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HomeMy Public PortalAbout6027 SULTANA AVE_Building__ 76A63BACE#8033-66 APPLICATION FOR BUILDIN PERMIT LJ COUNTY OF LOS ANGELES . BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS ele BUILDING AND SAFETY DIVISION LOCALITY J JOHN A. LAMBIE. COUNTY ENGINEER NEAREST * f COLEMAN W. JENKINSSUP'T OF BUILDING CROSS ST. Ell FOR APPLICANT TO FILL IN DISTRIF TOO. G J IT YPE CONST.::121Le BUILDING -[\� + STATISTICAL C IFICATION S WER MAP ADDRESS Qa 7 p sUJ.T NA CLASS NO. DWELL UNIIITS BK PZ LOT NO. BLOCK USE ZONE MAP /') NO. (/ V TRACT Ica SPECIAL N0. OF SLOGS. CONDITIONS SIZE OF LOT NOW ON LOT USE OF zXt STINO BLDG. BLDG. SETBACK FROM TEL, p L ,FRONT PROP. LINE OF (STREET) OWNER FA.I. NO. oZO 7 7(,0 I TYPE OF I EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS A d ? 41 ssfl�_,7_AA)A HIGHWAY WIDTH 'ROM C.L. CITY BLDG. SETBACK FROM ARCHITECT TEL. ENGINEER NO. SIDE PROP. LINE OF (STREET) TYPE OR EXISTING SETBACK HIGHWAY - +_ YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM.C.L. EL. CONTRACTOR r' NO 7G SO CORNER CUTOFF YES NO c ADDRESS/4/21-6 IC CITY CI' ~' c6 SEE REVERSE.SIDE FOR SPECIAL APPROVALS Dc DESCRIPTION OF WORK c co NEW ADD ALTER REPAIR DEMOLISH SO.FT. NO. OF NO. OF SIZE STORIES FAMILIES- US E AMILIESUSE OF STRUCTURE SIGNATURE OF APPLICANT VALUATION$ �� APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. S6 FOUNDATION, LOCATION FEE$ FEE$ , s FORMS,MATERIALS FRAME, FIRE STOPS,- r I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS 9UILDING CONSTRUCTION. 1 CERTIFY THAT. IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S COMPENSATION INSURANCE. LATH. EXT. SIGNATURE OFI HOUSE NUMBER COR- PE4tMITTEE / RE AND POSTED +m ADDRESS-/ o FINAL • JOHN F. LEWIS. 16RINCIPALATURAL ENGINEER PLAN CHECK V411ATION CK. o. CASH _ PEPJV= VALIDATION CK. M.o CASH L1 .0 6 8 3 SEP 18 1 D 9.00- WORKERS'COMPENSATION DECLARATION IIkgrqb ';a�firm that I have a certificate of consent to self `� N F® BUILDING PERMIT I 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 co is hereby furnished. FOR APPLICANT TO FILL IN BUILDING PY Y ADDRESS 60 -7'7 ❑ Certified co is filed with the county building inspec- BUILDING n,,,, moo. PY tY 9 P ADDRESS 01 6414 A tion department. C CITY . C_ CA— ZIP 0 LOCALITY Date Applicant NO.OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. GZ�i�t;�A% /t, COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK LOT'NO. MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) EL 'n OWNER NO,d.� ; USE ZONE MAP NO. 1 certify that in the performance of the work for which this SPECIAL permit is issued, I shall not employ any person in a manner ADDRESS �OZ � CONDITIONS CL so as to becom subject to the Work rs'Compensa on Laws. .ry O // QQ , CIN — C ZIP v k Date /�/ v 1 Applicant ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PRO SED BY NOTICE TO PPLICANT: If, after Ing this Certific of ;ENGINEER . NO. CO ZONE O Exemption, you should become ubject to the Workers' Compensation provisions of the La or Code, you must forth- :?ADDRESS s a with comply with such provisions or this permit shall beTEL• STATISTICAL CLASSIFICATIO APT. CONDO. N deemed revoked. :.CONTRACTOR NO. z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC. and Professions Code,and my license is in full force and effect. CLASS BK. PG. 'T V/�WC�ATION #:SQ. FT. NO.OF NO.OF CHECK License Number Lic. Class SIZE 2. (� STORIES e� FAMILIES ONE VALUATION f T4�-R,-• Contractor Date r DESCRIPTION OF WORK NEW ❑ �„ n 'E ADD ❑ ❑I am exempt under Sec. dale� 1 ^ ® ALTER � CHECK a•e,;..,r'- B.