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Home My Public Portal About6370 SULTANA AVE_Building__ DEPARTMENT OF COUNTY ENGIIVEm DIVISION OF BUILDING AND SAFETY ` 1 COUNTY OF LOS ANGELES NG WILLIAM J. FOX, .COUNTY ENGINEER APPLICATION CASSATT D. GRIFFIN, SUPT OF BUILDING FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING i DISTRICT NO. PLAN Ck.OR REc.No. PERMIT NO. ADDRESS ,- _ G7 �J R6CE1 ED BY DATE OF APDL. D ISSUEP LOCALITY g2w Y I iPt: 4 s NEAREST 9 a M CROSS ST ti p UILDING ADDRESS Q 0 r OWMAILNER LOCALITYI.. DDRESS NEAREST `Q�/� �/ { /Pp �. TEL CROSS ST. 6� CITY A,-AAAl �'7.+w� . NO. f jr ARCHITECT OR TEL. FIRE NO. OF 6 P ENGINEER V NO. ZONE I PLANS BLDGO. . t ADDRESS SETBACK LINE TEL. USE APPROVED CONTRACTOR NO. ZONEI BY DATE ADDRESS !r HOUSE NUMBERING LEGAL 7 I MAP NUMBER :?f1/ Q N6. ASSIGNED BY DESCRIPTION LOT NO. BLOCK TRACT /.2 _lYto,4CORRECTIONS NO OF BLOGS SIZE OF LOT I NOW ON LOT 3 O F• S�j 3 -3 A, USE OF : NO. OF EXISTING BLDG. .,#J ' FAMILIES DESCRIPTION OF WORE NEW ALTERATIONADDITION - __ o REPAIR DEMOLITION r SQ. FT. A NO.OF SIZE �! �� ROOMS TORIES � COVLL RF I COVERING USE OF TRUCTURE G, V L7 APPROVALS .INSPECTOR'S SIGNATURE. DATE. FOUNDATION:LOCATION FORMS, MATERIALS O I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP-'+ FRAME: FIRE STOPS, PLICATION AND STATE THAT THE INFORMATION GIVEN IS BRACING, BOLTS CORRECT. % I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE:LOCATION. AND STATE LAWS REGULATING BUILD/SING CONSTRUCTION. GAS VENT. DUCTS SIGNATURE OF , LATH, INT. PERM . LATH. EXT. ADOREae V h 1 PLASTER. INT. AUTHORIZED AGT. PLASTER, EXT. FEE' S J HOUSE NUMBER COR- RECT AND POSTED VALUATION FEE "'4 FINAL e9e99SA OS9 S 9-92 w..+s WORKERS'COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to selfI APPLICATION - O R U I L D I N G �P E RM I T insure,or a certificate of Workers'Compenstion Insurance,or • a certified copy thereofi (Sec. 3800, Lab. C.) Policy No. 230770 Company State Comp j COUNTY OF LOS ANGELES BUILDING AND SAFETY' ❑ Certified copy is hereby furnished. ' 71 BUILD FOR APPLICANT TO FILL IN ' ADDRESS 6370 Sultana -n Certified copy is filed with the county building inspec- i BUILDING tion department. I ADDRESS 6370 Sultana LOCALITY' TeMple C LY NEAREST Date 10/9/$0 Applicant �KS' LvJ CITY Lem le Cit 'ZIP CROSS ST. CERTIFICATE OF EXEMPTION FRONO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP,BOOK IPAGE PARCEL (This section need not be completed if the permit is for one /� + USE ZONE MAP TRACT �s V BLOCK LOT NO. / NO. � o o3 hundred dollars ($100)or less.) Q Y TEL. �t SPECIAL CL I certify that in the performance of the work for which this OWNER E wards N0.2$5-2759 t CONDITIONS DIST GROUP TYPE FIRE PROFESSED BY V permit is issued, I shall not employ any person in any manner ti so as to become subject to the Workers Compensation Laws. ADDRESS 6370 Sultana i�� CONST ZONE IM CITY Temple CitV ZIP �' a Date Applicant STATISTICAL CLASSIFICATION APT. CONDO. u NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. UJ Exemption, ydu should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS H Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be deemed revoked. - TEL' - BK. PG, VALIDATION CONTRACTORMontebello Rf . N6.722-6975 LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS BARr+ NO. d VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC. 1890.00 Professions Code, and my license is in full force and effect. CITY M CLASS ;.,19 $ SQ. FT. NO.OF NO.OF CHECK License Number- '248852 Lic.Class C-19 ' SIZE STORIES FAMILIES ONE ContractoMonJ--t- a 1QRJFgDate 1-0/9/Ro DESCRIPTION OF WORK Reroof existin NEKldM ElI am exempt from the licensing requirements as I am a ADD [O� licensed architect or a registered professional engineer ALTER ❑ FINAL acting in my professional capacity (Section 7051, REPAIR DATE Business and Professions Code). USE OFFINALn r EXISTING BLDG. dWellin DEMOL ❑ By Lic.or Reg.No. Date APPLICANT TEL. OWNER-BUILDER DECLARATION i (PRINT) _ NO. I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): PRESENT El 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 kADDRE 2 2 P. 7044, Business and Professions Code). TEL. ❑ I, as owner of the property, am exclusively contracting CTOR NO. 0 0 0 0 0 1 with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code). 