HomeMy Public PortalAbout6131 CAMELLIA AVE_Building__ 78A638A CE 0803 1/71 `�
APPLICATION FOR BUILDIf'aG PER T
~-OUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK FADE PARCEL
B=ING AND SAFETY DIMION BUILDING �J
ADDRESS
COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY
FOR AP T F IN NEAREST
CROSS ST.
BUILDING D181 T GR�UP TYPE PR
ADDRESS I.� i CONST.
STATISTICAL E IFICATION SEWER MAP
LOT NO. BLOCK ClA NO DWELL,UNITS BK
TRACT i USE ZON P
NO.OF BLDGS. Nb. O
SIZE OF LOT NOW ON LOT SPEIAL
USE OF C (TIONS
EXISTING BLDG, _
TEL
OWNERaLA4 - NO. BLDG.SETBACK FROM
ADDRESS FRONT PROP.LINE OF (S fREET)
TYPE OF EXISTING SETBACK HIGHWAY t YARD = TOTAL
CIT P HIG FfWAY WIDTH FROM C.L.
ARCHITEC R TEL, t =
ENGINEER V NO. BLDG.SETBACK FR
ADDRESS SIDE PROP.LINE OF (STREET)
TEL. TYPE OF I8TING SETBACK HIO t YARD = TOTAL
CONTRACTOR NO. HIGHWAY WIDTH FROM C.L.
ADDRESS N0. t =
LIC.
CITY CLASS CORNER CUTOFF YES ❑ NO ❑ W
CONSTRUCTION LENDER a
NAME AND BRANCH AE
E SIDE FOR SPECIAL APPROVALS
ADDRESS
SQ. FT. NO. OF NO. OF NEW
SIZE STORIES FAMILIES
USE OF ADD STRUCTURE
ALTERREPAIRSIGNATU OF APPLIC T DEMOLVALUATIONSLS DATE INsP on's BI A n
71 FOUNDATZ LOCATION
FEE S FEES l V f.! FORMS MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I RAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT-THE ABOVE If CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, ,
WITH ALL ORDINANCES AKD LAWS REGULATING BUILDING CQN- GAS VENT, DUCTS
STRUCTION. IC
THAT IN DOING THE WORK AUTHORIZED
HERESY I WILL NOT EMPLOY ANY PERSON IN VIOLATIC OF THE LATH, INT.
LABOR CODE OF THE STATE OF -CALIFORNIA IN REXTING TO
WORKM EK,a COMPE!(RATION INSURANCE. LATH, E}(T,
SIGNATURE OFHOUSE NUMBER COR-
' PERMITTEE RECT AND POSTED
ADDRESS FINAL ��J
+7f.GG!
JOHN F.
LEWIS.�FPRI NC'
TRUCTURAL EE
PLAN CHECK VALIDATION CK. M.O. CASH _ rL.LLLVJEl VALl1JA CK. 4.0.
� F s � AM17 1 D 1 2,00-c
f
DIVISION OF BUMI)ING AND SAFETY BUILDING
Depwtawat of County Ehg leer
County of Los Angus'
f WM. J. FOX, COUNTY ENGINEER APPLICATION
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT PLAm OK.OR RIM Mo. FKRM T N0.
ADILBUILDINO CZ
SS
DRINOE
RED[IVED BY DATE OrAPPL. DA ISSUED
LOOALMTY Z r/
NZARIST
BUILDING
e
ADD=
OWNER
MAIL / LOOALITY
ADDRESS / M�ll10T
OROSE QT.
1 T� vW { FIR[ Na OF TYPE ROLP
A PHIT[OT ON ZOH[ FLANK
TEL
ENOIMEER N0. SLOG. ORD. N0.
