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Home My Public Portal About5041 SULTANA AVE_Building__ ,n b DEPPTMENT OF BUILDING AND SAFETY APPLICATION FOR PERZYM '', COUNTY OF LOS ANGELES BUILDING S Vp ' C ® ' WM. J. FOX. CHIEF ENGINEER r ^ FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING • DISTRICT NO PLAN CK NO /nPERMIT NO 13, ADDRESS `� �` , • '• 1 `F 17 O t LppALITV G � ! RECEIVED BY DATE OF APPL DA DATE ISSUED NEARESTOROM ST- Te,`,e ki O r. / - J Q q BUILDING OWNER " ADDRESS �/ ` _ �• f�t1 C� ADDpEB6/ b • -� ♦ Q LOCALITY 7-e A*:: C Ctj �' NO NLABEST ORO®BT ./'. FIRE { NO OF// TYPE GROUPI T ARCHITECTOR TEL ZONE PLANS ENGINEER NO BLDG I --� -- ORD NO DD SETBACK LINE APPROVED TEL By I DATE CONTRACTOR NO USE APPROVE I DR ..N- ION I DATE CORRECTIONS DEBCRGIPTION LOT NO �IC LOCK D I / TRACT � 5, • JAL SIZE OF LOT O I NOW ON LDT UBE OF NO OF NO pF EXISTING SLOP FA !L[ D DESCRIPTION OF WORK ! `' n — -- — — — — NEW ALTERATION ADDITION I 1 q REPAIR MOVING DEMOLISHSo FT No or I ril77 1 L O SIZE •l ROOMS STORIES WALL ROOF COVERING COVERING CO UBE OF NEW BUILDING S 1 �( 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IB CORRECT FOUNDATION LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS �•�Rti3 AND STATE r.LA`ApLW/S�/REGULATING BUILDING CONSTRUCTION V FG/I /l�� / •. a(� FRAME FI,BOLTS t. SIGNATURE O BRACING,FI.SOLOS PERMITTEC LATH, INT AUTHORIZED ACT U LATH, EXT 1' 3 /,P 76� 9- De -a mN B[ lFrr=- p PLASTER.INT 3 OOO• E \PLASTER.EXT VALUATION FINAL DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PEHNIIT COUNTY OF LOS ANGELES BUILDING 1 1 ® � 1►B r WM J FOX, CHIEF ENa1NEER UJL. N G - FOR APPLICANT TOFII.i. INFOR OFFICE USE ONLY BUILDING ` DISTRICT NO PLAN CK NO �f PERMIT NO ADDRCBS --s- LOCALITY s LOCALITY RECEIVED BY DATE OF PL DATEISSUED NEAREST � ' ; O CROB6 BT -BUILDING ADDRa" 5 cpo n/o J u T .aJP OWNER MAIL LOCALITY •- `- ADDRESS 17-dNEAREST TEL CROSS ST 1 CITY NO FIRENO OF TYPH 6RO�I(_ ARCHECT OR V TEL ZONE PLANS IT �. ENGINEER NO BLDG ORD NO SETBACK LIN! ADDRESS APPROVED TEL. BY DATE CONTRACTOR NOUB6 APPROVED ' 9NE -1 BY DATE ADDR[SS HOUSE NUMBERING LEGAL DESCRIPTION` I LOT NO 3 BLOCK MAP NUMBER FIELD CHECK BY TRACT NO ASSIGNED BY DA TE- NO O eLDGe CORRECTIONS SIZE OF LOT NOW ON LOT USE OF V NO OF I v EXISTING BLDG FAYILI[[ i DEBCR13MON OF WORK I 6 h T NEW ALTFAATION I I ADDITION O REPAIR DEMOLITION NO OF O_ B Z6 / ROOMS STORIES Z EXT WALL ROOF // T' COVERING I COVERING mss•/� '� - � .F!' ro GTS_ US! STRUCTURE APPROVALS INSPECT SSIGNATURE DATE 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FOUNDATION LOCATION PLICATION AND STATE THAT THE INFORMATION GIVEN 18 FORMS, MATERIALS CORRECT 1 AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME FIR!STOP - HEREON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING BOLTS /( t '✓_ LAWS REGULATING BUILDING CONSTRUCTION FURNACE LOCATION. SIGNATURE OFEIK GAS VENT, DUCTS PERMI E�yy L, /-�� ,{/ ADDRESS 1"lA 7,3 0 A /J..