HomeMy Public PortalAbout6402 SULTANA AVE_Building__ VZPARTMENT OF BUILDING AND SAFETY Al'1'l.1GA 11V1Y run vram m1 i
COUNTY OF LOS ANGELES � ' ® '
WM. J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
ILDINGJ/, Ne����4,.� DISTRICT NO. PLA4�N�K.NO. PERMIT NO.
ADDREBB
LOCALITY i�'!e'/;.�A �r�i, ,i7^�,i'!" RECEIVED BY DATEOrAPPL. DATE ISSUED
NEAREST 3 �i 3 S d
CROBB ST. 3 Ix
BUILDING
OWNERl' „,.rte%1 ADDRESS
MAIL LOCALITY A?- t�
ADDREBB f✓�' Il_'+c
TEL. /i NEAREST
CROSS ST.
CITY NO.f_ f•<<i�[l O mz' E?Al
! FIRE NO.OF TYPE - / GROUP
ARCHITECT OR TEL ZONE+---- PLANS
ENGINEER NO.
BLDG. ORD No
ADDRESS BETBACK LINE �fl s/I � ✓� '+
r
APPROVED
CONTRACTOR NO. BY DATE
USE �1 APPROVED
ADDRESS ZONE x(/ BY DATE
LEGAL - �, o .� CORRECTIONS
DESCRIPTION LOT NO. B6GCKr_.
� t _ moi f
TRACT low, 7;, /t� it s: / d �' _ -7
SIZE OF LOTX31 NO.OF SLOGS.
NOW ON LOT �
-'ti •
USE OF / NO.OF NO.OF
EXISTING BLDG. / FAMILIES ROOMS
DESCRIPTION OF WORK
NEW ALTERATION ADDITION O
A
REPAIR MOVING DEMOLISH p
Sq.FT. NO.OF / Z
SIZE ROOMB J STORIES
WALL ROOF
_COVERING J7`/�CC(j I COVERING i%'r! '-P
USE OF NEW f
BUILDING fLj t? fjjQ/yJ
/C -s J z>'F// C e'--
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE 18 CORRECTPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION
FORMS,MATERIALS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
FRAME: FIRE STOPS,
SIGNATURE OF I �s _011j;w - BRACING,BOLTS
PERMITTEE 111 +� !
LATH, INT.
AUTHORIZED `A/ LATH, EXT.
7GA63BA-3 7-49 $ d0 p,D. PLASTER,INT.
FEE PLASTER,EXT.
VALUATION S Sa J�
FEE , FINAL MAXIMUM ACCOMPLISHED 8-I5-5I
DEPARTMENT OF BUILDING AND SAFETY' APPLICATION FOR PERMrr
COUNTY OF LOS ANGELES T, p ��p
WM. J. FOX, CHIEF ENGINEEL R N
FOR APPLICANT TO FILL IN f FOR OFFICE USE ONLY
DDRE8NG
8 +^, /�/, �J �^,��j fl/l,,f' DISTRICT NO. PLANCK. N0. PERMIT NO.
OCALITY Jf Jv'I,� l_h a iJ R• ABY DATE OF AP¢PPLL. e�DATE ISSUED
EAR ST o-z }� f 2 !,,-o ` ,A 7—.,o' 'e�-s
'ROSS ST. f�9 n_ (h'&A) .,
BUILDING /
OWNER �'f`'.' � J. .�/.!L'F11...�. .,f��� ADDRE89 Y / 0 C�'Pe,¢is'Z,•���, /`�"
MAIL 1 J�
ADDRESS rryl a �. I _ LOCALITY
Tr
CITY 9 r1°�ia 47/f�LS�ut. i � � ! CR083
NO: 9T.
f/ FIRE NO.OF TYPE—I GROUP
ARCHITECT OR TEL. ZONE�I-PLANS--- "®�
ENGINEER NO. ��`+O�
BLDG. ORD. NO.
ADDRESSSETBACK LINE
APPROVE
CONTRACTfjO�RJi� t�• Gf I �r:)f7J`;' fe1f NOLS �If�/Wiry• til(} s 8Y DATE
ADDRESS 1 1 /+r(1'� ,f�P'A�}" �� t/ A ZONE ByUSE DATE DATE
DE CERIPTION I LOT NO.GAL I BLOCK CORRECTIONS
y'q- Ji
TRAC
SIZE OF LOT' I ADW ON LOT
USE OF I NO.OF 1 I NO. OF
EX (�
ISTING .BLDG. FAMILICS / ROOMS
DESCRIPTION OF WORK
NEW ALTERATION �_d
ADDITION O
REPAIR MOVING DEMOLISH p
sq. FT. ► / jfA"rNO.of
SIZE, _FOOMS �j'. STORIES r
WALL ROOF' fl L�i
COVERING.�() yR�,L� I COVERING
USE OF NEW /j_�• / f � I'
BUILDING
APPROVALS
1 HEREBY. ACKNOWLEDGE THAT I HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE 18 CORRECT FOUNDATION: LOCATION, �i SPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS l li S 0>10
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS,
SIGNATURE OF BRACING, BOLTS A,1lLVul I' y
OWNER '
�j� LATH, INT.:
AUTHORIZED AOT.-K eEl =4L° �+" �► 11 � 1>�� l
+ LATH, EXT.: `�
P. C.S PLASTER, INT.
FEE PLASTER, EXT.
