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Home My Public Portal About5057 SULTANA AVE_Building__ APPLICATION FOR BUILDINGJPERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER S COMPENSATION DECLARATION ✓ FOR APPLICANT TO FILL IN BDIInING ss 1 hereby affirm that I have a certrfcate of consent to self Insure BULLDNG ADORE9.R v ��+ or a oerhtcate of Workers Compensation Inaurari or a certified copy thereof (Sec 3800 Lab C I Cm ZlP , policy No Company q 1l O LOCALRV SIZE PF LO t NO OF BLWS NOW ON LOT ❑ Certified copy a hereby fumehetl 1 X 180 a 1�2(j0 S,F NEAREST CROSS ❑ Certdied copy a filed with the county Wilding Inspection TRAQT �� BLOCK . LOT NOw 1 department _ , T USE ZONE MAP N0 tm Data ApplicantSSOR MPP BOOK PAGE FARCEV r - 5b1 12-13 TEL ISPECIAL CONDMONS Glil7� D/ CERTIFICATE OF EXEMPTION FROM WORKERS' R A JLLlta#% HL14 81 -7-0 VZ?3 WITHIN 1000 FT OF SCHOOL VES NO COMPENSATION INSURANCE ADDRESS DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED By (Tlsec need not W completed If the permit a for one hundred 5o5-1 SLL1}aKA Avt�u-Q.. dollars ($1010 0)a less) i LP I certify that'n the performance of the work for which this permit Is Issued 1 ansa not employ arty person in any manner se, as to ARCHTT� ENGI�R 1 No O become subject to the Workers Campereation Laws STATISTICAL CLASSIFICATION PPi CONDO Date Applicant ADDRESS _ CLASS NO C;2,/— DWELL UNITS NOTICE 70 APPLCANT 0 after making the Certificate of REGUIRED TOTAL SETBACK FROM EXIST Exemptori you should become subject to the WorkersTEL NO SET BACK YARD HWY PROP LINE WIDTH OON` vi Compensation Provisions of the Labor Code you must forthwith n comply with such provisos ADDRESS LIC NO PILor the permit shall be deemed revoked FRONT L LICENSED CONTRACTORS DECLARATION _ _ SIDE CITY LIC CUSS PL I hereby affirm that I am licensed underproveera of Chapter 9 SEWER MPP (commencing with Sechon 7000)of Dive,ori 3 of IW(Business andSO NO OF STORIES NO OF FAA9JES Profsss Code and my license Is In full force and affect NEW ❑ BK PG polo. }d License Number Lc Class DESCRIPTION RK ADD VALUVALUATIONION Contractor Date ALTER ❑ $ 4t O ❑ 1 am exempt under Sec REPAIR ❑ QF¢J ISAPC for this reason DEMOL ❑ LOMA P/C �J,J Date USE QF EXISTING Bl.pfi 1 r. URM ❑ — a ,S - 1^ CLIA , �Sgnature ` ?�'T z Pleas owner of the property a my,emPloYees with wages as, W&ARRomrj+' J J 1 Z8 -8LL3 LOMA Perm♦ 1 I ,'Ar tll .T Z their seta compereatKm will do the work and the structure Is AnoRESS /' nn p.3 net intended or offered for Bale (Section 7044 Baness and ' SV K. CA -II FINAL OATS Q Professions Code) WILL THE APTi,nxT OR RnuRS rAAl.PuvG UFYNL NAroIE A NAz.wpous MATERIA ' ❑ I as Owner of the property am exclusively contracting with oR A wxTLaE QONFIN 1G A iuvTmous AUTERUL EQUAL TO OR a TER THAN TUE - 1 licensed COTII(aCS0r9 f0 C0r1911UC[ the AAIXMTa BPECIFIEP TRE HAZARDOUS MAERMLS N ORWiTICN GUIDE? FINAL BY project (Section 7044 yE5❑ ra i T Business and Professions Code) - C -r YPLL THE VrTFN USE OF THE eUDLNG BY TIE ASTI[/JTI OR FUnRE BUIPflG t , �JTJJ `-�=. OCCURIHT REQUIRE A PERM(T FOR GpJSTRUGrKxi OR M006x:AtlN FROM TIE SCUM-1 CONSTRUCTION LENDING AGENCY GCOAST uo EsouwTv Mw.oEAENr wsrwcT tsTwa"'°i SEE PERMrTTwa aEcxusr FOR r- 1 l I hereby affirm that there is a construction lending agency for Yes Np� , `I A the performance of the work for which the permit a Issued(Sec i C Imo', f ITOTAL 8:3 �. 