&P.C, for this reasonCD C t' $ REPAIR tii •.,;r Date: USE OF ' EXISTING BLDG ( D J2 Signature APPLICANT rgg_" TEL• !! FINA (PRINT) JAM C He NO.2"d 1-6��:i` .r [I[t[r[I-[I[f[;1 � � ,- OWNER-BUILDER DECLARATION. c DATE :116x::'_ I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESSQZ FIN Professions Code): PRESENT By El 1, as owner of the property, or my employees with ADDRESSSG } l�oa wages as their sole compensation,will do the work and t �.� the structure is not intended or offered for sale(Section LOCALITY ;` 3 Ari 7044, Business and Professions Code.) MOVING TEL. s tt� I,as owner of the property,am exclusively contracting CONTRACTOR NO. 1 TEt SE with licensed contractors to construct the project(Sec- O 5. 30 tion 7044, Business and Professions Code..) ADDRESS ` �_��.. REQUIRED TOTAL SETBACK FROM EXIST. CHECK 1�'0� CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH CHECK 1 I hereby affirm that there is a construction lending agency for FRONT CHl 157071 the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name (�0 -�Q01 5 61x9 S P.C. Fee$ Permit Fee s V� LDMA Ref. # u y Lender's Address 17 1 AM t_� 33 31 1 certify that I have read this application and state that the Issuance Fee r LDMA P/C# 2 above information is correct. I agree to comply with all County @Investigation Fee ordin ces and State la s relating 6 building construction, Total Fee � LDMA Perm. # and h reby authorize re resentativgs of this County to enter upon a above-mentio d property for inspection purp se . o SEE REVERSE FOR EXPLANATORY LANGUAGE Tignature of Applicant or Agan} Dat a=� -I(PORKERS'COMPENSATION DECLARATION 6° reby affirm that I have a certificate of consent to self ® �m insure, or a certificate of Workers'Compensation Insurance, A P P L I CAT FOR BUILDING IT 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 APOP,LICANT TO FILL IN BUILDING ADDRESS b 0� 't/ El Certified copy is filed with the county building inspec- BUILDING 6 es7 �.�LT�� tion department. ADDRESS /� �/� Date Applicant CITY em a cif G/T ZIP 67/ Q(/ LOCALITY � ' CERTIFICATE OF EXEMPTION FROM WORKERS' ` NO.OF BLDGS. NEAREST y. COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CRO55 ST. b / (This section need not be completed if the permit is for one $' ^ ASSESSOR � hundred dollars($100)or less.) TRACT �fJ� BLOCK LOT NO. 7 MAP BOOK PAGE PARCEL T IF / TEL. I certify that in the performance of the work for hick this OWNER Jf1r' LU�u NO.aB D USE 7—/ NOP permit is issued, I shall not employ y person in a manner SPECIAL < Vi so as to ecom subject to the Wor rs'Compens on Laws. ADDRESS ��L CONDITIONS O p� OU Date " 0 Applicant CITY L& C� CA- ZIP '7(70'L � NOTICE AP LICANT: If, after king this Certificat of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY O Exemption, you should become ub'ect to the Workers' ENGINEER NO. CONST. ZONE U P Y I � Compensation provisions of the La or Code, you must forth- ADDRESS /1/ J � J a with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. fA deemed revoked. CONTRACTOR NO. CLASS NO. �� DWELLUNITS z LICENSED CONTRACTORS DECLARATION LIC. . I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS U NO. (commencing with Section 7000)of Division 3 of the Business and oe LIC, SEWER Professions Code, and my license is in full force and effect. CITY CLASS BK It PG J 6 VALIDATION SQ.FT. NO.OF NO.OF / CHECK License Number Lic.Class SIZE STORIES FAMILIES ! ONE VALUATION _ n DESCRIPTION OF WORK = NEW ❑' Contractor Date z ADD $ I am exempt under Sec. ilEl ALTER ❑.; B.BP.C. for this reason cin i3 4-66 REPAIR ❑ $ USE OF DEMOL Date' EXISTING BLDG. �f /L. ❑;; APPLICANT TEL. Signature PRINT C Np, - U FINAL OWNER-BUILDER DECLARATION f+ LTG L• FINAL Q A DATE 1 hereby affirm that I am exempt from the Contractor's License (�X/L J Law for the following reason (Section 7031.5, Business and U ADDRESS B # 0 a 0 0 a Professions Code): PRE EN Y 6711 1, as owner of the property, or my employees with ADDR SS t 1 - 30675 wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY ® !0 - 306755 7044, Business and Professions Code). - MOVING TEL. ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. Q27-88 with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). a REQUIRED TOTAL SETBACK " CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP.LINE 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. Lender's Name LDMA Ref. # n P.C.Fee$ Permit Fee _ - �. Lender's Address a I certify that I have read this application and state that the Issuance Fee I MA P/C# R above information is correct. I agree to comply with all County Investigation Fee -_ 09 ordinances and State laws relating to building construction, Total Fee LDMA Perm.q an hereby authori representatives of this County to enter up n ilia above-m boned property for inspe//ctio pur ses. d l� SEE REVERSE FOR EXPLANATORY LANGUAGE r Signature of Applica r nt ate c v L V 3a.� tis WORKERS'COMPENSATION 13ECLARATION • �,• I have a certificate of consent to self insure, oraefcertif catte of Workers' Compensation Insurance, r ® ■e, LICATI F BUILDING or a certifiv!l copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. CompanyBUILDING / Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS c'(JZ Certified copy is filed with the county building inspec- BUILDING /_ tion department. ADDRESSr4��(C,Jr 1�ft,7 & s L �7 `� Date Applicant CITY C // ZIP %/ v LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' G NO.OF BLDGS. Z NEAREST COMPENSATION INSURANCE SIZE OF LOT V NOW ON LOT q CROSS ST. (This section need not be completed if the permit is for one Q BLOCK LOT NO. / ;.MAPBOOK PAGE PARCELASSES SOR hundred dollars($100)or less.) TRACT TEL. USE ONE MAP I certify that in the performance of the work for which this OWNER T C� NO. NO. permit is issued, I shall not employ ny person in a manner Z SPECIAL so as to bec me s b'ect to the Wo ers'Compens on Laws ADDRESS �© f( CONDITIONS sJ U Date Applicant CITY C ' ZIP NOTICE A LICANT: If, after eking this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY O ENGINEER NO. CONST. i ZONE F-- Exemption, you should becom subject to the Workers' �7 , / V Compensation provisions of the L bor Code, you must forth- ADDRESS V � a with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSI CION APT. ENDO. IL deemed revoked. CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION V LIC. ;, CLASS NO. A DWELL. UNITS 1 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.FT;:w NO.OF NO.OF / CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE VALUATION Contractor Date DESCRIPTION OF WORK A D El. $ /�/I d o I am exempt under Sec. V(� ALTER ❑ B.BP.C. for this reason AftREPAIR ❑% $ Date: USE OF ��� `� `G DEMOL ❑; EXISTING BLDG. ri Signature APPLICANT PRINT C NTEL. FINAL 0. OWNER-BUILDER DECLARATION DA I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS 5(�vZ /V F 1 J �I Professions Code): PR IN T �'. BUILDING I, as owner of the property, ormy employees with ADDRESS # 0 0 0 0 0 1 wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY ® I o 1 1550 7044, Business and Professions Code). MOVING TEL. I,as owner of the property, am exclusively