VALUATION S 00
FEE FINAL
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ARiELES' BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN-. ' �(�}J�ApREs�S,
I hereby affirm that I have a certificate of consent to self insure, BUIL ADDRESS O
or a certificate of rkeB'C mpensation Insura ce, a c Ified CITY ZIP �?
copy them' a C.) LOCALITY
Policy N�I Comp SIZE OF LOT NO.OF BLDGS NOW ON OT
❑ Certified copy is hereby furnished. l
NEAREST C SS ST
❑ Certified copy is filed with the county build i�IJRq a TRACT BLOCK LOT NO.
/department. f USE ZONE MAP NO.
y Dat plicant ASSESSOR BOOK PAGE PARCEL
5 S� o/ 0 Z SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FSGM WORKERS' OWNER TEL NO.
COMPENSATION INSURANCE 44 s;0 :117 WITHIN 1000 FT.OF SCHOOL? YES NO
(This section need not be completed if the permit is for one hundred ADDRE
DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY
dollars($100.)or less.) Az
CITY ZIP
I certify that in the'performance of the work for which this permit 7 7r _
is Issued, I shall not employ any person in any manner so as to ARCRITE OR NGINEER TEL NO.
become subject to the Workers'Compensation Laws. �r S-� _,/ ' STATISTICAL CLASSIFICATION APT CONDO
Date Applicant ADDRESS c 6 CLASS NO. DWELL UNITS
N677CE TO APPLICANT If, after making this Certificate of J • Y f`i t ' REQUIRED TOTAL SETBACK FROM EXIST
Exemption, you should become subject to the Workers' CONTRACTOR TEL NO. SET BACK' YARD HWY PROP LINE WIDTH
Compensation provisions of the Labor Code, you must forthwith FRONT
comply with such provisions or this permit shall be deemed revoked. ADDRESS .V LIC.NO. _ P U
LICENSED CONTRACTORS DECLARATIONS SIDE
CITYLIC.CLASS P L
I hereby affirm. that,I am licensed underprovisions of Chapter 9 � T_-1 mmm SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OFSTORIES r NO.OF FAMILIES
Professions Code, i full force an effect. NEW BK PG }
DESCRIPTIO F WOKALUATION , C
EL
License Number Lic.Class ! ADD Jr� C
Contractor Date + 3 ALTER El $$ ,6 9— d�'v0 C:
_ REPAIR 11 _C
❑
❑'1 am exempt under Sec. d, , M
B&P.C.for this reason DEMLDMA P/C#
USE OF EXISTING BLDG. URM ❑ /a/
e_ y tf
Signature APPLICANT(PRINT) TEL NO. LDMA Perm# +�I
❑ i, as of the property, or y employees with wages as Z ' (`j
their sole compensation, the work and the structure is ADDRESS O' °
not intended or offs r sale (Section 7044, Business and FINA(LD//�T�E / Q. _101.50
Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING•OCCUPANT HANDLE A HAZARDOUS MATERIAL r� -a '-i - }'7 97
f ❑ I, as owner of the property, am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Q 330 L i�t°
Y Y g AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY 1
licensed contractors to construct the project (Section 7044, W4404 ~' .4-ITEMS
Business and Professions Code.) YES❑ No❑
WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING 725- 47�"
�'€"
' OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH -TOTAL
TS.F 1 OTA!'iL
CONSTRUCTION LENDING AGENCY COAST AIR OUAUTY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKUST FOR
GUIDELINES. CHECKI.,.+,.11 725.47
I I hereby affirm that there is•a construction lending agency for YES❑ NO❑
C11 the performance of the Work for Which this permit is issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 't�HN�GE NO °
3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE,
Cq TITLE 2.CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS
Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD.
aLender's Addrass
OWNER OR AGENT
I o I certify that I have read this application and state under penalty 324M I Aril:�473
c
of perjury that the above information is correct.I agree to comply P.C.FEE ,r ,�� PERMIT FEE n r
C4 with all county o e and State laws relating to building ��� d a
constructioe, by thorize representatives of this County ISSUANCE FEE. ��I�O
m to enter t e abo tioned property for inspection purp03 s
m 7 INVESTIGATION FEE TOTAL FEE 2
n ft a Ap�Swn a Z_.
SEE REVERSE FOR EXPLANATORY LANGUAGE