HomeMy Public PortalAbout5628 SULTANA AVE_Building__ L/� TEMPLE-CITY
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\1 APPLICATION FOR BUILDING PERMIT
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COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER woDR-s
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE. COUNTY ENGINEER NEAREST
A JENSEN OF T OF BUILDING CROSS,ST
DIST IC N GROUPT.PE PR ES BV
FOR APPLICANT TO FILL IN �' CONST
BUILDING STATISTIC CLA981PIGTION SEWERMAP
ADDREBB B PG
CLA88 NOW-LL UNITS J
LOT NO1 LOCK WATER NOT REQUIRED RECEIVED
1 CERTIFICATE
TRACT MAP q HIGHWAY STATE MAJOR SECOND LOCAL
O O B DGS NO OO ICIRCLE)
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OF CONDITIONS
EXISTING BLDG 1
TNEO
B ILDOWNER ING YARD STREET NAME EXIST
�/ ETSACK WIDTH
ADDRESStj
RONT
ARCHITECT"O TEL P L
ENGINEER NO SIDE
P N
ADDRESS
EL INSPECTION RECORD 0
CONTRACTOR NO
ADORERS _ w
DESCRIPTION OF WOHS / �� 7� �J �L vIG� O
SO FT ADD ALTER NO OF REPAIR NO OF / JT/Of) / (�(r/JJ ?
IZE STORIES FAMILI
USE OF
STRUCTUR!
SIGNATURE OF / 1 v
APPLICANT.
VALUATION S 0
41, `9F •��T�`
—APPROVALS kA+El INSPECTOR H SIGNATURE
FOUNDATION LOOT ION /J
FEE F!E
FORMS MATERIALS / ) /�%
�— FRAME FIR-STOPS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY FURNACE LOCATION /
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION I CENTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL HOT EMPLOY ANY PERSON IN VIOLA LATH INT �J
TION OF
THE 1AS01 OE OP THE STATE OF CALIFORNIA RELAY /
INC TO WOIIKMEN 8 CO FENBATION INSUR NC[ LATH
EXT
SIGNATURE OF HOUSE NUMBER COR. a
PERMITTE NTCT AND POSTED
ADDREBB FINAL
CLYDE N DIRLJAM PRINOIPAL STRUqMURAL ENGINEER
PLAN CH= VALIDATION « w D PERNIIT VALIDATION ISO CABX
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.. TEMPLE CITY 1
APPLICATION FOR BUILDING PERMIT``
COUNTY OF LOS ANGELES ASUDR!U
DEPARTMENT OF COUNTY ENG94M ADOR
BUILDING AND SAFETY DIVISION IACAL
JOHN A LAMBIE, COUNTY ENaINHER NEAREST
WI AJENSEN. SUPTILOINa CR089 ST
DIST N GR U TYPE P
fi APPLICANT TO FILL IN CONST
BUILDING STA TI STICAL CLASSIFICATION SEWER MAP
ADDRESS ) K Po
69 NO VV
UNR
LOT NO ATERt NOT REQUIRED RECEIVED
CERTIFICATE
TRACTMAP HIOHwAr
NO OF B DGS O NO OO ICIRCEI STATE MAJOR SECOND LOCAL
L
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL t
USE OF ! CONDITIONS
EXISTING BLDG
TEL
OWNER / NO BUI ING YARD HWY EET NAME EXIST 1
SETBACK WIDTH
ADDRESS FRONT-
ENGH'TER ORC. G NE P L
SIDE /
ADDRESS }
INSPECTION RECORD J a
C NTRACTOR T, O
� � V
ADDRESSfir C
DESCRIPTION-OF, WORK 6 r`r reg r " t ',E 4 c O
ADD ALTER REPAIR DEMOLISHWTN
SO FT?75NO OF NO OF �-� '� �O/" � Z
SIZE STORIES FAMILIES
USE O _
STRUCTURE t '
o-
O eorAr�x� cry ,- 7 �7 �K
SIGNATURE OR L ' .l.e� +� —fJ tit--'f c L
APPLICANT 7 O
VALUATION
I•APPROVALS DATEIX9P - ISNATURE
P CPMT FOUNDATION LOCATION I
FEE 'FEE FORMS MATERIALS / .✓'�
FRAME FIRESTOPS
IHERESY ACKNOWLWQC THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ASOV¢ IY CORRECT AND AGREE To COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
0UILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HGESY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR E OF TIO STATE OP CA IfOSN IA R¢LAT
ING TO woRKM¢M a OA PE OF THE RAN 1 Y� , 1/`'
_ LATH EXT l
SIGNATURE OF HOUSE NUMBER COR-