��('IjJ L r LATH, INT LATH. EXT O' I'L AUTHORIZED AOT PLASTER, INT s✓FT �� 76A6 Of= 1046 IS 78a P C 4 (D Q F� PLASTER, EXT VALUATIONF66 S 'S CQ FINAL WORKERS COMPENSATION DECLARATION hereby affirm that I have r ceiCmp of tionconsent to Insurance APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers' Compensation Inauronce or a certified copy thereof (Sec 3800 Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company BUILDING Certified copy is hereby furnished FOR APPLICANT TO FILL IN ADDRESS Certified copy is filed with the county budding inspec- BUILDING hon department Iva LOCALITY NEAREST Dote Applicant CITY ZIP f Z SQ CROSS ST CERTIFICATE OF EXEMPTION FROM WORKERS' NO OF BLDGS ASSESSOR COMPENSATION INSURANCE' SIZE OF LOT _ fJOVI ON LO7 � MAP PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE IMAP hundred dollars ($100)or less ) TRACT BLOCKLOT NO NO TEL / SPECIAL �. I comfy that in the performance of the work for which this OWNER NO S CONDITIONS 0. permit is issued, I shall not employ any person in any manner Dj5TRjCT GROUP TYPE FIRE PROCESSED BY O so as to`becomme ssubjje��eccssst to the Workers'Compensation LLL ADDRESS CONST Z E U ,flr Date V�Il phcant '0& J CITY ZIP O STATISTICAL CATION 0 NOTICE TO APPLICANT If, after making'this Certificate of ARGMEER NO CLASS NO DWELL UNITS_ ser Exemption, you should become subject to the Workers jy Compensation provmorm of the Labor Code, you must forth- ADDRESS SEWER MAP/ N with comply with such provisions or this permit shall be Z deemed revoked CONTRACTOR NO SK PG VALIDATION LICENSED CONTRACTORS DECLARATION LIC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO VALUATLON (commencing with Section 7000)of Divman 3 of the Business and LIC Professions Code, and my license is in full force and effect CITY CLASS " SO FT NO OF NO OF CHECK License Number Lic Class SIZE STORIES / FAMILIES ONE , nactor Dote DESCRIPTION OF WORK NEW ❑ s trADD I am exempt under Sec J4J ALTER ❑ FINAL B 8P C for this reasonREPAIR ❑ DATE ./ L Dara a EXISTING ,PES/�e GGA DEMOI ❑ FINAL E%ISTING BLDG !//GG„�✓ ' Signature APPLICANT BY TEl T/ OWNER-BUILDER DECLARATION PRIM / NO 1 hereby offrm that I am exempt from the Contractorb License A 0 (� ,.j fd , Low for the following reason (Section 7031 5, Business and Pref ams Code) - a 3 1 2,3 A BUILDING i, as owner of the property or my employees with ADDRESS 1f� is • is • • 1 wages as their sole compensation,will do the work and - the structure is no,intended or offered for sole(Section LOCALITY _ 2 • 1 2 4 8 8 ` JW7044, Busmess and Professiorm Code) MOVING TEL u ` `^ 1 2 4 8 8 1, as owner of the property, am exclusively contracting CONTRACTOR NO - � - �• L ' with licensed contractors to construct the project (Sec- r tion 7044, Busmen and Professions Code) ADDRESS - - - ,0 624 -83_ ET BACK TOTAL SETBACK FROM EXIST S CONSTRUCTION LENDING AGENCY -SET BACK YARD HWY PROP LINE WIDTH pool r I hereby affirm that there is a conatnlchon lending agency far PRONT ' he performance of the work far which this permit is ensued P L iSec 3097, Civ C ) SIDE PL r Lender s Name , . t 6 Lender's Address P C Fee S Permit Fee r I certify that I have read this application and state that the nuance Fee S� above information u correct I agree to comply with all County Investigation Fee ” ordinances and State lows relating to building construction Tomf Fee and hereby authorize representatives of this County to enter t a uponthe ore-mentione/d property¢ for Inspection purposes W_1 3—®3 SEE REVQY FOR EXPLANATORY LANGUAGE c gnature of Applicant or Agent Dot - I ma