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Home My Public Portal About6355 SULTANA AVE_Building__ aCEyJle09 1/71i/�' J[C/o'" e ��\•G �. . APPLICAl O�N FOR�UILDING PERMIT COUNTY'OP LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING �� • w ADDRESS COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY rQ R. F (� FOR APPLICANT TO FILL IN NEAREST Print or tvDe onl CROSS ST. DISTRICT GP ONST. A /0 ,3 .5s SPR, AESvn� ADDD BY RESS (�!� a, ? � C�►� mpf STATISTICAL CLASSIFICATION SEWER MAP LOT NO. h�jp Z BLOCK CLASS NO / DWELL,UNITS '- BK PG TRACTTRACTrA,12 L.A o - USE ZONE MAP NO.OF BLDGS. --. NO. !! SIZE OF LOT S3 NOW ON LOT ' r SPECIAL USE OFCONDITIONS EXISTING BLDG, 2E.5 Id e.n C- ! h OWNER . u /�, NO. jpI 2 II BLDG.SETBACK FROM ADDRESS j,3 S S S&L I Q pI eL FRONT PROP.LINE OF 0-_(STREET) AN /`/}� IL TYPE A EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY /lrJ_ HIGHWAY WIDTH FROM C.L. S ARCHITECT OR ((`` TEL. 0�.41 �� t '2O =zL7 ENGINEER ,]C' O 1,COIL' iiahNO. BLDG,SETBACK FROM ADDRESS SIDE PROP.LINE OF (STREET) TEL. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL a CONTRACTOR NO. HIGHWAY WIDTH FROM C.L. v ADDRESS NO + C LIC. CITY CLASS CORNER CUTOFF YES ❑ N05< a' CONSTRUCTION LENce NAME AND BRANCH_3"n2. SEE REVERSE SIDE FOR SPECIAL APPROVALS ADDRESS r Add SQ. FT. �� NO. OF, NO. OF NAW a t �� cp_ SIZE STORIES FAMILIES ❑ _ USE OF " ADD STRUCTURE 2 � C ` ern 'Klk , uA ALTER � SIGNATURE'OF REPAIR❑ APPLICANT DEMOL ❑ VALUATION S 7 _ APPROVALS DA-dg INSPECTOR'S SIGNATURE P.C. PMT, rL tj FOUNDATION: LOCATION FEE S , S FEE$ �� FORMS, MATERIALS FRAME: FIRE STOPS, I HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS Z ANO STATE THAT THE ABOVE 19 CORRECT AND AOR EE TO COMPLY FURNACE: LOCATION, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR CODE OF THE STATE OF -CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATIO! iSURANCE. LATH, EXT, z, L SIGNATURE OF HOUSE NUMBER COR- PERMITTE RECT AND POSTED ADDRESS S.G FINAL ( r� V�` JOHN F. LEWIS. PRINCIP ISTR .b\RAL ENGINEER PLAN CHECK VALIDATION cK. M.O. CASH _ PERMIT VALIDATI •c KJ M.O. CASH F379v APR 723 A 3735A c L�t,o u&o A 9 .9 N App 1 D 6 2.2 5N e APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN ~ BUILDING ADDRE 1 hereby affirm that I have a certificate of consent to self insure, WUII,�IN�G or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) ZI LOCALITY Policy No. Company NO.OF BLDGS.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 O. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' TEL NO. COMPENSATION INSURANCE -t '� WITHIN 1000 FT OF SCHOOL? Yes No (This section need not be completed if the permit is for one hundred AOD,E5�5 dollars($100)or less.) ' DISTRICT ROUP TY E CONST FIRE ZONE PROCESSED BY. I certify that in the performance of the work for which this permit ZIP 7 9�—v is issued, I shall not employ any person in an manner so as to ARCHITE OR ENGINEER TEL NO. 0 beco s je t to the Workers' p a aws STATISTICAL CLASSIFICATION APT CONDO Dat Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CON R TE /�/,..�,�}} SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith �� 4�)&�L FRONT comply with such provisions or this permit shall be deemed revoked. A977,3 l/ LIO PL LICENSED CONTRACTORS DECLARATION G(� SIDE LIC. PL , I hereby affirm that I am licensed underprovisions of Chapter 9 C I SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZIf NO.Op STO IES NO.Oq FAMILIES NEW 1:1 BK PG Professions Code,;8y licen in full force 1 ffect. I 1 a Licens er. Lic. Iasi ` DE NOF WORK ADD ❑ VALUATION Q Contractor l 31fJRjAAALTER ❑ $ 11� o V ❑ I am exempt under Sec. - REPAIR El $ U B.BP.C.for this reason ' W c��Q,QV d dDEMOL 11 Date: USE F EXI ING BLDG. s� URM ❑ LDMA P/C# co Signature APPLI, NT LOMA Perm# ACCT.Or Z ❑ I, as owner of the property, or my employees with wages as eL— Z their sole compensation, will do the work and the structure is ADD ESS �j / O 3303 158.85 not intended or offered for sale (Section 7044, Business and ( 7 FINAL DATE ITEMS OR Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL `��- OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ❑ 1, a3 owner of the property, am exclusively contracting With AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY TOTAL -0 59 a 80-5 licensed contractors to construct the project (Section 7044, YES❑ NO 11Business and Professions Code.) CHECK 158085 WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING CHANGE o O0 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(3CAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. I hereby affirm that there is a construction lending agency for YES❑ NO❑ a the performance of the work for which this permit is issued(Sec. 0000'0001 ZO/ y��5 a 1 HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 'J CM 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, TITLE 2.CHAPTER 2.20 Lender's Name MATERIALSEPORTING AND FOR SOBTAINING A PERMIT FROM THE SCAQMD.CONCERNING 2.20.100 THROUGH 2.20.140 HAZARDOUS 25L L i /1M 9:06 e fy L 0 Lender's Address DWWR OR MEW 13R 1'1,1 7 IJO 0 oI certify that I have read this application and state under penalty 0 of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE 130 CM with all county finances and State laws relating to buildingco uctio , nere uthorize representatives of this ounty ISSUANCE FEEto er n - ntion d property for inspe ose Q�ro � SINVESTIGATION FEE TOTAL FEE m Aad mo m DO. I SEE REVERSE FOR EXPLANATORY LANGUAGE