contracting CONTRACTOR NO. 0 0 0 0 0 a 0 with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK 1 7 6 0 0 t j CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH rS 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 o P.C.Fee$ Permit Fee D LDMA RL# J Lender's Address I certify that I have read this application and state that the Issuance Fee (!. LDMA P ? above information is correct. I agree to comply with all County Investigation Fee ordinances and State la s relating to building construction, Total Fee V LDMA P an hereby authorize r resentatives of this County to a ter $ up the above-mentio d property for inspecct/tioRy, e .I k". (QSEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or A rtf WORKERS'COMPI�NSATIOWDECLARATION her .affirm that I have a certificate of consent to self G B ®I N G PERMIT -.1 e insure, or a certificate of Workers'Compensation Insurance, APPLICATION F ) u L or a certified copy thereof(Sec. 3800, Lob. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING / tion department. ADDRESS Z700 DateApplicant CITY ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT q'dNOW ON LOT CROSS ST. (This section need not be completed if the permit is for one i ASSESSOR hundred dollars($100)or less.) TRACT (/ BLOCK LOT NO. MAP BOOK PAGE PARCEL TEL. USE NE MAP I certify that in the performance of the work for which this OWNER C147iNO DO — NO. permit is issued, I shall not employ a y person in any m nner e ( SPECIAL so as to b come ubject to the War s'Compensatio aws. ADDRESS CONDITIONS V Date Applicant CITY ZIP NOTICE A LI NT: If, after king this Certificate ARCHITECT OR TEL. DISTRICT ROUP TYPE FIRE PROCESSED BY O0 ENGINEER NO. /' CONST ZONE Exemption, you should become ubject to the Workers' U Compensation provisions of the La or Code, you must forth- ADDRESSaI with comply with such provisions or this permit shall be EL. „ STATISTICAL CLASSIFICATION APT. I CO�Y. U) deemed revoked. CONTRACTOR NO. Z. LICENSED CONTRACTORS DECLARATION U LIC, CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS • NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business and LIC, Professions Code, and my license is in full force and effect. CITY CLASS BK PG VALIDATION SQ. FT. NO.OF NO.OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE VALUATION Contractor pole DESCRIPTION OF WORK NEW ❑`• $ ❑ ADD ❑ I am exempt under Sec. 94 W, ALTER pill B.BP.C. for this reason REPAIR ❑;, $ 4 1 3 8 6 A Date: USE OF EXISTING BLDG. DEMOL 0 0 0,0 0 1 Signature APPLICANT TEL. — FINAL OWNER-BUILDER DECLARATION PRINT NO. DATE :1 a a 6 Q 5 0 1 hereby affirm that I am exempt from the Contractor's License 0 0 0 0 0 0 0 Law for the following reason (Section 7031.5, Business and ADDRESS dZ FINAL t— Professions Code): PRESENT By o 0 0 6 0 5 0 N 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 7044, Business and Professions Code). MOVING TEL. ❑ 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 SETT BACK YARD HWY TOTAL SETBACK LANE WIDTFROM t: I 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 P.L. Lender's Name �^ i P.C.Fee$ Permit Fee Ref. it = Lender's Address PP I certify that I have read this application and state that the Issuance Fee (/. LDMA P/C fi above information is correct. I agree to comply with all County Investigation Fee //ll ordinances and State laws relating to building construction, Total Fee 10, 110 LDMA Perm.# and he�by authorize re resentatives of this County to enter upon t above-mentio d property for inspectio pu oses. SEE REVERSE FOR EXPLANATORY LANGUAGE g ature of Applicant or AOMI to