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Home My Public Portal About5831 SULTANA AVE_Building__ DEPARTMENT OF BUILDING ANSAFETY AYYLl(,�Al'lUN rvx Y) r�xmri COUNTY OF LOS ANGELESJT WM. J. FOX, CHIEF ENGINEER v RADING NO. OFBLDG. ORD.NO. DISTRICT NO. PLAN CK. NO. PERMIT NO. PLANS SETBACK LINE [ rJ FiRB APPROVED ZONE BY DATE RECEIVED BY DATE OF APPL' DATE ISSUED USE APPROVED ZONE / 1 BY DATE APPLICANT FILL IN HEAVILY OUTLINED PORTI01v ONLY BUILDING E J O It NAME J / ADDRESS F W J W Z ADDRESS LOCALITY tq I Z 3 NEAREST U W CITY CROSS ST. STATE "� TEL. LICENSE N:. NO. E NAME, v. ' ' W MAIL KO NAME �> 3 ADDRESS U O TEL. Q ADDRESS CITY NO. lr aZ~ 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS CITY APPLICATION AND STATE THAT THE ABOVE IS CORRECT U STATE TEL. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LICENSE NO. NO. AND STATE LAWS REGUI:ATING BUILDING CONSTRUCTION. Z LOT NO. ' SIZE OF LOT ��Q SIGNATURE OF / !' O OWNER -1 F. NO. OF BLDG3. f" Q dBLOCK NOW ON LOT �� AUTHORIZEQ ACT. O C ,+ W TRACT '? Y� CORRECTIONS O USE OF BLDGS. r, _ NOW ON LOT •'W DESCRIPTION OF WORK , USE OF BUILDING / 1* n , ..._ .tea• _' ._cn of arc -_c a i�`.".�a :. , 'cu c c.,! _ :,l ort ,� Pr0duc1icriDcc,; r'i z d C Icc: h.Eo-� � u1g .e Work aut,,or:rccl y this permit y r r NEW �/� TYPE GROUP NO. OF NO. OF ALTERATION ROOMS FAMILIES ADDITION SIZE REPAIR STORIES MOVING WALL COVERING I `'_= e e DEMOLISH I ROOF COVERING $ / P.C.$. FINAL APPROVAL FEE INSPECTOR'S VALUATION FEE ' �_= DATE NAME WORKERS'COMPENSATION DECLARATION PPLI T6 I h�ref,5y affirm that I have a certificate of consent to self insure, or a certificate of Workers'Compensation Insurance, N F®� BUILDING PERMIT' or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY No. Policy -` Company_ _15AMU P ,o t r"'"' ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING DES �g 3/ - InZ1 Certified copy is filed with the county building inspec- BUILDING L,9 tion department. ADDRESS Date Applicant. CITY ZIP LOCALITY — o CERTIFICATE OF EXEMPTION FROM WORKERS' 1;' I NO.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 TEL. USE ONE MAP I certify that in the performance of the work for which this OWNER ' NO. NO J�l� 6� permit is issued, I shall not employ any person in any manner �� SPECIAL IL so as to become subject to the Workers'Compensation Laws. ADDRESS i CONDITIONS 0 CI ZIP Date Applicant ARCHITECT O TEL. AM ® NOTICE TO APPLICANT: If, after making this Certificate of DISTRICT GROUP NST. ZONE PR CESSED BY, 0 Exemption, you should become subject to the Workers' ; ENGINEER NO. 6 Compensation provisions of the Labor Code, you must forth- ADDRESS —�" J� - with comply with such provisions or this permit shall be 9 deemed revoked.. CONTRACTOR JEQ STATISTICAL CLASSIFICATION APT. CONDO. LICENSED CONTRACTORS DECLARATION - LIC. CLASS NO. _DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 A DRE NO. ffl (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 S-i BK PG6 VALIDATION SQ. FT. NO.OF NO.OF a CHECK License Number 1-0354!1!5 L_Lic.Class�� SIZE STORIES FAMILIES tl ONE VALUATION Contractor t4k0A 07. Date a DESCRIPTION OF WORK EW ❑ $ 7,8j 670 ❑ I am exempt under Sec. DD S A a e ALTER ❑ .` B.BP.C. for this r son via REPAIR ❑ $ USE OF t5te: EXISTING BLDG. DEMOL ❑� SignSign t 2 APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION PRINT NO. DATE I hereby affirm that I am exempt from the Contractor's License I 1 1` .IYJPQPK Law for the following reason (Section 7031.5, Business and ADDRESS 9 FIN Professions Code): PRESENT BY 9 5 2 a 3 R BUILDING ❑ I, as owner of the property, or my employees with ADDRESS # 0 0 0 0 0 wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 1 - 273.75 7044, Business and Professions Code). MOVING TEL. ❑ 273.755 5 I,as owner of the property, am exclusively contracting CONTRACTOR NO. o 0 2']3.']5 with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). 0 a20-86 CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAPREOTPAINEFROM WIDTH 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. e Lender's Name ` �. P.C.Fee$ Permit Fee (1/ 3�aJ LDMA Ref. # - Lender's Address _ -• LU I certify that I have read this application and state that the Issuance Fee � JU LDMA P/C# pop x above information is correct. I agree to comply with all County Investigation Fee 7 ordinanc s and State laws relating t wilding construction, Total Fee �� '�-� LDMA Perm. # and h y authorize rep sen ativ this County to enter pan a above-men tio pr ert f r inspection purposes. a _ SEE REVERSE FOR EXPLANATORY LANGUAGE 0 Signature of Appnt or Ag licat Date '"I Fi Ieby offfrm thaf`I have a certificate of consent to self , 76A667A ins&e;or a certificate of Wprkers'Cbmpensatio Insurance, CE 817(REV. 10/81) l� or a certified copy t ereof (Sec. 3800, ob. q) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy N.o. Company A4"i 9 r Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS Certified copy is filed with t cou ty building inspec- NUMBER FIXTURE OR ITEM @ FEE tion depart nt. LOCALITY i 7v`y tF�1T/`/�✓ WATER CLOSET NEAREST Date Appli4ant CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB L CROSS ST. COMPENSATION INSURANCE I SHOWER OWNER C (This section need not be completed If the work involved by MAIL [sift,"• I�� the permit Is For one hundred dollars($100)or less.) LAVATORY ADDRESS t� I certify that in the performance of the work for which this SINK CITY �� .� TEL. NO. permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' CITY ICA AIWA �J7 f TEL.NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE]� 1} LIC. deemed revoked. WATER HEATER LICENSE.NO. 01 CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO.�s PROCESSED BY 1 hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS C/6 (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER 9 and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL17 , VALIDATION DATE License Number Lic. Class C FINAL/ C Contractor Date BY C Q ❑ I am exempt under Sec. { C B.&P.C. for this reason Plan check fee ® G u Date: PLUMBING PERMIT ISSUING FEE$ e Signature / TOTAL FEE �v Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and Professions Code): City Tel. No. ❑ I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section 5 3 G 3 A 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY # 0 0 0 0 0 5 1 hereby affirm that there is a construction lending agency for ) o o 4 6 5 0 the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). o o,o 4 Q 5 0 5 Lender's Name 0 Q 9 4`"8 6 Lender's Address I certify that I have read this application and state that the above information i rrect. I agree to comply with all County ordinances and St fe ws regulating Plumbing, and hereby size re re's ntatives of this County to enter upon the ov.e-ment' n roperty for inspect 41-rpose SEE REVERSE FOR EXPLANATORY LANGUAGE —si-g-n—aturuff of Permittee IDate