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Home My Public Portal About5414 SULTANA AVE_Building__ L = APPLICATION FOR BUILDING PERMIT Z COUNTY OF LOS ANGELES BUILDINo DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A LAMBIE,COUNTY ENGINEER NEA CAiBATT D GRIPFIN �LO1M0 rwlslsEtr DISTRICT NOORO TYPE PR EBBED Y FOR APPLICANT TO FILL 1N S I CONST BUILDINGSTATISTICAL CLASSIFICATION SEWER ADDRESS B �Pa LOT NO a0 711' BLOCK CLASS NO DWELL UNIT S en MAP A E yES NO NUMBER HWY TRACT USE ZONE SPECIAL NO OF BLDGS CONDITIONS SIZE OF LOT NOW ON LOT USE OF EXISTING BUILDING CK YARD HWY STREET NAME EXIST OWNER SETBACK FRONT MAIL P L _ ADDRESS 61DE TEL P L NO -� INSPECTION RECORD ARCH IT CTO TEL ENGINEER NO ADDRESS T / CONTRACTOR ,NEO I 7, 5V /� v fp R DESCRIPTION OF WORK EW ADD ALTER REPAIR DEMOLISH FT /, NO OF NO OF �7i /� T rAlF/i SIZE D STORIES FAMILIES USE OF STRIUCTURK i 6APPLIURE F / APPROVALS ND E/_'t�CT 9NEFs Ok!)L DATE INSPECTOR l SIGNATURE ADDRE88 FOUNDATION LOCATION Z FORMS MATERIALS E FIRESTOy�� cr s SAO -- FEH f FB�RACING BOLTS / / ,d ✓W VALUATFURNACE LOCATION FEE Al GAB VENT DUCTS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP_ LATH INT A PLICATION AND STATE�THAT THE ABOVE I8 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORD[ ANCES AND GTN OCT STATE LAWS REG IND BUILD[ STR ION 810NATURE 0 / HOUSE NUMBER COR- , PERM[ RECT AND POSTED wooRe FINAL CLYDEN Dl% PRINCIPALST LENo1NEER FPdH CEZ=VALMJMON CK. u o CASH VALWATION cu r o cAYB t 2 7 Jt2, 17 1 A 500 i(J�yL WORKERS COMPENSATION'DECLARATION APPLICATION FOR BUILDING PERMIT hereby affirm that 1 hove o certificate of Content to soli insure or a cen'ficote of Workers'Compenwnon Insurance or a certified copy thereof (Sec 3800 Lob'C ) ' t COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company Certified copy is hereby furnished FOR APPLICANT TO FILL IN BUILDING 6� ADDRESS Certified copy is filed with the county budding mspec BUILDING /l tion department ADDRESS 5-41& Dote Applicant CITY ZIP 9 LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS - NO OF BLDGS - NEAREST COMPENSATION INSURANCE , SIZE OF LOT NOW ON LOT ST (This section need not be completed if the permit is for one ASSESSOR hundred dollars ($100)or less ) TRACT BOCK LOT NO MAP BOO( PAGE PARCEL I MAP I certify that in the performance of the work for which this OWNER v USE ZONE NO I NO permit is Issued, I shall not employ any person in any mannersL�.7(f- SPEOAL so as to become subject to the War 'Compenwilon Laws ADDRESSCONDITIONS ,8 Dote Applicant CA(tC1nTECT ZIP TEL NOTICE�NT if, ohm making this Certificate of ENGINEER NO DISTRICT GROUP TYPE FIRE SY O Exemption, you should become subject to the Workers n CONST ZONE Compensation provisions of the Labor Code you must forth ADDRESS V g with comply with such provisions or this permit %hall be deemed revoked CONTRACTOR $p NO�� 6 -� STATISTICAL CLASSIFICATION CON to LICENSED CONTRACTORS DECLARATION , LK: CUSS NO DWELL UNITS_ Z I hereby affirm that I am licensed under Provisions of Choplar 9 ADDRESS ef NO b?32 (commencing with Section 7000)of Divaion 3 of the Busmess and _ - LIC SEWER MAP Professions Code, and my license is in full force and effect CITY _ y CLASS lf-� BK PG r VALIDATION i SO FT NO OF V NO OF CHECK License Number Lic Class----L_ SIZE STORIES FAMILIES ONE VALUATION Contractor Date DESCRIPTION OF WORK NEW 11 7; $ , I am exempt under Sec ADD ALTER B dP C for this reason REPALR $ Date USE OF EXISTING BLDG wiiWX Signature APPLICANT TEL FINAL OWNER-BUILDER DECLARATION PRINT NO DAT! 3 " 8 5 5 2 A I hereby affirm that I am exempt from the Contractor's License Low for the following reason (Section 7031 S Business and '�� iqf e e e e e Professions Coda) �' ' 1 • 3 i Q,6 I, owner of the property, or inBUILDING t employees with ADDRESS • e,e 3 a Q Q 0 wages as then salecompensation, ed f o the work and LOCALITY ' ) 2- 09-87 the structure is nottIntended or offered for sale(Section 70/1, Business and Professions Code)- MOVING - TEL I as owner of the property, am exclusively contracting CONTRACTOR NO with licensed contractors to construct the project (Sec- ADDRESS - - tion 7011 Business and Professions Code) L SETBACK F� cAlZij CONSTRUCTION LENDING AGENCY BACK YARD HWYID PROP LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is tuned P L - - (Sec 3047, C,v C ) SIDE PL Lender s Name 1DA Ref Lender s Address "C Fee S Permit fee 'o M ' I certify that I have read this application and state that the luuance Fee LDMA P/C E c above information is correct I agree to comply with all County Imedigonon Fee r �� $ ordinances and State jaws relating to building construction Total Fw 1DMA Perm IF - R and hereby authorize representatives of this County to enter uPon t e above-�tioned property for inspection purposes , m !EE fEVEM FOR EX/IANATOfY LANGUAGE Signature of Applicom or Agent - l-