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Home My Public Portal About5516-5518-5520-5522 SULTANA AVE_Building__ CE NBD*"(REV I I�7 J APPLICATIO OR BU IN PERMIT - COUNTY OF LOS ANGELES BUILDING _ fid_ a FORPLIgAWT T.Q FILL I BUILDING ADDRESS BUILDING LOCALITY _ v G� TV �� NEAREST CITY ZIP CROSS 51 NO OF BLDG5 ASSESSOR SIZE OF LOT NOW ON LOT `q MAP BOOK S PAGE PARCEL - r,r y- DISTRICT GROUP i PEI FIR P DBV TRA BLOCK LOT NO CO ST TEL / O � {� L� OWNER NO ;T ? ff2 - STATISTICALC FI 10 SEWER7P ADDRESS 4 CLASS NO DWELL UNIT BK f PG G �j aTR Pd ARCHI O T TEL VALUATION $ / ENGINEER - ' NO - , ADDRESS / BLDG SETBACK FROM FRONT PROP LINE OF (STREET) CONTRACTOR O P TOTAL SETBACK FROM TVPEOF EXISTING LIC HIGHWAY + YARD FRONT PROP LINE Kl�*AYJ WIDTH ADDRE11 LIC � + CITY CONSTRUCTION LENDE ♦ BLDG SETBACK FROM SIDE PROP LINE OF (STREET( NAME AND BRANCH _ _ HIGHWAY + YARD TOTAL SETBACKFILM TYPE pF EXISTING ADDRESS CITY SIDE PROP LINE HIGHWAY WIDTH I SO FT NO OF NO OF CHECK - -- + SIZE STORIES I FAMILIES ONE USE Z MAP DESCRIPTION OF WORK r NEW - NO - - ) SPECIAL W w ADD �- - CONDITIONS ALTER FINAL /� �L/ BY `— REPAIR DATE USEOF DEM_OL )" _ EXISTING BLDG /j _ /�-� __ • APPLICANT TEL (, W/QJ 9 � 1 59 3 A I klk By SIGNATURE) 7�� l 3 2---- 60 0 0 HEREBY ACKNOWLEDGE THAI I READ THIS A GTION AND STATE �, I / • RYA THAT THE ABOVE IS CORRECT AND AG E TO COMPLY WITH ALL ORDINANCE _ FL . . . 6 00 0 5 AND LAWS REGULATING BINIDING CONSTRUCTION CERTIFY IN DOING THE , I WORK AUTHORIZED HEREBY WNOT EMPLOY ANY PERIN SON IN VIOLATION OF Q O 0 7_ QV O THELABOR CODE OF THEStniE OFF GLIFORNIA IN RELATING TO WORKMEN SCOM U PENSATION INSURANCE SIGNATURE OF PERMITTEE ADDRESS _' 21 5 9 4 A ' TEL - F # . . . . . 1 CITY N '7 qQ 2 • 991 00 - - PC Fee b � 7 6-0 Permit Fee l/ > . . 9 9 1 0 0' - eg Issuance Fee '— T.,.I Fee _ - I WORKERS COMPENSATION DECLARATION insure, aivert that I have a certificate of consent to self - -APPL-ICATIO F �IL G PER ' T msure,or d�ertihcate of Workers'Compenoion Insurance, if 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 G ADDRESS Certified copy is filed with the countyibuildmg mspec- BUILDING _ / (- tion department ` ADDRESS LOCALITY p�� NEAREST Date�_Applicant CITY ZIP p V CROSS ST CERTIFICATE OF EXEMPTION FROM WORKERS NO OF BLDGS ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT -� MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE O hundred dollars ($100)or less ) TRA R OCK LOT NO - Y TEL SPECIAL M1 OWNER I certify that in the performance of the work for which this NO — - CONDITIONS O permit is issued I shall not employ any parson in any manner DISTRICT GROUP TYPE FIRE D BY V so as to become subject to the Workers Compensation Laws ADDRESS - CONST CITY 1 ZIP Date App I ma nt AAISTATISTICAL CLASSIF CAT - - APT CONDO NOTICE TO APPLICANT If after making this Certificate of RCHN�R Y NO _ - uE Exemption you should become subject to the Workers ENG / \ CLASS NO DWELL UNITS_ N Compensation provisions of the Labor Code you must forth- ADDRESS,// 6 145 s SEWER MAP Z with comply with such provisions or this permit shall be deemed revoked CONTR NO 0 BK PG VALIDATION LICENSED CONTRACTORS DECLARATION uIC I hereby affirm that I am licensed under provisions of Chopter 9 __ ADDRESS NO VALUATION (commencing with Section 700D)of Division 3 of the Business and ILIC D ay-1 I Profession Code and my license is in full force and effect C CLASS - $ 50 FT NO OF NO OF CHECK License Number. 1Jy� Lic Class�- SIZE STORIES FAMILIES ONE i Contractor U"L /� L S S e l- �.te��7�� DESCRIPTION OF WORK - NEW E om exempt from the licensing requirements as I am a - ADD [ bcensed architect or o registered professional engineer _ _ _ _ ALTER - FINAL //ll acting in my professional capacity (Section 7051 DATE�-(,p'"$ / Business and Professions Code) USE OF REPAIR r EXISTING BLDG �- DEMOL FINAL Iv/ Lia or Reg No Date APPLICANT - TEL fly 4 OWNER BUILDER DECLARATION PRINT NO 1 5 9 5 A I hereby off irm that I am exempt from the Contractor s License Law for the following reason (Section 7031 5 Business and ADDRESS 11 r-, # • • • • 23 Professions Code) OBUILDING _ _- - - _ - 2 - - 7920 , I as owner of the property or my employees with ADDRESS wages as their sole compensation will do the work and • • • 7 9 2 0 3 the structure is not intended or offered for sale(Section LOCALITY 7044 Business and Professions Code) MOVING TEL # �+ 07-80 ® I as owner of the property am exclusively contracting CONTRACTOR _ _ NO I1 with licensed contractors to construct the project (Sac ADDRESS tion 7044 Business and Professions Code) - --- - -� - REOUI TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SET U'P YARD HWY PROP LINE WIDTH I hereby offvm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P L -9 1 5 9 6 A r (Sec 3097 Civ C ) EIDE - _ - - - '- _ # • • i • • 1 1 / PL Lender s Name ,2 1 0600 $ P C Fee S '� Permn Fee r _ Lender s Address l:&� > I certify that I have re6J this application an state that the Issuance Fee e, • • 1 0 6 0 0 above information is correct I agree to comply with all County esiponan Fee O A 0 7—8 p ordinances and State laws relating to building constructionI /b and hereby authorize representatives of this County to enter Total Fe V upon th ov mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Aboton,or Agent Date 0s