH. INT.E LAISOR COD[ OP E STATA OF CALIFORNIA RELAT-
CT AND-PQ$TFp oe
KS M N NSURA
TH. EXT.
HOUSE NUMBER COR-
E R FINAL
p JOHN��+F..�L�7E.WES.. PRINCIPAL ST RAL F-NWNEER
PLAN".CHECK VALIDATION CK. M.O. CASPLaaMI H _ VALIDATION MA. CAAIH
LNLo 0 4 1 3 .."31 1 D���� " 9.00-
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING
ADDRESS
BUILDING.
ADDRESS LOCALITY
}}rr NEAREST
CITY L G ZIP. CR06S ST.
,OF BLDGS. ASSESSOR
SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCH
D5-MCT GROUP TYPE FIRE
TRACT 19 33 M LOT NO. / ` D nl �� CONST. Zz BY
OWNER &Pgo)l4c�Z1b J b
STATISTICAL CLASSIFICATION' MAS
ADDR CLASS NO. DWELL UNITS L' B �j PG
Q TY ZI P
ARCHITECT OR TEL- VALUATION $
ENGINEER NO.
ADDRESS BL M
FRONT NOP.'U N E 0 F (ST RE ETI
O 1
TEL
i// HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXIST NG
T
ADDRESS LIC FRONT PROP.LINE HIGHWAY WIDH
LIC-
CITY
ICCITY CLASS
BLDG.SETBACK FROM
CONSTRUCTION LINDER .
NAME AND BRANCH SIpE PROP.LINE OF - (STREET]
HIGHWAY + -YARD TOTAL SETBACK FROM TYPE A EX STING
ADDRESS CIT SIDE PROP.UNE HIGHWAY WIDTH
SQ. NO.OF NO.OF CHECK +_
SI STORIES FAMILIES ONE
DESCRIFTION OF WORK �X I T NEW P.C- Fee$ I Permit Fee
�!V ADD ❑ 7
Issuance Fee
ALTER
REPAIR Total Fee
USE OF //
EXISTING BLDG. C? DEMOL t-/Q ,�yy� C—+'i� . . ^
APPLICANT TEL 77'' / :� '6'4x9 A
(PRItin Io 0 0 o23
BY LSIGNATURE) 2,o'o OL 1,6 0
I HEREBY THAT I HAVE TFQS APPL.)CATYON AND TE
THAT THE ADOVE IS AND AGREE Y.AITH ORDrL 10 0,.- 2 1,6 O,US
AND LAWS REGULATWG LDING I CE?TIFY IN DOING THEWOW .
LABOR COOEZOF THE STATE OF NOT EMPLOY TIN I T O04
PENSATION INSURANCE •0 4 2 f�7 f--
7 9
140EL0A
SIGNATURE OF
PERMITTEE :# 0 0j0 0 0 1
ADDRESS
2!� 3'4:0 0
� CITY _ TEL / '
34,0Q.-6
USE ZONE NO. Q
0-3
SPEClA1 > 0 4,27 r 7 q
I
CCt4 D[T K)NS
FINAL BY
DATt
T
76AA 3/A L?//•]'11-14
APPLICATION , FOR, BUILDING PERMIT 1
DIVISION OF BUILDING AND SAFE Y BUILDING Q
DopfII� un
II! Of County En in w ADDRESS .
County of Lod Angel" LOCALITY
WM.J. FOX, COUNTY ENGIN33![PR NEAREST
CAJMATT D.GRIFFIN,SUPT OF EULLDIM• CROSS S,
FOR APPI.ICA T TO FIE1 IN DISTRICT NO. I GROUPS BER MAP
TYPH
CUILDING / - COk- ilkN
ADDREI4S 1 ,j _
N BM SR O✓ bHWY - � O
LOT NO. DLOCK U$-ZONE SPECIAL
-6-L- CONDITIONS
TRACT - - _ ��
NO. OF DLDGS.
SIZE OF LOT NOW ON LOT Z BUILDING YARD HWY STRVET NAME EXIST.
USE OF SETBACK WIDTH
EXISTING DLDG. LAPE C%4A. FRONT 2c) 'r
P. L
OWNER - EIDE v
MAIL P
ADDRESS 6101 A . C "
1 1.