2-3 m 3097 Civ C) a GKUMT RIALsTIERoniRwAwry AN3 PMY Emaaar±uu+p AS UNmDEirR FiHTiouUYnSE SGCY CODE Tu n 7 .] Lerder s Name Lenders Address CHANGE '00 o aA.eR w.ccm I certify that I have read the application and state under penalty g of perjury that the above Information is correct I agree to Comply PC FEE PERMTT FEE $ with all county q�rces and State laws relating to W Ing S0, constudim a represematnes he my ISSUANCE FEE ,` io ter red property to ire (O 7 7fr3'7 1 Ah111 41 a INVESTIGATION FEE TOTAL_FEE SEE REVERSE FOR EXPLANATORY LANGUAGE \� WORKERS COMPENSATION DECLARATION '• msu eb.r a`am ,tion I hove r certificate Compensation a, consent to self --- -- - - APPLICATION FOR —BUILDING- PERMIT— - cR imure ore certificate a Workers Compensation Insurance or a certified copy thereof (Sec 3800 Lab C ) "' 'I - � - d t� COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No �,Company n - - El Certified copy is hereby furnished „ FOR APPLICANT TO ILLIIN =amu Certified copy is filed with the county budding mspec - BUILDING -p''/ - - '+tion department ' ADDRESS Dore 7_ �' AppLconr' 1 �1v-, CITY zip h ' LOCALITY - CERTIFICATE OF EXEMPTION FROM WORIFER5 - — -NO OF BLDGS-- - NEAREST.. COMPENSATION INSURANCE SIZE OF LOT NOW ON l07 ST - I (TMs section need not be completed if the permit is for one — - --_ J__ ASSESSOR - - hundred dollars ($100)or less ) TRACT BLOCK LOT NO MAP BOOK " _ " PAGE PAROL v TEL q p VSE ZONE I certify that in the performance of the work for which this OWNER L. q O 2"46 NO y I •� SPECIAL d so as t a issued, I shall not employ any person m any manner ADDRESS CONDITIONS - - -- - - V so as to become subject to the Worker Compen tion Laws - i �s ��i (s�C t, f , Date�Apphcant III CRY - ZIP _ __ - _ _ _ _ - _ _ W OR NOTICE TO APPLICANT If, affer making this Certificate of AN INETER NTEDISTRICT GROUP TYPE _ _ FIRE D BY_ F� ' Exemption your should become subject to the IWarkers "- BY— CONST I ZONE ;U Compensetioroprovisions of the Labor Cade you must forth ADDRESS 5 s V a K EEELLL with comply with such provisions or this permit shall be ,,•• `- 'L - deemed revoked • , - CONTRACTOR N L(i X NO S/O/ S STATISTICAL CLASSIFICATION i APT NDO LICENSED CONTRACTORS DECLARATION. _ _ LIC_ . CLASS NO 7-1 DWELL1 UNITS— _ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS h].tO (commencing with Section 7000)of Division 3 of the BusinessandLIO - _ _ SEWER MAP _ Professions Code, and my license is in full force and effect CITY _ _ _ -CLASS LL - - - VALmATiONBK - vT __ 5o FT NO OF PGI 0) License Nurnfxr. 