.1 RECT AND POSTED { -
ADDRESS d ' FINAL L. 1
N1, CLYDE N DIRLJIM PRINCIPAL STRU URAL ENGINEER
PLAN CH= VALIDATION, CK. mo PMM VALIDATION No CASH
l 2249
r
�s'1 s —T 31 _ L 1 73
WORKERS COMPENSATION DECLARATION
hereby affirm that I have o certifcertificate of consent to self APPLICATION FOR- BUILDING PERMIT
insure, a c
a emCo
flcote of Workers Compensohon Insurance, ,
or a cenihed copy thereof (Sec 3800, Lob ME) COUNTY OF LOS ANGELES . _ BUILDING AND SAFETY
Policy No l71� -ompany S/A/E- 1 /
❑ Certified copy Is hereby furnished - FOR APPLICANT TO FILL IN ADDRESS �(p •- 9 SV�( �Q-
flL
Certified ropy Is filed wdh the county building InffMC- BUILDING = - - i -
tion de rtment j°DO
Date�� ��Appllca CITV ZIP LOCAUTV_-
CE FI TE OF ExEMPTION FROM WORKERS' SIZE OF LO - NOW ON LOT NEAREST
COMPENSATION INSURANCECROSS ST
ASSESSOR
(This section need not be completed if the permit is for one TRACT a_L0CK___1 LOT NO MAP BOOK 1 - PAIS PARCEL
hundred dollop ($100)or less ) - NO USE ZONE MAP TEL
I comfy that m the performance of the work for which this OWNER B7�--- _
SPEC
permit is issued, I shall not employ any person in any manner ADDRESS / Q / Q 3' CONDDITIONS d
so as to become subject to the Workers Compensation Laws / O
CITY ZIP *40 - U
Date Apphcan ARCHITECT ✓TELW
NOTICE TO APPLICANT If, after making this Certificate of ENGINEER NO DISTRICTRWP Tr T FIRE BV O
Exemption you should become subject to the Workers' ' � � -
Compensation provisions of the Labor Code, you must forth- ADDRESS
N
with comply with such provisions or this permit shall be
deemed revoked CanA - / STATISTICAL CLASSIFICATION APT CONDO Z
deemed revoked CONTRA u � p CLASS NO 2// ALL UNITS_
LICENSED CONTRACTORS DECLARATION LICADDRESS Ov -�
I hereby affirm that I am licensed under prowsioro of Chapter 9 LIC SEWER MAP
(commencing with Section 7000)of Division 3 of the Business CITU _
and Professions Code and my license is to full face and effect VALIDATION
y� SO FT NO OF # _
License Number 2W 70( Lic ClassG-37 SIZE STORIES FAMILIES ONE
T[,,LC - _ � 'El
VALUATION
Cgnhar� ✓ Ir V Date_��/ �1 DESCRIPTION OF WORK
Elam exempt under Sec as�1 ADO ❑
ALTER ❑ - pop
B&P C for this reason $
REPAIR
nateUSE OF
IXISTING BLDG OEAAOL El
Signature APPL]CANTTEL FINAL
OWNER-BUILDER DECLARATION (PRINT) s DATE
I hereby aff rm that I am exempt from the Contractor s License �d
Law for the following reasonin
(Section 7031 5, Business and ADDRESS //T� 'YV i7 6 pl 1
Professions Code) - _ _ PRESENT
13I, as owner of the property, or, my employees with BAmDIN
wages as their sole compensation,will do the work and LOCALITY
the structure is not intended or offered for sale(Section -
❑ 7044 Business and Professions Code) MOVING TEL _
1 as owner of the property, am exclusively contracting CONTRACTOR NO r 1 1TEh
with licensed contractors to construct the project (Sec- ADDRESS ICIIAL 143 . 63
tion 7044, Business and Professions Code ) Ol
CONSTRUCTION LENDING AGENCY RET REQUBIPRED- YARD MSV1' TOTALFROM IX - :HEi f 147.67
E WIDTH
I hereby affirm that there is a construction lending agency for FRONT L l4FiMIlE .)]I]
the performance of the work for which this permit is issued P L -
(Sec 3097 Civ C ) SIDE
PL _
Lenders Name
_ .- LDMA Ref N
P C Feet Perms Fee , �I]7E 1 kM 11:1]yJ
{ Lenders Address .
