HomeMy Public PortalAbout5629 1/2 SULTANA AVE_Building__ ��. fFT.3134 5-(v� %v
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR P
COUNTY OF LOS ANGELES - ` 1 A 1
WM J FOX, ClIIIEP�ENGINEER k 3 :Zc� U./
1 FOR APPLICANT TO FRS IN FOR FFICE USE ONLY
DISTRICT NO P CK NO PERMIT NO
InADDRESS .7 d �• `
CA EM RECE V AP BY DAT PDATE ISSUED
NEAREST ` • 7'
CR0868TB
11 UILD(
OWNER 1 ; p0 ADDRESS
MAIL ' IV A LOCALITY 7-1
ADDREp (� py
ITEL J _Oo/2 CROBer L,'I-- ✓N
CITY NO FIRE NO OF TYP O
ARCHITECT ORTEL. ZONE PLANS Z4 Ip
ENGINEER NO IT• BLDG /
• •t SETBACKLINE
ADDRESS 1, APPROVED
VTEL BY 'L- DATE
CONTRACTOR ♦ fi) NO ZOE �,NBYP i DATE)
ADDRESS ) ,/ Ve HOUSE NUMBERING
LEGAL
DESCRIPTION LOT PO BLOCK• MAP NUMBew 0 •IHLD CHECK BY
TRACT S,AIA.,y View R 14 NO ASSIGNED BY OAT
y NO OF BLDG$ q CORRECTIONS
SIZE OF LOT O Z'/� NOW ON LOT L •/ ([.C(�I / TN
UBE OFNO OF
EXISTING BLDG, eev. IFAYulfl
DESCRIPTION OF WORK
NEW ALTERATION I ( ADDITION I _
O
REPAIR DEMOLITION - -A
80 FT NO OF _ 0
81263 ROOMS STORIES
COVER NO WALL J !uOV SR
C(io CI N6 C
dI� T'
USE OF 8TRUCTUR
e G
APPBOV
INSPECT 6SIGNATURE DATE
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS Al' FOUNDATION LOCATION
PLICATION AND STATE THAT THE INFORMATION GIVEN IB FORMS. MATERIALS f�
CORRECT
1 AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME PIRESTOP0. /
HOtEON AND WITH COUNTY O INANCE8 AND STATE BRACING, BOLTS
LAWS REGULATIN UIL 1 COfTUCT10
�(•! FURNACE LOCATION, 1
SIGNATUR601 GAN VENT. DUCTS � i1
PERMITT 1 •�
wDortm If LATH. INT �•
LATH, EXT
AUTHORIZED AOT •
PLASTER, IM
aM DW IOW
69400
4000 P • / /L
FEEE PLASTER. EXT
VALUATION V S1.�� FINAL /
FEE 4.•vlLG- / CO` ,
� Y
WORKERS COMPENSATION DECLARATION 1
hereby affirm that I have a certificate of consent to self APPLICATION FOR BUILDING PERMIT -
insure or a certificate of Workers Compensation Insurance
or a certified copy thereof (Sec 3800 Lab C )
COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No Company '
Certified copy is hereby furnished FOR APPLICANT TO FILL IN BUILDING
AGGRESS
Certified copy is filed with the county building inspec
nBUILDING S
on department ADDRESS
Date Applicant CITY ZIP I O LOCALITY
CERTIFICATE OF EXEMPTION FROM WORKERS 40 OF BLDGS NEAREST
COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT ROSS ST &LAP V16
(This section need not be completed if the permit is for one ASSESSOR
hundred dollars ($100)or leu ) s TRACT BLOIX LOT NO MAP BOOK PAGE PARCEL
OWNER WSs TNp�L USE ZONE
I certify that in the performance of the work for which this NO }
permit is issued I shall nor t
ploy any person in any manner / SPECIAL p„t
so o beco bled ro y(orkers Compensation L ws A � ` - COs Sc` p. CONDITIONS' i CITV ,A� 2 ` k. ZIP l,7p O �
NO CE TO A ICANT If after making this Ce is of ARCHITECT
OR TEL
_ DISTRICT GROUP TYPE FIRE BV 0
Exemption, you should become subject to the e.- CONST ZONE VR
Compensation provisions of the Labor Code, you must forth ADDRESS �r 0 L,/
with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION APT CO V+
deemed revoked CONTRACTOR NO 5 7 -C Z
LICENSED CONTRACTORS DECLARATION LIC CLASS NO DWELL UNITS_
I hereby affirm that jam licensed under provisions of Chopter 9 ADDRESS 9"( NO
(commencing with Section 7000)of Division 3 of the Business and LIC SEWER MAP
Professions Code and my license is in full force and effect CITY CLASS g BK PG VALIDATION
1 ► 9 0 �� SIZZE � IND NO STORIE FAMILES ONEK
License Number Lic Class
VALUATION
Contractor Date DESCRIPTION OF WORK E NEW = s
E] I am exempt under Sec -2 gel S
ALTER
B 8P C for this reason REPAIR $
Date USE OF DFMiOL `
EXISTING BLDG
Signature APPLICANT TEL FINAL
OWNER-BUILDER DECLARATION PRINT NO DATE
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason (Sachets 7031 5 Business and ADDRESS RN
Professions Code) ET❑ Z2 ADDRESS $O2J8A
I as owner of the property or my employees with ADDRESS
wages as then sola compensation well do the work and # • • • • •i1
the structure is not intended or offered for sale(Section LOCALITY
7044 Business and Professions Code) MOVING TEL �/ �✓N4�� I is e 4 9 8 8
1, as owner of the property am exclusively contracting CONTRACTOR - NO / 4 9 8 8�i
with licensed contractors to construct the project (Sec- ADDRESS �y
tion 7044 Business and Professions Code) /y� !/
CONSTRUCTION LENDING AGENCY SET BIRE YARD HSVV IOTA O 4 V 0 7 2 0 8 8
AIX PROP LINE WIDTH
I hereby affirm that there is a<onsfruction larding agency for FRONT
the performance of the work for which this permit is issued P L
(Sec 3097, Civ C ) SIDE
PL
Lender's Name
TDMA Ref Y
Lender is Address
P C Fee$ Permit Fee q 3X ,
I certify that I have read this application and state that the Issuance Fee LDMA P/C N
above information is correct I agree to comply with all County Inwshgvtion Fee
8 ordinances and State jaws relating to building construction Tobl Fee LDMA Perm •
R and herele a ae representatives of this Court to ant
n thk a.Tvs boned prpperty for n piurpo
s
SEE REVBfE FOR OIMANATORI'IAMOUAfit
S�groMe f Applicant or t Date -