HomeMy Public PortalAbout6272 SULTANA AVE_Building__ 7GA638A CE#6089-66 APPLICATION FOR;'BUILDING ERIV[rr
COUNTY..OF LOS ANGELES :BUILDING
DEPARTMENT OF COUNTY ENGINEER, ADDRESS
BUILDING AND SAFETY DIVISION !LOCALITY J
JOHN A. LAMBIE.COUNTY ENGINEER (NEAREST
COLEMAN W. JENKINSAUP'T OF BUILDING CROSS ST.
:DISTRIC T N Oma/ ar_ - PE; PR BY
FRE
APPLICANT TO FILL IN ��J^ VI CONST.
r
�f� ' - STATISTICAL C�/�SSIFICATION SEWER MAP'
• CLASS NO. DWELL UNITSBK BLOCK USE ZONE MAP
NO.SPECIAL
NO. OF BLDGS. CONDI IONS
NOW ON LOT
BLDG. SETBACR FROMTEL.• ItT PROP. LINE OF (STREET)
NO. TYPEkr EXISTING SETBACK HIGHWAY YARD,' _ TOTAL
ADDRESS
HIGHWA D FROM C.L.
+'
CITY BLDG..SETBA FROM
ARCHITECT O TEL. SIDE PROP. LIN OP (STREET)
ENGINEER NO. _
TYPE OF EXIST SETBACK HIGHWAY i-. YARD TOTAL
ADDRESS 9 • i HIGHWAY WIDTH FROM C.L.
CONTRACTOR fiw .NOL.�s7O
IC
Ad S'0 e NO CORNER CUTOF YES NO
CITY I cL SEE REVERSE SIDE FORS CIAL-APPROVALS
D SCRIPTIO.N . F WORK
NEW ADD ALTER. REPAIR 'DEMOLISH C
SQ.FT. NO. OF NO. OF
.SIZE STORIES FAMILIES
USE OF
STRUCTURE
I I
s
SIGNATURE OF j
APPLtCAN7
1,
VALUATION$ ii`J !, ? / •00
' 1 ' ' APPROVALS DATE INSPECTOR'SSIGNATURE
P.C. PMT. I .FOUNDATION, LOCATION
FEE$' FEE$ d� ; FORMS,MATERIALS
FRAME, FIRE STOPS,•
•)•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
GUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK'
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA-i LATH. INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-I ..
ING TO WORKM N'S COMPENSATION INSURANCE. t LATH. EXT. ,
SIGNATURE 4. HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS r F I NAL G,
' ) JOHN F. LEWIS. PRINCIPAL ST!7R:L ENGINEER:W, eazv
"
PLAN CLEC A ATION M.o. enBH !_ PERNIIT VALIDATION .D CASH
cl
-< -4.7.3::-6-to (AYg7 1 D x.00"' ,a
1
WORKERS'COMPENSATION DECLARATION
hereby affirm that I have r certificate of consent to self, A P P L I CATIOI N 'F OR BUILDING P E RM I T
idi5urr,or a cefl�,tificate of Workers' Compensation Insurance;
or a certif!ed coy thereof(Sec. 3800, Lab.C.) Jp' COUNTY OF LOS ANGELES BUILDING AND SAFETY
Poli y No. � o21 mpany � L� BUILDING .r
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS
Certified copy is filed with the county building inspec- BUILDING
tion department. ADDRESS loa
I
Date licant �� CITY ZIP LOCALITY
PP --�6'� —� NO.OF BLDGS. NEAREST
CERTIFICA OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. �i
COMPENSATION INSURANCE ASSESSOR
(Th!s section need not be completed if the permit is for one TRACT O •BLOCK LOT NO. 2LO MAP BOOK PAG PARCEL.
hundred dollars ($100)or less,) j OWNER TEL USE ZONE MAP
�' NO. NO.
I certify that in the performance of the work for which this ,fJ / ECIALL / r
permit is issued, I shall not employ any person in any manner ADDRESS .?� jet,O f`�' CONDITIONS A /d a
so as to become subject to the Workers'Compensation Laws. 3 OO
' CITY ZIP C'
Date Applicant ARCHITECT OR TEL.
