The URL can be used to link to this page

Home My Public Portal About5826 SULTANA AVE_Building__ APPLICATION FOR BUILDING PERMIT FUR APAICANT TO FILL IN (print or type only) BUILD' NGSCOUNTY OF LOS ANGELES ADDRESS DEPARTMENT OF COUNTY ENGINEER CITYzIP BUILDING AND SAFETY DIVISION may{ NO.OF BLDGS. BUILDING % SIZE OF LOT �� NOW ON LOT f ADDRESS TRACT a� BLOCK LOT NO LOCALIT 1 TEL- t/ NEAREST OWNER NO. 7� CROSS ST. / ASSESSOR ADDRESS �b MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE(,7SSED BY CITY ZIP C ST ZONE ARCHITECT OR TEL. Q ENGINEER / NO. STATISTICAL CLASSIFICATION �/ SEWER M6 ADDRESS/ A/C S• v oTi CLASS NO.`S DWELL,UNITS BG CONTRACTOR F� awe.TEL. / G USE ZONE MAP LIC. NO. ADDRESS 61 7 NO. ,�3�I�I CONDIT ONS CSPECAL 4 e '0. LIC. / CITY � CLASS C'L ROA DEPARTMENTAPPROVALREQUIRED YES❑ NO❑ CONSTRUCTION LENDER NAME AND BRANCH DIT BL G.SETBACK FROM y F NT PROP.LI NE OF (STREET) C ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING C: SQ. FT. NO. OF NO. OF CHECK HI WAY + YARD FRONT PROP. LINE HIGHWAY WIDTH SIZE f'! STORIES FAMILIES ONE F NEW 1:1 + 11 DESCRIPTION OF WORK /,U BLDG.! FROM a a 2.� ADD SIDE PROP.LI (STREET) ALTER HIGHWAY + YARD = ObrAL SVUgkCK FROM TY EXISTING i s REPAIR❑ SIDE PRIOP. LINE HIGHWA WIDTH USE OF r + EXISTING BLDG.W_g'1A-Vcfg DEMOL ❑ APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑ (PRINT) N0. BY (SIGNATURE) � IN OPEN SPACE YES ❑ NO ❑ ✓"��i Q IN COASTAL ZONE YES ❑ NO ❑ VALUATION A 9,00- I CATEGORICAL EXEMPTION YES❑ NO ❑ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATION IN URANCE, SIGNATURE OF PERMITTEE ADORESS k G X1, ^ /7L TEL. FINAL DATE j IBY CITY NO. 7 PMT. %IAKE (.111-(.Ks PAYA(3L P.C.7U: FEE $ / FEE HARVEY T. BRANDT. COUNTY ENGINEER PLAN CHECK LIDATION CK. MO. CASH o PERMIT VALI ION ' M O. CASH G7 ;3 ' 1' � 3 .O ) "r � 7 �-3 JJL _ I1 1 D � 8 21 D 76A638A CE#803 12/72 WORKERS'COMPENSATION DECLARATION ��, insure,-orafcerlifiatteofWorkes'CompensatonI have a certificate of eInsuranent to lf (rU �1��1 I� ®K 15 lJILDIfVC� PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING El Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS (J Certified copy is filed with the county building inspec- BUILDING NQ /L tion department. ADDRESS 0 1 � fes` Date, I m ApplicantCITY '>Z+ ZIP LOCALITY J & 11Z ICERfIFICATE OF EXEMPTIO FROM WORKERSN OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one ASSESSOR hundred dollars($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL 1 TEL. USE ZONE MAP (.certify that in the performance of the work for which this OWNER �+ NO `� I NO. permit is issued, I shall not employ any person in any manner SPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESS CONDITIONS CITY ZIP Date Applicant ARCHITECT OR TEL. NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO DISTRICT ROUP TYPE FIRE PROCESSED BY Exemption, you should become subject to the Workers' Q CONST. ZO E Compensation provisions of the Labor Code, you must forth- ADDRESS Sr r +: with comply with such provisions or this permit shall be TEL a �]L STATISTICAL CLASSIFICATION APT• �• deemed revoked. CONTRACTOR ?�"�GI NO.-I `v LICENSED CONTRACTORS DECLARATION 1_a _'„QAC, s3 1 G�.� CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS ® 11@l �ul� D 3 (commencing with Section 7000)of Division 3 of the Business and LIC. SEWER MAP Professions Code, ,a2and Qmy license is in full force and effect. CITY � � CLASS v O BK PG VALIDATION a 71 f�1� _ SFT. F FA OF CHECK License Number Lic.ClassSIZE ST ES FAMILIES ONE V �j �. NEW VALUATION Contractor �" � Date! P v CRIPTION OF WORK . ® ❑ $ 3 O ADD , I am exempt under Sec. ALTER ❑ B.BP.C. for this reason REPAIR ❑ $ N Date: USE OF ��//J� ,,�� MOL ❑ EXISTING BLDG.1; Signature APPLICANT a1� TEI. FINAL OWNER-BUILDER DECLARATION PRINT O( Y DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS�F FIN Professions Code): PRESENT By ❑ BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7q nn% I 1 7044, Business and Professions Code). CMOVING TEL. ONTRACTOR NO. ® 8 3 8 I, as owner of the property,am exclusively contracting 1 0 2 2 with licensed contractors to construct the project (Sec- ADDRESS aoo tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK o 0 2 2 a o 0, CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH1 O 8 -88 I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name - LDMA Ref. # to P.C.Fee$ Permit Fee Lender's Address I certify that I have read this application and state that the Issuance Fee a&7) LDMA P/C# g above information is correct. I agree to comply with all County Investigation Fee 4 ordinances and State laws relating to building construction, Total Fee v LDMA Perm. # R an ereby horize representatives of this County to enter u t o e-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE m �s� Signature of Applicant or Agent Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1106270085 PHONE: (626) 285-0488 EXT: LEGAL ID: N0. OF CONST BUILDING ADDRESS: ITR: 5905 IT: 103 SQ. FT STORIES TYPE 5826 SULTANA AV [ I (STRUCTURE: 2000 V-B TEMP CA 917801838 [ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS 15387-015-019 1 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, Cl TENANT: 1EXIST BLDG USE: RESID USE ZONE: R-1 JISSUED ON: PROCESSED BY: [EXIST OCC GRP: 106/27/11 SR OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IF mDAT$ FINAL BY: CODE: ]WONG SHEK F;KAM M (626) 286-6019- 1 6,000 1X�J111, 1 15826 SULTANA AV '`,jv TEMP 917801838 FEES PAID EISCRIPTION OF WORK REMOVE ROOFING HOUSE & GARAGE INSTALL 7/16 OSB INSTALL 30 YRI IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:ICLASS A COMPOSITION SHINGLES APPLICANT: TEL. NO: I IREYES, SANTIAGO (562) 397-8116- IAA BLDG PERMIT ISSUANCE 27.80 113739 CULLEN ST. IAB STATE GREEN BLDG FEE 6000.00 VAL 1.00 ISPECIAL CONDITIONS: IWHITTIER, CA 90605 IAC STRONG MOTION RESID 6000.00 VAL 0.60 1 ID2 PERMIT W/O EN-HC 6000.00 VAL 149.70 TOTAL FEES 179.10 CONTRACTOR: TEL. NO: [APPROVALS DATE INSPECTOR SIGNATURE JIM'S ROOFING A PARTNERSHIP (562) 397-8116- 1 1 113739 CULLEN ST. LIC. NO ILOCATION AND SETBACKS IWHITTIER, CA 90605 960451-C39 I SOILS ENGINEER APPROVAL 1ARCHITECT OR ENGINEER: TEL. NO: - 1 1FOUNDATION/TRENCH FORMS I I I 1 LIC. NO: 1 (SLAB/UNDER FLOOR I I I [ I (RAISED FLOOR FRAMING. I 1 I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( (UNDERFLOOR INSULATION I I 1 1150H265 3 001 I I I I I IFLOOR SHEATHING I I [ INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I I I I 1 0 NO 21 1 1ROOF SHEATHING I SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS I I I (AIR QUALITY: 1000 FEET MATERIALS I I I I [ NO NO NO I IFRAME INSPECTION IFIRE SPRINKLER HANGERS I I [ 11NSULATION/WEATHER STRI9 1 I I NTERIOR LATH/DRYWALL I I [ [ [EXTERIOR LATH I I [ IRATED FLOOR/CEIL ASSEM. [ I [ IRATED WALL ASSEMBLIES [ [ IRATED SHAFTS/OPENINGS [ [ [ IT-BAR CEILINGS I I [ 1 1* ADDITIONAL DATA ON FILE [ ILOT DRAINAGE [ [ [ [ 1-1-1 [ IREPORT ID: DPR261 ROUTE TO: BS0508 I I I [