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Home My Public Portal About5931 SULTANA AVE_Building__ i ISA638A CE hos-8-57 APPLICATION FOR BUILDING PEJRMIT 1. . COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DMSION LOCALITY JOHN A.LAMBIE,COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. DISTRICT.NO. GROUP TYPE EWER MAP FOR APPLIC25 TO FILL IN CONST &"EK BUILDING ADDRESS STATISTICAL CLASSIFICATION CLASS.N DWELL.UNITS LOT NO. BLOCK MAP STATE YES /; f1/ O NUMBE HWY. TRACT V USE NE SPECIAL NO.,OF BLDGS. CONDITIONS SIZE OF LOT NOW LOT a 'p USE OF EXISTING BLDG. BUILDING EXIST. /„r l 9:_ /•t� SETBACK YARD HWY STREET NAME WIDTH OWNER (�(� d 1� FRONT MAILP.L: ADDRESS SIDE TEL. :P.L. CITY NO. INSPECTION RECORD ARCHITECT OR v TEL. ENGINEER NO. ADDRESS TEL. CONTRACTOR NO. ADDRESS DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH � —SIZE /0. 12, STFT NO RF•S I FAMIILIESr USE OF STRUCTURE . SIGNATURE OF APPROVALS APPLICANT ADDRESS a .+�r DATE.- INSPECTOR'S SIGNATURE FOUNDATION: LOCATION //l1qq FORMS,MATERIALSP. FEE S ,yam F BRACING.BOLTS FIRE S, J� VALUATION S q O` , FURNACE: LOCATION, FEE p�' GAS VENT,DUCTS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP_ LATH,INT. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REG NG H_ 1pEi G CONSTRUCTION. LATH,EXT. SIGNATURE O ((////// . HF,US AND POSTED E NUMBER - FERMITTEF �� / �'� ADDRESR FINAL c3 IOHN A.LAMBIE,COUNTY ENGINEER, CLYDE N.DIRLAM,PRINCIPAL-STRUCTURAL EN R PLAN CHECK VALIDATION CK. M.O. CASH PEIRW VALIDATION cK. M.o. 0a l 3 7 ;ISN 5 1 .A 2..: . ®.. APPLICATION FOR BUILDING PERMIT. COUNTY OF LOS ANGELES I BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING A Ess I hereby affirm that I have a certificate Of consent to self insure, BUILDING ADDRESS .- or a certificate of Workers'Compensation Insurance,or a certified Cm, n ZIP copy thereof,(Sec.3800,Lab.C.) !� LOCALITY Policy NO. Company SIZE O LOT 1110.OF BLDG&NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. •department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK• PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNERTEL NO. • COMPENSATION INSURANCE ` WITHIN 1000 FT.OF SCHOOL? YES NO ADDRESS (This section need not be completed if the permit is for one hundredK1� DISTRICT GROUP TYP CONST FIRE ZONE PROCESSED BY dollars($100)or less.) / slI certify that in the performance of the work for which this pCITY ermit ` �O �n O is issued, I shall not employ arty person in any manner so as to ARCHITECT OR ENGINEER TEL NO. v(J become subject to the Workers'Compensation Laws. STATISTICALCL9SS1 (CATION APT CONDO Date Applicant, ADDRESS CLASS NO. �( DWELL UNITS N07ICE TO APPLICANT• If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you .should become subject to the Workers' CONTRACTOR TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith H 0lA1;WJ LeM f 2 D FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION ,12 li�l 403~ LI SIDE CITY UC.CLASS PL I hereby affirm that I am licensed underprovisions of Chapter 9 1z A4 Pa Q '91732- SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES NEW ❑ BK PG ► a Professions Code,and my license is in full force and effect. License Number SLID.Class DESCRIPTION OF WORK ` / S ADD ❑ VALUAnON 07f V Contractor Date ALTER ❑ $ I �� 0 ❑ I am exempt under Sec. —Tae REPAIR 11 $00, U EMP.C.for this reason PDEMOL ❑ LDMA P/C# Date: QOLDG. URM ❑' ANT. CD Signature APPLICANT(PRI TEL NO. LDMA Perm 3! ASC•i°a z ❑ I, as owner of the.property, or my employees with wages as O (] 1 !'°1=� their sole compensation,will do the work and the structure is ADDRESS not intended or offered for sale (Section 7044, Business and FINAL ''�[yATE 9101- 1 ITEMS Professions Code.) i WALL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL i -J m r ❑ 1, as owner of theproperty, am exclusive) contracting with 1 OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE TOTAL 107 0 Y 9 licensed. contractors to construct the project (Section 7044, AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY / �t YES❑ No❑ / {(J�° LJ Business and Professions Code.) I WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING (� I OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKUST FOR ` GUIDELINES. i I hereby affirm that there is a construction lending agency for YES❑ NO❑ ci the performance Of the work for which this permit is Issued(Sec. (HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 0 a3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, O � _� �(� 6/12M TITLE CHAPTER Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM4THEOSCAOMD.6 HAZARDOUS 00825 1 AM Q�3 3 .20 SECTIONS 2.20.100 THROUGH 0 Lender's Address C OWNER OR ADEM o I certify that I have read this application and state under penalty of perjury that the above information is correct.;)agree to comply P.C.FEE PERMIT FEE LL N with all county'ordinances and State laws relating to building construction,and hereby authorize representatives of this County ISSUANCE FEE �; /y� C9 to enter upo a abovey!entjg d�roper 6r insp ction purposes. CI CO W 6 �Z INVESTIGATION FEE TOTAL FEE /D / O a SEE REVERSE FOR EXPLANATORY LANGUAGE