DISTRICT GROUP TYPE FIRE . PROCESSED BY
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER Lt s NO. ��� CONST. ZONE
Exemption, you 'should become subject to the, Workers' �
Compensation provisions of the Labor Code, you must forth- ADDRESSL v 2'^`'' a
with comply with such provisions or this permit shall be L•f�A7 9 STATISTICAL CLASSIFICATION t'iAro CONDO. Z
deemed revoked. CONTRACTO O. "'d1 v:
LIC. • /� CLASS NO. DWELL. UNITS ''7;
LICENSED CONTRACTORS DECLARATION ADDRESS /• NO. 2•ri 1°
I hereby affirm that I am licensed under provisions of Chapter 9, SEWER MAP i,ir-
(commencing with-Section 7000)of Division 3 of the Business LIC. i NEMIl
and Professions Code,and my license is in full force and effect. CITY CLASS BK..G PG. NALIDA O
SQ. FT: NO.OF NO.OF CHECK i�li t :L o, bo
License Number Lic. Cldss SIZE STORIES FAMILIES / ONE
��'� � a�i i / DESCRIPTION OF WORK NEW ❑ VALUATION `t •6t C 1 i
a=Pry"' J 1 ii.•_ n e .t7_■l.•j.+
'Contract ..ttom� B'� i
ADD 10 ` =�} �_.r+ dit�
.❑I am exempt under Sec. Q ��� ►
ALTER ❑ �• TEHE;
BAP.C. for this reason7ZO o U44 $ _
( -i
REPAIR ❑ I},f
—,3�, '-
Date: USE OF 11�i d .a''&6 r
EXISTING BLDG. DEMOL ❑ tAto� s C=1
APPLICANT ; Q &Iffiri 3 ,,`{'�;'!r�r
Signature OWNER-BUILDER DECLARATION (PRINT) OFINA® DATEL C'H'ANGE •ISI+
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason (Section 7031.5, Business and ADDRESS. FINAL'
Professions Code): PRESENT By
,_ r-) 9./1319.,: .
El I, as owner of the property, or- my employees with. BUILDING �0n1
ADDRESS #;-!I_14 ) ,r.('I { :I
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 tol'construct the project (Sec- ADDRESS
tion 7044, Business and Professions Code.).
' REQUIRED TOTAL SETBACK FROM EXIST.
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
I P.C. Fee$ Permit Fee LDMA Ref. #
Lender's Address _
I certify that I have read this application and state that thei Issuance Fee LDMA P/C#
above information is correct. I agree to comply with all County' Investigation Fee
ordinances and State laws relating to building construction, Total Fee f - .7 LDMA Perm. #
and hereby authorize representatives of this County to enter
upon the above-mentioned property for inspection purposes.
f SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applican or Ag't Date
?• COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF DUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0612180020
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
TR: 5904 IT: 206 BL: .001 SQ. PT STORIES TYPE 6272 SULTANA AV
STRUCTURE: 2479 VN TEMP CA 917801553
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LONGDEN
5364-007-015 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, C
TENANT: EXIST BLDG USE: REBID USE ZONE: R-1 ISSUED ON: PROCESSED BY: EXPIRES ON:
EXIST OCC GRP: 12./18/06 JK 12/13/07
OWNER: TEL. NO: FLOGS. NOW ON LOT' VALUATION: MA/. F Y: CODE:
LUONG, BILLY (626) 285-4592- 7,620
6272 SULTANA AVE.
TEMPLE CITY CA 91780 FEES PAID DESCRIPTION` OF WORK
EXTENDED FRONT ENTRY PORCH I�S.F. TEAR ROOF & REROOF WITH
FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: 30 YR. COMPOSITION SHINGLES
APPLICANT: TEL. NO:
SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION REBID 7620.00 VAL 0.76 SPECIAL CONDITIONS:
AX BUILDING REVIEW FEE 54.70
D2 PERMIT W/0 EN-HC 7620.00 VAL 183.00
TOTAL FEES 266.21
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER
LIC. NO LOCATION AND SETBACKS
SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION TRENCH FORMS
i
F
LIC. NO: SLAB/UNDER FLOOR
RAISED FLOOR FRAMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION
153H265 3
Oil
FLOOR SHEATHING
N0. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: .41
NO 21 I ROOF SHEATHING
SCHOOL WITHIN HAZARDOUS SHEAR PANELS
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO FRAME INSPECTION
REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- INSULATION WEATHER STRIP
SIDE PL-
INTERIOR LATH/DRYWALL
EXTERIOR LATH
RATED FLOOR CEIL ASSEM.
RATED WALL ASSEMBLIES
RATED SHAFTS/OPENINGS
T-BAR CEILINGS
LOT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BS0508