KET'BADK LIN[
A.D
USE APFiZIIvim
OONTRADT'OR f7 TQ y'` ZOM[ fl' DATE
f HOUSE NUMM[RINO
` MAP NUMBER- NO. AMIONED fY
LtnA,. CORRECTIONS
D[SORTI
IFOM LOT N0. ■LdOK
T'RAOT
M0. OM* ML D'S
613[ OF LOT MOW ON.LOT
USE OF N0. OF
Xxil INC■LDO. FAM,
LIM
DESCRIPTION OF WORK °
a_
NEW ALTIDIATION ADDITIDN �n Q
REPAIR DEMOLITION r
I"FT. N0.OF j
III= ROOMS STORIKS _
EXT.WALL ROOF
DOV CPHN0 OOVERM N0
USE OF STRUDTUR[
IN EP
FOR r APPROVALS
.13M A EIYAM INIPEOTOR'BBIONATURE DATE
FOUMDATIONI L.ODATION
FORMS, MATICRIAIJ
I HERESY AOKNOWLiDsi THAT 1 HAVE READ THIS AP-
PLICATION AND STAT[ THAT T'H[ INFORMATION GIVEN to FRAM[I'FIR[STOP
OORR[OT. TOORAOIM SOLT2
AND RTATTT LAWS REOULATINcampLy S BUILDING CONSTRUCTION.
RIRNAQEI LOCATION,
BAS V[MT DUDT5
C
■IOHATUR[ OF ��C�� Q LATH, INT.
P[RMI
�� LATH. ExT.
ADDREMIL
PLASTER, INT.
AUTHORIZED AST-
PL.ASTLM, ECT.
P.0.*
FEI HOUME NUMBER OUR-
VALUATION # 9TED
- _ -
� � REPT AND P0
FINAL
76AB339A Du 3 1-62
DEPARTMENT OF BUILDING AND SAFETY APPLICATO FOR ORRPERMT ;
COUNTY OF LOS ANGELES I L ® I �\ G
WM. J. FOX, CHIEF EMOIN[[R BU
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
SUILDINO DISTRICT Mo. PLAN OK. NO. PERMIT NIL
ADDRESS �— ?
LDOALITYe N'✓f, [I D DATE'OF A"LL D�ATI ISSUED
OROSa �f Q� ^f 0—1 P
CUILDINYY
Ol/ l
M?i[R 1. ADDR[SE
MAIL
ADDREOS �. LOCALITY 1 .
NEAREST
CITY Z.4 G a6r ref N` 8 .�' Z.4 DROSS ET.
r�
ARCHITECT OR FIRE NO.OF TYPEs�/ GROUP
TIL ZONE r PLANS
V
ENGINEER `e. No. r
B LD O, 01110. NC.
ADDRUM EETSAOK LINE
APPROVED
T
DONTRADOR mm BY DATE
USE APPROVED
ADDRESS ZONE �� BY DAT[
DEHOMAL
RI"IOM I LOT NO.. ■LOOK CORRECTIONS
`
/ I NO. of ■LDOS.
BIZ[ OF LDT O
NW ON LOT
USE of No.OF 'No. O
KXISTINO ■ O. FAMILICO ROO ■ -
DESCRIPTION OF WOKS
NEW ALTERATION ADDITION
0
x
REPAIR MOVING X D—EMOLI13H p
aq FT. N0.of
o1Z[ ROOM■ STORIES
WALL- IROISF
[
OOVRINO 13UVERINO
USE OF NEW
SUILDD,,IINE
AV�� .f f�1��'2 �l5•j��
1 HERESY ADKNOWLEDO[ THAT 1 HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE A190VX IS OORREOT FOUNDATIONI LOCATION, rj}.
AND ADR[[ TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS N<l TOR ^ � �(
AND STATE LAWS R[DULATINO SUILDINO OONSTRUEMON. F'RAM[1 FIR[ ■TRPS, 1V!�+t
■IONATUR![ OF GRADING, RLT7
OWNER LATH, INT.1
AUTHORIZED AOT
LATH, [XT.j
P. D. #�
I'LASTER, INT.
/�f fo"t9 ------ FE[ PLASTER, EXT.
VALUATION * Q
nm ��� FINAL
a WORKERS' COMPENSATION DECLARATION
pur , or
fffxftica I.have certificate of consent toselfAPPLICATION FOR BUILDING PERMIT
•, `Ir�ure, or a certificate of Workers' Compensation Insurance,
+.� or a certified copy thereof (Sec 3800, Lab. C) a .
COUNTY OF LOS ANGELES BUILDING AND SAFETY
Poflcy No. Company
❑
Certified copy.is hereby furr)Ished. FOR APPLICANT TO FILL INAp�S �
❑ Certified copy Is filed with the county building Inspec- BUILDING
tion department. ADDRESS e
n '
Dates Applicant CITY zip (/ LOCALITY _
NO..OF BLDG& / NEAREST
CERTIFICATE OF D(EMPTION FROM WORKERS'. SIZE OF LOT/I// NOW ON LOT CRASS ST. !