O I certify that I have read this application and state that the Issuance F , fj—v LDMA.P/C N
above Information is correct I agree to comply with all County Investigation Fee � �j
ordinances and State jaws relating to building construction, Total Fee . LDMA Perm N
< and ris y authorize r presentanvn of this County to enter
PYt u e above- ntl ed perry fa inspectloip
pun s
L Sit REVERSE FOR IDMANATORY LANGUAGE '
Signature o Appllcont or Agent e
• COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC FORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 SL 0508 1203300028
PHONE (626) 285-0488 ERT
(LEGAL ID NO OF CONST BUILDING ADDRESS
ON FILE SQ FT STORIES TYPE 5628 SULTANA AV
STRUCTURE 5200 V-B TEMP CA 917BO2331
(ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET
15387-025-022 THOMAS PAGE 596 GRID 143 LOCALITY TEMPLE CITY CAI
I I
(TENANT EXIST BLDG USE RESID USE TONE R-3 TISSUED ON PROCESSED BY I
EXIST OCC GRP 103/30/12 SR
IOWNBR TEL 0- iBIOGS NOW ON TOT VALUATION 11 PINAL BY CODE
VAUGHN PATRICIA E TRUSTEE (619) 340-5171- 1 14 800 /IA/Y^/
III CAMISA LN 1
FEES PAID ]DESCRIPTION OF FORK
] ITEAR OFF AND REROOF WITH COMPOSITION 30 YEAR SHINGLES
] (FEE DESCRIPTION QUANTITY DOM AMOUNT I
1APPLICANT TEL NO I
IPOWELL, GARLAN (310) 909-3292- AA BLDG PERMIT ISSUANCE 27 80 1 - 1
13748 MILITARY AVE AB STATE GREEN BLDG FEE 14800 00 VAL 1 00 ISPECIAL CONDITIONS ]
ILOS ANGELES CA 90034 AC STRONG MOTION RESID 14800 00 VAL 1 50 ] ]
D2 PERMIT W/O EN-HC 14800 00 VAL 300 60 ]
I 'TOTAL FEES 330 90 ]
(CONTRACTOR TEL NO (APPROVALS DATE INSPECTOR SIGNATURE
]EDGE ROOFING (310) 909-3292-
13748 MILITARY AVENUE LIC NO VOCATION AND SETBACKS
1LO9 ANGELES CA 90034 (OMI B/L
ISOILS ENGINEER APPROVAL ] I
ARCHITECT OR ENGINEER TEL NO I (FOUNDATION/TRENCH FORMS I I
LIC NO ] SLAB/UNDER FLOOR I
I -
IRAISLD FLOOR FRAMING
MAP NO SEWER MAP BOOR PAGE FIAE ZONE CHIP 1 (UNDERFLOOR INSOi,ATION I I I
147H265 3 001 I I I
I IFLDOR SHEATHING
1NO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS ] ]
0 NO 22 I (ROOF SHEATHING
SCHOOL WITHIN HAZARDOUS SHEAR PANELS
AIR QUALITY 1000 FEET MATERIALS
NO NO NO IFRAME INSPECTION
I
1 (FIRE SPRINKLER HANGERS I
INSULATION/WEATHER STRIP
I I I
INTERIOR i.A1'FI/WtYfALL ]
(EXTERIOR LATH
] _ (RATED FLOOR/CEIL ASSEM
I
RATED WALL ASSEMBLIES I I
I
I RATED SHAFTS/OPENINGS I
IT-BAR CEILINGS
ADDITIONAL DATA ON FILE
ILOT DRAINAGE I
(REPORT ID DPR261 ROUTE TO BS0508
I I I i I