HomeMy Public PortalAbout5056 SULTANA AVE_Building__ APPLICATION FOR COUNTY OF LOS ANGELES
BUILDING PERMIT TY EN
DEPARTMENT OF COUNGINEER
BUILDING AND s TY DMSION
BUILDING
'i FOR APPLICANT TO FILL IN ADDRESS t�0
BUILDING ,`
ADDRESS OS SU IJ LOCALITY
CITY 0 ZIP NEAREST
CROSS ST
NO OF BLDGS ASSESSOR
SI E OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
_ I DISTRICT GROUP TYPE FIRE SED BY
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OWNEPQ & NO STATISTICAL CLASSIFICATION
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ADDRESS OS' SU L CLASS NO DWELL UNITS BK �PG
CITY ZIP U ZONE MAP
NO
ARCHITECT OR TEL _Z SPECIAL
ENGINEER NO CONDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑
COtNTRACTO OFTELLpZd 9 BL DG SETBACK FROM
LCV l FRONTPROP LINEOF (STREET)
ADDRESS U&-�Y`NOIHIGHWAY YARD
TOTAL SETBACK FROM TYPE OF EXISTING
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CIT /^ r - LIC FRONTPROP LINE HIGHWAY WIDTH
F 1' CLA55
CONSTRUCTION LENDER
NAME AND BRANCH BLDG SETBA ROM O
ADDRESS CITY SIDEPROP LINE (STREET) Cl
50 FT NO OF NO OF CHECK HIGHWAY } YARD = TOTAL SETBAC TYPE OF EXISTING C
SIZE / STORIES FAMILIES ONE SIDE PROP LINE HWAv WIDTH
DESCRIPTION OF WORK NEW ❑ } N
DD CORNER CUTOFF YES ❑ NO
ALTER
IN OPEN SPACE YES ❑ NO ❑
EPAIR
USESOF BLDG ENOL C:] IN COASTAL PERMIT ZONE n YES ❑ p'dNO ❑
APPLICANT TEL
(PRINT) NO
BY (SIGNATURE) '
X![[!Y THAT
THE
ACKNOWLEDGE THAT I HAVE READ GR 1P COMPLY /
AND !TAT[ THAT TNC SABOVEAND III WS RCT AND AGREE COMPLY
WITH ALL 01101 XANC[f AND LIN DOING THE W K AUTHOLDING CON-
HERESYIOM 1 CERT)IT THAT NPERTHE VIGIL AUTHORIZED THE
H[RLIIT WILL NOT STLOYAT ANY
CALIFORNIAPERSON
VIOLATION OF THE
1�
LABOR CODE M THE !TNTC OF CAPOMIIN RELATING TO
WORKMEN'S COMPENSATION INIIUfAMC! - 77
SIGNATURE OF FINAL / 2�i/ BY
LPEFRMITTEE DATE
TE PC Fee$ Permit FDS ZNOIssuance Fea
ION / ¢
Tots[Fee
PLAN CHECK VALIDATION CK .0 CASH PERMT VALIDATIO . M o CASH
61 :5 29 1 0 89.25m1
T[AGMA CBIfOfB 12178
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7dA63BA CE Jr 803 S-ezAPPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES aooR°ess O S6
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER _ NEAREST
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST
DISTRICT O G P TYPE D
FOR APPLICANT TO FILL. IN coNsr
BUILDING STATISTICAL KATION EWER MAP
ADDRESS BK
CLASS NO DWELL UNITS
LOT NO — BLOCK WATER
CERTIFICATE NOT REQUIRE RECEIVED
TRACT �j` � – MAP HIGHWAY
NO OF BLDGB NO O ICIRCL¢I STATE MAJOR SECOND LOCAL
SIZE OF LOT NOW ON LOT IF USE ZONE SPECIAL
USE / CONDITIONS
EXISTING BLDG tx
EL
OWNER / NO2 27-g337 BUILDING EXIST
SETBACK YARD HWY TREET NAME WIDTH
ADDRESS FRONT
ARCHITECT OR TEL P L
ENGINEER NO SIDE
P L / }
ADDRESS TEL
CONTRACTOR NO
ADDRESS ,A
DESCRIPTION OF WORK
N AD ALTER REPAIR DEMOLISH � N
SO NO OF, NO OF Z
SIZ &A F STORIES -FAMILIES ¢
USE OF v
–� , R
STRUCTURE er
SIGNATURE OF Y,• ✓ 1
APPLICANT !�
VALUATION $ 4
f o-O APPROVALB �/ ATE IN¢P[CTOF SSIOMATUR6I
PC PMT �–y7 FOUNDATION LOC TION 163
FEE $ FEE S FORMS MATERIALS
FRAME FIRE STOPS y
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRA('.ING BOLTS 1
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY Fl1RNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CON¢TRUCTION I CERTIFY THAT IN DOING THE WORN
AUTHORIZED HERESY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INTp
TION OR THE LABOR COOC OP THE STATE OF CALIFORNIA RELAY
INC TO WORKMEN S COMP WTI N INSURANC[ LATH EXT
' SIGNATURE OF HOUSE NUMBER COR
PERMITTEE _ _ RECT AND POSTED
' ADDRESS , S l0 4 FINAL
JOHN F LEWIS PR NCIP L 6TRUCTU RA EN
PLAN CHECK VALIDATION CK MO CASH _ PERM VALIDATION CK M O CApN
1
3347 APR 15 1 D 1150~