CITY TE - .j I 1W111 I UNIT g INDUSTRIAL
2 DUPL >4 E - UNIT 6 PUBLIC ELDG
ARCHITICCT OR TEL
ENGINEER NO. 3 AFI' UNITS 7 ADDN.,ALT., ETC.
ADDRESS - 4 COMMERCIAL 8 MISCEL
CONTRACTOR Sjpj&Q7 NO.-S 3'S
INSPECTION RECORD
ADDRESD
DESCRIPTION OF WORK.
NEW ADD &---ALTER REPAIR •DEMOLISH _
SO. FT. NO. OP NO. OP
SIZH BTORIES FAMILIES
USE OF STRUCTURE
SLK
SIGNATURE OF
APPLICANT APPROVALS !t'
ADDRESS DATE INSPECTOR'S SIGNATURE
P. C. ! FOUNDATION:FORMS,
MATERIALSTION f
.FE[ FRAME: FIRE STOPS,
VALUATION BRACING, 15OLTS
FEE FURNACE: LOCATION _
OAS VENT DUCTS /-I-�'
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
APPLICATION AND STATE THAT THE D
AOVE 19 CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT.
TAND ION.STATIR LAW RiOULATINO D INS CONSTRUC-
LATH, mCT, 1
SIGNATURE OF HOUSE NUMBER COR- "
PU.RMITTQE RECT AND POSTIED
ADDR FINAL
.W&L J. Fox. county Z w1km VALIDATION
i DEPUTY ETRJTY
r
DY , GY s�
m _ DEPUTY --- -- -r- - DEPUTY
' WO�21�RS'COPENS�TICxJ DFC!dRA1101� -85_27`.!c' )�ZOA j I y_
I hereby af{Irm ttat I hgve a certificate of consent, ?o. self _ "PERMITi
fflcate of W .ff' Com cation Iaiurortce PP�LI AT I ON �F R:.B I L D I IV C�. P RNI I.
Insure, or a cert prk A - O .
&a`certtfled`cbpy ttieteof'(Sec.'3800,ia: C.) . .. _ _ - __ _. _... n�
s COUNTY OF LOS ANGELES BUILDINd AND WEtY
POI 1c�I o 8�F-2lF1353'campa y, _ .. -
. Certified Copy Is hbreby,f rrnlzhed. •: FOR APPLICANT TO FILL IN ADDRESSBUILDID I
�' Certified io' li filedlvltf5 iherCo`ghty bull:In Inspet, BUILDING
Hort departtfi'erit '. 'U1't::',1 ADDRESS 6122 $ CAMIA
. fir..: •.,.r ' .•-1 '. c, ,,-�:-� ���'u� _ _ ..__ . . .. _._ ... - •- - -^----- -- - - - - ----- -. _ _ _I
Date '.t :, t PII4dnt$ div^ :.�MP�__T crry ZAP 1 LOCN1rY
"�2TIHCATE 0F EXIJIAPTIOP{�ROM iIVORI�RS�." n' •; r NO:OF BLUCS. . CLARESr_ __'_
sIZE of for Now ON LOT
-:' C OOMPfNSAiION`INSURANCE - "•. ,-. , -
(Thls•sd(itfon h*ednol be'Com leted tflthe'perrmlt IvfaF,4ne.. : -; T r'= - - LOT NO MAP BOOK - PAGEPARCa
h�rtdred dollbrs 0100)4F�¢s) -. ,. .- 7� ��
- - - 7R7t7DF�'. ZONE- . .
I tlfy rhos fn'the.perfarrt�ance a the %i^ for lilr�i this NO.
It'Is jssub2l, r shall not em to do r, n�`n an"y"rnRnner �sL
perm P Y Y S-"-10 ADDRESS -6 - ._'..
LZbconie iublect tti The Vlrorken tompensatibn Laws. CDNDMO -
- : - M . TEMMXX1T __ wP 9th
IPcaht -
ONE
NOTICE"Ta ApPLI F �'oft'br rt5aklfip thli"Certlfl4ate of 13,ONARCH ER OR NO. RISTRICr:- TYvE _ -. 9K BX.