2 ` Lic Closs SIZE - STORIES FAMILLIIEC S ONE 1 �1J f VALUATION ` Conti" &&_(A f� BCp� ' DESCRIPTION OF WORK x�1 NEN' : /aDJ'1/7 Od I am exempt under Sec r R ADD - _ ALTER B&P C for this rection t "F F REPAIR f -- ' - USE OF Dat EXISTING BLDG DEMOL i Signature - APPLICANT flL�q� ---- 3 9 8 7 A l OWNER- UIL ER DECLARATIO ---,__ _J I hereby off ern that I am exempt from the Contractor s License tis - U # e • • e~e A� Low for the following reason (Section 7031 5 Business and ADDRESS FIN • �' Professions Code) By - C- 124.88 i ❑ BUILDING 1 I, as owner of the property, or my employees with _ ADDRESS _i 2&88Q 88 V wagesas their sale compensation, - ' " - - - -' , "- ded or on,will f o the work and LOCALITY the structure is not intended or offered for safe(Section ' '0205-86 - -- 7004 Business and Professions Code) - � MOVING - -- - TEL- - - -- - - - I - 1 as owner of the property am exclusively contracting =RA NO a with licensed contractors to construct the project (Sec - ADDRESS c - hon 7044 Business and Professions Code) _- M_ CONSTRUCTION LENDING AGENCY B WIDTH u g7 ACK YARD -HWY TO AL PLINE ` Y I I hereby affirm that there o construction lending agency for FRONT the performance of the work for which this permit is issued P L - - - - _ _ „ ,I T / (Sec 3097 Civ C ) SIDE _ PL Lender s Nome _ LDMA Rel Y i Lender's Address - PC F.$ - - - Permit Fee certify that I have read this application and state that the - Issuance Fee - - - - r dove information is correct I agree to comply with all County Investigation Fee irwnces and State lawn relating to building construction, _ _ _ _ Total Fee- -s 0 0 - LDMA Perm 9 hereby authorize representatives of this County to enter thea e-mentioned perty for mapecti n rppses l fH REVERSE FOR EXPLANATORY LANGUAGE ( A nature of Apph Agent+ - - bate L • ' ' _— COUNTY OF LOS ANGELES TEMPLE CITY BUILDING PERMIT DEP TMENT OF PUBLIC WORKS 9071 LAS TUNAS RESIDENTIAL ADD BUILDING AND-SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 980618)004 • J PHONE' (818) 285-0488 EXT1 LEGAL TO NO. LDING ADDRESS ON FILE SD FT STORIES TYPE OCCUP GF5057 SULTANA AV STRUCTURE 0 1 VN R3 TEMP CA 917803046 ASSESSOR INFORMATION NUMBER GARAGE 504 1 NEAREST CROSS STREET: PENTLAND 5388-020-016 OTHER THOMAS PAGE 596 GRID H5 LOCALITY TEMPLE CITY TENANT EXIST BLDG mt- USE ZONE ISSUED ON PROCESSED BY EXPIRES ON EXIST OCC GRP 06/18/98 UT 06/18/99 OWNER TEL NO BLDGS NOW ON LOT VALUATIC31: FINAL DATE CODE- HW KENNY,JULIAN A (626) 287-8227- 2 13,000 5057 SULTANA AVE TEMP 91780 FEES PAID DESCRIPTION OF WORK NEW RESIDENTIAL GARAGE-211X 24, APPLICANT FEE DESCRIPTION QUANTITY DOM AMOUNT SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27 75 AC STRONG MOTION-RESID— 13000 00 VAL 1 30 SPECIAL CONDITIONS- AX BUILDING,REVIEW-FEE=!::�--�--�, 54 70 D2 PERM I T.W/O=EN-HCjE LES 13000'OO,VAL 268 65 U' TOTAL/FEES 352 40 CONTRACTOR TEL NO SAME AS OWNER _ /\,OBJ SVAPPROVALS DATE PECTW SIGNATURE T\ LIC NO / LOCATION AND ARCHITECT OR EN INEER TEL NO 3 SLAB/UNDER FLOOR LIC N0NO OF FAMILIES DWELLING UNITS APT/COND: STAT CLASS 1111117 RAISED FLOOR FUME— 3 1 ILE) IST LEVEL FLOUR SHEATH No zt \ 1 0 O ----9LwoaF9rrffw HAZARDOUS AIR QUALITY 1000 FEET MATERIALS O � � �PpROOF SHEATHING �' " NO NO NO A �i� '9rnff-m" FRAME INSPECT SET BACK YARD HWY PROP LINE WIDTH `REQUIRED TUIAL btitsACK FROM EXIST6/rC �O`� FRONT PL- Service ThatSHEAR PANELS 14 SIDE PL- r, INSULATION/WEATHER STM INTERIOR LATH/DRYWALF— SMOKE DETECTION DEVInr FIRE DEPARTMENT APPR5 W REPORT ID DPR261 ROUTE TO BS0508