COMPENSATION INSURANCE
ASSESSOR
(This section need not be cam laced if the permit Is for one TRACT BL(X7C LOT NO. MAP BOOK PAGE PARCH
hundred dollars (;100) or less.? owNs�</ec 12P USE zOtE MAP
I certify that In the performance of the.work for which thb
permit Is Issued, I shall not employ arty person In any manner ADDRESS 41 ' t2 SPEaALl()NS
so as to become subject to the Workers, CCONDIT
ompensation LawnO _ O
CIT 1 . zIP /f
Date Applicant ARCH ITE(rTEC
NOTICE TO APPLICANT: If, after making this,,Certificate of ENGINEER NO. DISTRI GROUP TYPE RE P BY Q
Exemption, you should.become subject sub L ,to the Workers' rfj COf�ST z
Compensation provisions of the Labor Code, you must forth- ADDRESS
with comply with .such provisions.or this 'permit shall be STAT15T1CA1(1A.SSIFK:411[}N APT. CONDO.
Z
' deemed revoked. - (XXJI'RAC.'T(KR NO. _
LICE�JSEU CONTRACTORS DECLARATION UC NO. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS �'
UC y ""SEWFSf AMP
(commencing with Section 7000)of Division 3.of the Business �, CLAM
and Profeuions Code,and my license is in full force and effect. a ATION
Sq. NO. OF NO. OF C H ry'8K PG. RwTV
LIcense Number• Uc Classes_ SLZE STORIES FAMIUES (NE t17.�7
_ VALUA 7
3307 43
Contractor pate DESCRIPTION OF WORK NEW
❑I am exempt under Sec ; 1 ITErS
,qDb Li
97
B.BP.C, for this reason ALTER ❑ ; J b b b �a' -74 mac-} p
REPAIR ❑ DECK 7417■97
Dritw: USE.OF m
EXISTING BLDG. DEMOL ❑ #� •W
Signature APPU�T TEL.
p� NO. PIH •
OWNER-BUILDER DECLARATION DATE
I hereby affirm that I am exempt from the Contractors License
Law for the following reason (Sectlpn 7031.5, Business and RIiA1tj
1 8/1L/E
Professions Code): . '\J �, �7 1 �
\ BUILDING
❑ I, as owner of the property, or my employees wHh r
wages as4heir sole compensation,will do the work and 1
the str (Section Is not Intended or offered for sale Section LOCVJTY
7044, Buslnees and Professions Code.) MOVING TEL - 9CT.i
CONTRACTLJ I, as owner of the property, am exclusively contracting � NO. _ J i .' M7 x.75
with licensed contractors to construct the project (Sec-
tion 7044, Buslness and Professions Code.) ADDRESS 1 ITEMS
CONSTRUCTION LENDING AGENCY REQU IRED YARD HWY TOTALMWg FROM '
I hereby affirm that there Is a constructlon lending agency for FRONT E TOTAL 895.75
p& `' OEGK 8 5.75
the performance of the work fat which this MIs Issued P. .1 t
(Sec 3097, Clv. C,). STDE
Lenders Name P.L.
P_C Fee Permit Fie LDMA Ref. 1
Lenders Address . . �OW1 9/29/89
o I certify that I have read this appllcatlon and state that the fasuance Fee / P
MA.PLGI - -
above informatlon Is cotrect. I agree to comply with all County " Im«ngatlon Fee _ 5969 1 AM $:5b
ordinances and State laws relating to building cortstructlon, Total Fee LDMA Perm.
and hereby authorize represent Ives of this County to enter
u thea entloned for InspectJon
/IIkSIR RaVMM PM D7LANATORY LANGUAGE
Signature of Applimnt or Agent DaM y
1 WOR E.RS' COAAPEKSATION DECLARATION
• :I sure or tict I have a certCompiof mrrner,t to vi t APPLICATION. FOR .BUILDING PERMIT
.' . ,-
11.•
Insure, or a certificate of Workers' CompsnscrTlon InturaTru, .. - " , .
or c(bertified copy thereof (Sec 3800, Lab. C.)
