HomeMy Public PortalAbout6218 CAMELLIA AVE_Building__ Tloty �
- WORKERS' COMPENSATION DE�LARA
J hereby affirm that I -have Q certtflcate of consertt,'To,� If
Insure, a s certificate Qt Workers' CompensoHon Insurance, AP P LI CAT I O RfO R B U I LD I N G-PERMIT::
or a certified copy thdreof (Sec' , lob ).' WU •.-OF SOS A O TELES - BVILDMG AND SAFETY'.."
P61 Icy,No: Company. yy
❑, Certified•copy Is,herpby famished. FOR APPLICANT-10 FILL IN-. , _ V
❑ .Certified copy la filed'with thdcounty building liiapec- BuluitNc3 - • -
bort¢epQrtment, ADDRESS
Date• Apphcpnt P �//p� LCAT- Y
CERYIRCATE OF-E)(F PTION-"-)APORKERS' SIM O4 LOT hJOW bf Y LOT
QOMPE14mnoN INSURANCE -' ASSF�SOR
r(This section need not be compigted if the'pefmIt'Is far_one TRACT Bt -LOT NO. '` IdAPBOCK - PAOE PARCEL
ftundred-doII¢m($l00)or lees.) y.
Us�Zo.ff.
-1 certify that In the.4-erforrnari4e of.the woNc #or.whlth this tY ^ ! ,.�/��.t �
permitys Issued,J shall'not employ pny.person it a.ny manr�e�1--���� 00 - LO� OtL- 4, 1140.
�bm
so as to ber:ome subject to the Workers'Cbmpengtloa:l awl� / - - O
ZP
Date. ApplicantARC}IITECT DI E. JURE ) 0NOTIEE T¢ A Lj�igNT: If, after rfiaking,thls Certificate of ENGI NO r
Exemption, fou,should �ecomq subject to the Wocl(ers
�f CONST t +> '
Com nsatlott vtsldns of the La �D0-
t
r '
pe gra ba'Coder,you rrruat fortfti• _ AbDRfS� '
th comp)y ivlt}t such'prpvisloris or ihU porTlt 'shall bd IA 9 STATISrlC.4a CLAS$JR--ADCC QONDO.
deemed revoked.. . �` �..
> LICENSED O0Ni-jAc bks.pEGTAtu+T+gt�1. ���io. 116001
sass No. uNrrs 'I T.T
7 hereby affirm thaii orn Ilcerued.uridif{ ovlflons.o# tpPtbr 9 _ }
(mmmertping.with•Settlpn 7000?rgf•DNIsI0rt 3.1of the Bush tsk � . . !� u� SEWHt MIW � '
and Proferijons Cie,p my'ILoJrtse 4n fuffforc+andeffect, V Ac PG '
SQ: �,yr� W. OF. NO.OF- CHECK
t License,r�un)bgr :` Llc Icss _ W STORIES, AMILIES OtE s' ' ' '1 V 74t•63
AIMA
;� 'cr..Y• ,. _ _ I��WOWtom+' ;..a ? F°'. CliEC�r. 1902:63
❑1 am exempt,under.$ec. - AW
J': B.aP.C.'for tfll; reason i. i'' 1 -- it- L❑J �. J .. 1
Dale-, DEMOL ❑ 0000--0[101= 7/29/96
Signature APPUaw7 T¢ I�fi►C .. 771 11. X1'112:23
OWNER-4UILDER DECLARATIOR NO– DATE'.
I hereby affirm that I am exempt.from.the Contractors License _ ':.
Law,for the follawlnp feason.(SeCtrorl 7031.5, Busbies Arid ADDRESS RrAL
IPrroolfewlons Code):, -
❑ 4he BUIIDiNG
J, d! owner of
prop", or my'employed with - ADDRESSr"
woges,as tkrolr solb-compensation,will do the work and
the strocfure is not Intended or offgrsd for sale(Section tOCA TTY - - - -
• - " .7W4, Bualndss cnd Professrorq-Code,) 13
hVNNG 7 .
'0' 1,d4 pwAer of the property, air,extluslvely-corltmctinp CO NO.
with.Ilcbnso Watr`actom to tonsrtud the prolgd (Sec., ADDRESS
tion 7044, j3cgIr&M,9nd Professrons Code.}'-.
COtJSTRUCTION LENDING AGEIJCY YARD HWY. FROM
L hereby affirm that there Is a•const uetron landing agency for FRO{fi
the perforn)ance Qf the work fqr whlch this perniit.Is Issued P `
(Sec- 3097, Civ.'C). SIDE_
Lender's Name f
_ LDMA Ref.
