HomeMy Public PortalAbout5830 SULTANA AVE_Building__ ��•,,, Wm
GOMPISATION DECLARATION
• f-het'NY affirm trial I hp g a certificate of consent to self I �I L®I N G PERMIT c
'insure, or a certiricate 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
ADDRESS v
❑ Certified ibopy is filed with the county building inspec- BUILDING ✓
tion department. ADDRESS
Date Applicant CITY ZIP ^LOCALITY
CERTIFICATE OF EXEMPTION FROM WORKERS' �. NO.OF BLDGS. NEAREST 30
COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST.ASSES' S
SOR
(This section need not be completed if the permit is for one TRACT• BLOCK LOT NO. �/ MAPBOOKPAGE PARCEL
hundred dollars ($100)or less.)
TEL. , a USE ZONE MAP
I certify that in the performance of the work for which this OWNER NO. NO.
permit is issued, I shall not employ any person in any manner SPECIAL
916
so as to become subject to the Workers'Compensation Laws. ADDRESS CONDITIONS
CITY ZIP99
Date Applicant '
NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT O /� % NLO h tSTATISTICAL
GROUP TYPE FIRE PR ESSED BY
ENGINEER L6 ; CONST riExemption, you should become subject to the Workers'
Compensation provisions of the Labor Code, you must forth-
ADDRESS — ,
with comply with such provisions or this permit shall be TEL. ASSIFICATION AP . CONDO
deemed revoked. CONTRACTOR NO.
LICENSED CONTRACTORS DECLARATION LIC. DWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 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 BK PG VALIDATION
SQ. FTNO.OF NO.OF CHECK
.
License Number Lic.Class SIZE STORIES FAMILIES ONE
VALUATION
DESCRIPTION OF WORK , NEW ❑.. -�-
Contractor Date ADD $ z — e
I am exempt under Sec. ❑'
ALTER ❑,.• n
J # �• m
B.BP.C. for this reason REPAIR $ _
USE OF
Date: EXISTING BLDG. i DEMOL ❑I ) 0 1 4a,63
Signature APPLICANT TEL. FINAL
OWNER-BUILDER DECLARATION PRINT f f NO. DAW
I hereby affirm that I am exempt from the Contractor's License ADDRESS rd7• /io�
Law for the following reason (Section 7031.5, Business and NAS/
Professions Code): PRESENT By y
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
7044, Business and Professions Code). MOVING TEL. ✓ n
I, as owner of the property,am exclusively contracting CONTRACTOR NO.
with licensed contractors to construct the project (Sec- ADDRESS
tion 7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY TOTAL SETBACK
LINE
WID H
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
m P.L. /
o Lender's Name " '• ' �^
Ref. #
Le is Address P.C. Fee$ Permit Fee
I certif that I have read s application and state that the Issuance Fee LDMA P/C# pop.
above nfo at! is corr t I agree to comply with all County Investigation Fee
ordi n s a tate I relating to building construction,
an eby oriz resentatives of this County to enter Total Fee LDMA Perm. #
u the ve-m ned roperty for inspection rpo S.
o SEE REVERSE FOR EXPLANATORY LANGUAGE
n
Signatur of Applicant or Agent P68
2
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0503310036
PHONE: (626) 285-0488 ERT:
LEGAL ID: NO. OF CONST NEW BUILDING ADDRESS.
TR: 5905 LT: 102 SQ. FT STORIES TYPE OCCUP GROUP 5830 SULTANA AV
STRUCTURE: 325 1 VN R3 TEMP CA 917501838
ASSESSOR INFORMATION NUMBER: GARAGE: NEAREST CROSS STREET: LAS TUNAS
5387-015-018 OTHER: THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, C
TENANT: EXIST BLDG USE: USE ZONE: ISSUED ON: PROCESSED BY: EXPIRES ON:
EXIST OCC GRP: / 03/28/06 JK 03/23/07
OWNER: TEL. NO: SLUGS. NOW ON LOT: VALUATION': FI;TA19 T� FINAL BY: CODE:
CHEUNG THOMAS;HELEN TRS CHEUNG TRUE (626) 548-5093- 25,240 ?!5'-(j
5830 SULTANA AVE
TEMP 917801653 FEES PAID DESqRIPjION OF WORK
ENr4RGE LIVING ROOM AND NEW BEDROOM 325 S.F.
FEE DESCRIPTION: QUANTITY: DOM: AMOUNT:
APPLICANT: TEL. NO:
CHEUNG (626) 548-5093- B1 PLANCHECK W/ENERGY 25240.00 VAL 452.99
5830 SULTANA AVE AA BLDG PERMIT ISSUANCE 7.75 SPECIAL CONDITIONS:
TEMPLE CITY CA 91780 AC STRONG MOTION REBID 25240.00 VAL 52
B2 PERMIT W/ENERGY 25240.00 VAL .95
TOTAL FEES 016.21
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
P S REMODELING CORPORATION (626) 378-2781-
9059 WOOLLEY ST LIC. NO LOCATION AND SETBACKS
TEMPLE CITY, CA 91780 754089B
SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL. NO: - FOUNDATION TRENCH FORMS
LIC. NO: SLAB/UNDER FLOOR
RAISED FLOOR FRAMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION
3 O1;
IST LEVEL FLOOR SHEATH
NO. OF FAMILIES: DWELLING UNITS: APT COND: STAT CLASS:
NO 21 2ND LEVEL FLOOR SHEATH
SCHOOL WITHIN HAZARDOUS ROOF SHEATHING
AIR QUALITY: 1000 FEET MATERIALS /y
NO NO NO FIRE DEPT. FRAME INSPECT -�
REQUIRED TOTAL SETBACK FROM EXIST BLDG DEPT. FRAME INSPECT
SET BACK YARD: HWY: PROP LINE: WIDTH: (/
FRONT PL- SHEAR PANELS
SIDE PL- (f
INSULATION WEATHER STRIP /
INTERIOR LATH/DRYWALL L
EXTERIOR LATS
LOT DRAINAGE
SMOKE DETECTION DEVICES
I
FIRE DEPARTMENT APPROVAL
i
REPORT ID: DPR261 ROUTE TO: BS0508