2 0 0 3 k 0 0 ED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY CK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for T o 0 0 3 (( � the performance of the work for which this permit is issued I(Sec. 3097, Civ. C.). I O.2 1 —8 Lender's Name $ Permit Fee 27.00 Lender's Address I certify that I have read this application and state that the Issuance Fee 7,00 above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee and ereby a thorize representatives of this County to enter u the a e- ntoned property for inspection purposes. g Pres a 10/9/80 SEE REVERSE FOR EXPLANATORY LANGUAGE D Sign lure of A is t r Agent Date ®s I • APPLICATION FORS,,BUILDING PERMIT yf r ' f .. COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING pAIDDRES! A I hereby affirm that I have a certificate Of consent to self insure, BUILDING ADDRESS �' /� W��A�T� or a certificate of Workers'Compensation Insurance,or a certified l93` Q VI A copy thereof(Sec.3800,Lab.C.) oldC 1 1 1 �,�LE crT y ZIP 9 I' S Policy No. Company 1 LOCALITY SIZE OFT ,1 17.OF BLDGS.NOW ON LOT T ElCertified copy is hereby furnished. f Qo V 1420 TW 0 NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection T SN�S� Z BLOCK LOT NO. E V�O� department. i� USE ZONE MAP NO.AS—.6 war 4. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL O� r 382 n)q �_ SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWWR f�ENY �.i M A TEL N . _C��loz COMPENSATION INSURANCE /1 WITHIN 1000 F.T.OF SCHOOL? YES No (This section need not be completed if the permit is for one hundred ADDRESS/ dollars($100)or less.) 07,4 l�'isd Lr m DISTR,IC/T GROUP TYPE CONST FIRE ZONE PROCESSED BY I certify that in the performance of the work for which this permit AN &Aer ZIP 4 1 5 /' _ is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL NO. d yam/ become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO.42-12�1 DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR I TEL NO. SET BACK YARD HWY PROP LINE WIDTH LJJ Compensation provisions of the Labor Code, you must forthwith QNEQ B� I— � Dc o G1� 1%q61-(--702. FRONT comply with.such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION SIDE CITY LIC.CLASS PL I hereby affirm that I am licensed underprovislons of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES O a , Professions Code,and my license is in full force and effect. NEW �. BK PG �� U License Number Lic.Class DESCRIPTION OF WORK ADD ❑ VALUATION C Contractor Date I CL05ET. KEPAR_ADD`PON ALTER ❑ $ "loco06 C 2 LAUNDIZY'F !L I L QE 0 ❑ I am exempt under Sec. REPAIR pf $ C BAP.C.for this reason DEMOL ❑ LDMA P/C# V Date: USE OF EXISTING BLDG. URM ❑ U Signature APPLICANT(PRINT) TEL NO. LDMA Perm# 23 I, as owner of the property, or my employees with wages as O AT a Or their sole compensation, will do the work and the structure is ADDRESS DATE not intended or offered for sale (Section 7044, Business and FINAL 3307 50a50 Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ❑ 1, as owner of the property, am exclusive) contracting With OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Y Y 9 AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY < 1 licensed contractors to construct the project (Section 7044, a Business and Professions Code.) ves❑ No El At 'T a T WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH y3'307 282.54 CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR GUIDELINES i� ITEMS I hereby affirm that there is a construction lending agency for YES[I No El1 ITEMS ��7 a the performance of the work for which this permit is issued(Sec. '' a IHAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMDPERMITTING TOTAL 333.a 04- N 3097,Civ.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS333.04 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. CHECK 0 Lender's AddressLJA ( I. O1NNEfl OR AGENTHAhi��. .011 LFI o I certify that I have read this application and state under penalty O of perjury that the above information is correct.I agree to comply P.C.FEE 10 PERMIT FEE N with tallunty ordi ces andStatelaws relating to building tiIJS 0000_000f 3/31/93 < and her authorize representatives of this County ISSUANCE FEE enthe abo mantioped property for inspe 'on p r oses. 7d. d Cil{ � I AM 9;34 31 INVESTIGATION FEE TOTAL FEE n m p2 t` SIgI,aIYn,W t W Date SEE REVERSE FOR EXPLANATORY LANGUAGE