Permit
o Iceitify that I.have read this applicatth
ion and state that e bw,a'nce s. LDMA P/C
above Information Is correct.I agree to comply with all County InveClQoHon.Fei. i
ordinances and State laws'relating to building con4tructloq; Total Fee LDMA,
and hereby putho?Ize repr•eerntatives of this County to enter
upon the above-meatlormd,propbrt.y for Inspection purposei
M PiN f'Ok U04ANATOIEY UVOGUA64111
pnature of App �^ �—�
9 IImM or r Dant
` COUNTY OF LOS ANGELEt TEMPLE CITY 0 0508 BUILDING PERMIT
-DIPARTMM OF PLBLIC WMICS 9071. LAS TLMAS ALTEILATION/REPAIR
BUILDING AND SAFI`TY / LAND DEVELOPMENT TEMPLE CITY CA - BL 0508 9711100004
PHONE; (818) 255-0458 EXT:
LEGAL ID' MO. OF CONST allILDING
TR: 50836 LT: 0003 SO. FT STORIES. TYPE 6218 CAMELLIA AV•
STRUCTURE: 2700 VK TEMP CA
NEAREST CROSS STREET:
THOMAS PAGE: GRIB: LOCALITY! TEiPGE CITY
MIT-109–ME: KtbLI) USE ZONE; R-1 ISSUED ONt PROCESSM BY:
. EXIST OCC GRP: 11/10/97 _ RN . . . 1/1.0/98.
UWNt:KON LOT: VALUATION: FINAL DATE
CKV,•JEFF K (626). 309-1789- 1 T,500
6218 CAMELLIA AVE
TEIP ,CA 91780 FEES PAID Of wwx
OPEN PATIO 260 CF. SOLID R00
FEE DESCRIPTION: VIUAILTI-TY: LIOM: AMI"T:
APPLICMT: TEL. W:
SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75
- AC STRONG'MOTION RESID 7500.00 VAL 0.75 SPECIAL COWMIIONS:
AX BUILDING REVI E ['� ATO
D2 PERMIT W � ■fib VAL 1$3.90
000 fff111eL((L E 267.f0
SAME AS 06MER —v
LIC, NO
SETBACXS
ARCHITECT OR ENGINEER: TEL. NO: FOLIN�MON/TMZFTOW
•LIC. NO•
.,r - SLAB/LINDER FLOOR
I
MAP *0- SEWER MAP BOOK: PAGE: FIRE ZONE:
1A/
153H269 3.- p1 PUBLIC y � ORKS
IIING
.Na. OF FAMILIES-. DWELLING LIMITS: APT/COND: STAT CLAS!�-
I
No 21 �SCHOOL WIT91N1 SHOiTHING
AIR OLJALITY: 10QQ FEET MATERIALS I
NO NO NO / FRAME�O ~—
!'A
SET BACK YARD: HVY: PROP LIME: WIDTH:
FRONT PL-
SIDE PL- e'vi C
p T��
t e/
INTERIOR LATH/I)RYWALL
{ -
EXTERIOR LAnFRATED FLOOR/CEIL .
MUM
REPORT ID: DPR261 ROUTE F0: BS0508
s COUNTY OF LOS AAGELES TEMPLE CITY 0508 BUILDING PERMIT
DEPARTMENT OF PL13LIC WORKS 907LA
1 S TUNAS BL 0508 9608120031
NEW RESIDENTIAL t
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA r_
PHONE: (818) 285-0488 EXT:
NO. OF CONST N E61 nILDING ADDRESS:
TR: 30836 LT: 0003 SG. FT STORIES TYPE OCCLP GROW 6218 CAMELLIA AV
STRUCTURE: 2700 2 V R3 TWCA
GARAGE; 809 2 NEAREST CROSS STREET:
OTHER: F PAGE: GRID: LOCALITY: TEMPLE CITY
TENANT:' io/bli96 TC 08/12/97
OWNER: No- LOT: VALLI CAMELLIA HOMES L P (714).37-0433- 219,200 , -f—
2100 W ORANGEWOODWORr
ORANGE, CA 92868 NEW SINGLE FAMILY RESIDENCE
FEE-DESCRIPTI-0N: QUANTITY: UOFI: AMOUNT:
AL PER/CATANIA DEV., INC. (714) 937-0433- AA BLDG PERMIT ISSUANCE 27.75.
AC STRONG MOTION R IQ 1 00.00 VAL 21:92
B2 PERMIT W/EN¢RA200 DO VAL 2,239.05
F €S® 2,338.72
MNTRACTOR' L. -NO: 01, APIPROVALS
ERfQ"IA DEVELOPMENT, INC. - Q`�" '�
' 200 W. ORANGEWOOD AV.STE 110 LIC. NO �'/iLOCATION AND �
ORANGE, CA 92663 1943.. HONE
WRIFITTn"I TEL. NO:
LIC. M0: I „ „� SLAB/*ER FLOOR
RAISED FLOM FRAMINGZONE
3: Oi V S���J WOR EFJ
UNDERFLOOR INSULATION
153HZ67 co
MD. OF FAI41LIES: DWELLING LIMITS: AMEND. STAT CLASS:
- t. p2ND LEVEL FLOM SHWH
DO
i1 r
'n
WITHIN HAZARDOUS ROOF SqEATHING
AIR M�0 ITY: 10� FEET MATERIALS L � ;. �� -El �� D T�
``���f
SET BACK YARD: HWY: PROP LIKE: WIDTH: $HEAR PANELS �
FRONT PL- 7 `
'Cj�j - .7
SIDE PL-
EXTERIOR LATHT
FIRE DEPARTgNT-UMMM
REPORT ID: DPR261 ROLUE TO: 8SO508