Es emplion, you' Aould become sub(ect to,Aihec Workers T' r.�
Ctompensctlon piovlflons of•.the.Labon•Codh,you must forih V_'.W� �. T _ a- .
with comply.,wltfr.suah proytslons pr.Jfilt.,perm1t.ahgJl be..-- . _ _ __ _- --.
deemed•,rgvok*-d.' ,r, _ SfAT15r1CAl CLASSIFICA APT. `
� . ., � coNTR.ocroR .' 1 MPAI�. 26 1.8
LICENSED CONTRACTORS DEP ARATIQN #,,, �1, CLASS t O. DWELL UNITS
I herppy Offlrrn that I am licensed R PrQYhp�of Cir 9 ADDRESS 337 •^W61DE Al . - `�. 0496- sEV46t MAP
(cRrpro rt4 N' with SeSt1on7000)aF Divblon 3 of t�Buslr�a and At�� E .� LSC_. Orr
Prof�lQfb.Cro�e, avid My Ilcense V&16 full-f6tce'a�d`pffect• CrTy _�'+R�'ffi'�f l�F► Q,q� 37p',�'- y�MATIO , _
L t t �., - z. .,..•t SQ F{. OF [JO.-0F E}iECK.. i BK PG.a
vicense Nu.mher_�1 Llc Cla> 39 . .. i -. _ ONE
Contrdctor
SIH 1Q G(�ldl� 2 8�., t IPfIC)N of woRx fb NEW : 2304 00 "
❑I am exempt Under sec. PRIKPARKD C;ASS'-C� - ADD y 1 --- - ;2+6 4;4 A`
-O,o.n'o.e.� _I
BAP.0 for thl4 reason �.._.. REPAIR_ - -
_ e USE OF G
-- - - . -Date:—' - ExlsnNG BLDG. MAOL. ;- 5 9.2 5..-
- APPLICANT fEL
S19tature ' - - - - --- - - No. ! 1
OWNER-BUILDER DECLARATION _ ? a o 5 Q 2 5 •-!
-.I hereby affirm that Lam exempt from the Coritractods License„ ADDRESS Q. .O 6
Law for the folloWrrig`r}ason.(Seddon 7951.5, Business and
-Prbfii iotts'Code): _ ....� _ - 61r r - - i
BUILDING
I, as,owner of the property, or my employees with ADDRESS
wv i as thelr sole compensation,wllydo th*-work artd --' - - - - -the structure is not Intended or offered for sole(Section
- 704A,$ualrtesrand�rofe}slonrGodtr} MOVINGTEL
J,.as owner'of the property, am dxcluslvely contracting NO
-Mth Ilcensed contractors to construct the project(Sec-
tion 7044,Business and Profewlons'Code). ADDRESSTOTAL SETBACK tXJ,,L
-. - - CONSTRUCTION LENDING AGENCY'" - ^' - YARD HWY ' PROP. UNE WIDTH - - --
I hereby.affirm that there Is a construction lending agency for FROrrT
-the performantp-of the work for which-this-permit Is Issued -
(Sec, 3097, Clv. C, 514E
P_P 'r
Lend*-'f Norrie .. . . R _ -. - _ _ _ _ .• __. _ .. _ -_.'_ _ _ _ _ ._. ._ _._ __ _. . - .
_. . .- Ref. r -
] Lendera�lddrsns^' - _ P:C:'Fee f Perms Foe �i• 1 .
I owitfy.that,l have read thLi appllcatlon.and 00-te.-that the _ _ x"0.50 - - - - - i
above Infdnwtiw is correct.1 agree to,comply with all County In on Fos hrUan�Fe.-' ,�/C/'
_qrdI and State relatln to•bulldln o n, i
- �Y''� g.. . 9 S -alp . ._ .- -.__.. .�_ ._. Total Fee - . . -LDA1A Perm
and aut}toriza rep�ps�n I this COUuty to enter '
u n *-above-mwntl sect pr Inapectlon purposes.
p - 111MVlfi MR PIPLAIIATORY LA M#40i
stgrtafUr*:af Appltamt-or-Agent- - - _._. . ., Date