HomeMy Public PortalAbout6028 SULTANA AVE_Building__ - - APPLICATION FOR COUNTY OF LOS ANGELES
R
BUILDING PERMIT DEPARTMENT BUILDING AND SAFETY DIVISION
BUILDING
FOR APPLICANT TO FILL IN ADDRESS o
BUILDING ry
ADDRESS 7 LOCALITY , Q�
NEAREST
CITY G r' ZIP CROSS ST.
NO.OF BLDGS. ASSESSOR
SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
��}} DISTRICT GROUP TYPE FIRE PROC SED BY
TRAGTS7a BLOCK LOT NO. f (,9 Vr� CO ST. ZO E /
TE V �!-a- "v►aL� LJ
OWNER ' l NO. �,"/' STATISTICAL C�LAeSSIFICATION SEWER MAP
ADDRESS. CLASS NO,�DWELL,UNITS J�
BKS G
CITY ZIP l)SE�ONEIMA
NOP
ARCHITECT OR TEL •f*Cw./ SPECIAL
ENGINEER / //ff Jfly" r NO• r S xL"CONDITIONS
ADDRESS of {�, 1(J' YLsf aCy R ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
CONTRACTOR AiCNOL' `•a'7,� BLDG.SETBACK FROM
LIC.^r� FRONT PROP.LINE OF (STREET)
ADDRESS •� 07a HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
•LIC. FRONT PROP. LINE HIGHWA DTH
CITY CLASS
CONSTRUCTION LEN ER Al bC + = y
NAME AND BRANCH BLDG.SETBACK FROM RCC"
ADDRESS CITY SIDE PROP.LINE OF (STREET) E
SQ, FT NO. OF NO. OF CHECK HIGHWAY + YARD = T TAL TBACK FROM TYPE OF EXISTING 4--
S?
SIZE STORIES FAMILIES ONE E PROP. LINE HIGHWAY WIDTH
+❑ = C
DESCRIPTION OF WORK NEW y
ADD ❑ CORNER CUTOFF YES ❑ NO ❑ Z
ALTER ❑
REPAIR❑ IN OPEN SPACE ES ❑ NO ❑
USE OF IN COASTAL PERMIT ZONE YES ❑ NO ❑
EXISTING BLDG. DEMOL ❑
APPLICANT TEL
(PRINT) NO.
BY (SIGNATURE)
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 4 �LQ�lR
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMP Y ANY PERSON IN VIOLATION OF THE
LABOR CODE OF TME TE F CALIFORNIA IN RELATING TO
WORRMEN'S COMPENSA N U ANCE.
SIGNATURE OF FINAL BY
PERMITTEE DATE
r
ADDRESS //
TEL. P.C. Fee$ e� U . 10 Permit Fee CO
CITY NO.
�/ Issuance Fee '
VALUATION ,l A r+
Total Fee t�
PLAN CHECK VALIDATION CK. M.O. CASH - PERMIT VALID TON CK. M.O. CASH
746X0D�C 1421 0 20.70 ' .. .
7GA638A CE#8038 12/75 4 7 g D L' 14 1 V 6 9.0 O ,&�;b