:COUP Y OF LOS ANGELES -- BWLDING AN� SAFETY
Porlcj No. Compahy L
BUILDING I`
❑ Certified copy-I, Hereby furnished.. R)RAPPUCANT TO FILL'IN ADDRESS ry
❑ Certtfied copy la.filed with the county building•irt, c- BUILDING
tion deportment: SSS
I Dates— ZI
ApplIcant� ' r�./ LocA. rY
4 CERTIFICATE'OF.QMMPTION FROM WORI�RS' S OE IbT A'! ' 1S,7 NOW O4 IOT / M
I COMPENSATION INSURANCE ASSESSOR
(Th Is section need not tie cons I.eted if the permit'li fbr one TRACT BL= LOT Nb. p�qp Bpp( - r. PAGES PARCa
hundred dollars ($100) or law. -
OWNER' � N0. JAW USE v
I certify that In the performance of the'•work-fof which tiils ..,, yy _ -{_ .
permit Is Issue Lthall hot employ any person 111 any manner ADDRESS-� N`. ,#A' i . '
so as to become sublect tb the Wbrkrrs',Compensatlorr Lawi.. y ONS O
CfiY - — DP 1�6Pr�'- — - - . U
}
Date Ilcont ARCH FEU OR TEL
NOTICE TO APPLICANT: If,. after Mokinq.'thls,Certificate,of eAGINIER . !�I� NO $ -'_ 7,.,vv G P ITYPE'fa IT RRE BY Q
Exemption, you phould become sublod ta: the •Workers' }
Compensation provlslonsof the Lobor.Cod&,, you must forth- ADDRESS /1!j/� � +✓ �'��
SE
with comply with such provlslons or this pertnit,Iholl be Ta A TION i AFr. CONDO. N
deemed revoked. 6oNTRACTOR NO. -r y _.
Z
- WCENSED CONTRACTORS:DEC13 RATION :. .t uC ~CLASS NO. UNfrS
i I hereby afflrrnthat I am Ilcerned uhder provlsbnsaf.0 ter9 :. ADbRE55 NO'
{cbmrperKlN:with-Sedlon 7000)of Dlylslon 3 of.the'Buslness C� "."• ic•
and Rrofessi6Rs Code,and my license Is In full force and effect. Cn CLASS 8K . PG J VALIVADON
a FT. iJO. OF NO. OF CHECK
lJcerni Number IJt,Class SIZE STOREES FAMILIES ONE
r{ VALUATFON
Contrtictor'„ �=
ON oF. �'" ,4nU
ttYY , � �-4
❑I am exempt under'Sec r GRf r (1J• $
- ALTER Q ► ,
B:BP.0 for this reason :
DAJ
USE OF
Date- VAX
EXISTING&DCJ: DE
Signature f/! p p. �/ � -
OWNER-BUILDER DECLARATION - , r / Are 6 Z
I hereby Irm that I am exempt from the Contrgdors Lltense `r/ 7 ► (� '/r�• T/ �-�1-7
Law the fbllowlnq reason. (Stiction_ 0WT.5,,'Buslnew and ADDRESS F1NAL. 1, _ ,q.xli + 60■50
Y�wag.
of the prop", or my employees with ,Dp as their sole comppns rtion,will do the work and - - - � 60...15'I0
the structure Isnot Intended or offered for salt(Sedlon LOCALITY `
70.44,.Buslnpis and Professions Code.) - MOv1 TEL _ _ ► 60■+�
❑ I, as gwner of ttaa property;.am pxcluslvelycontra'dlnq
PDNTRACTOR NO.
with Ilgensed coRtractors to Construct the project (Sec- } ONE 't00
tion 7044, Builnew and Professions Code.) ADDRESS
OONSTkUCTION LENDING AGBJCY YARD HWY TOTALFROM... ;
I hereby.affirm.that them is-a construction lending ogeric)tfor OMD-WO1 9/19/89.
the performance-of the--.work for which.thls permit Is]a;oed --
(Sec. 3097, Clv. C).. $IDE ; 968 1 ' 0,8323
Lenders Name -
1D LDMA_Ref.
Lenders Address P C'.Fee
Perm Ft Fee s
I certify that I have tbla appllcatio and•state that the a 115MA-P/C
above In Ion Is ed.•I agree tri mply with all County Inwstfpatbnfee
-
prdlna nd StaW.lows relating ul(dl'DQ oonstrucoon, Total Fes ton 15 CDMA
and hA��
atl of this Coun to. ter
upons Irupedl0 pu.
,m=vW=HOR DQIANMTOQY ILANGLIA0a _
S[gmV of Appll