HomeMy Public PortalAbout6019 AGNES AVE_Certificate of Occupancy_1/31/1979_ P
76 A662-CE992A-477 -
n. , A.RPU CCATM 1 FOR OCCUPAN GY NSPECTMN
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISI%;N
FOR APPLICANT TO FILL IN RUILDING
(Print or type only) ADDRESS U 1 �
BUILDING Ia V
ADDRESS NQS LOCALITY
NEAREST ✓ ('
CITY Elewi I C� ZIP '
-77V
CROSS ST.
�
I v NO.OF BLDGS. ASSESSOR
665�SIZE OF LOT t/ NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT TYPE FIRE P CES E BY
TRACT 6,5 BLOCK LOT NO.� 7 �J oQ CONST. V ZON� �rQ� �
OWNER kin t- G 'yp%mou TO. ��� USE ZONE MAP
ADDRESS` r ,`*2- I, o���I�P/�:,�7c,� / �SPECIAL )_00-7
CITY n� 1_ w\ b Zip�)8�� 7ADITIONS
I BLDG.SET BACK FROM
SIZE OF I NO.OF FRONT PROP.LINE OF (STREET)
EXISTING BLDG. 7 STORIES
I NG
HIGHWAY + YARD - TOTAL SET BACK FROM TYPE OF WITH
- FRONT PROP.LINE HIGHWAY WIDTH
PRESENT USE OF BUILDING _ld f t�jp
BLDG.SET BACK FROM },
NO. PARKING j ,y SIDE PROP.LINE OF (STREET)l n.
SPACES PROVIDED
HIGHWAY + YARD- TOTAL SET BACK FROM TYPE OF EXISTING
- SIDE PROP. LINE HIGHWAY WIDTH
O
REASON FOR INSPECTION REQUEST VA. l + -
W
CORNER CUTOFF YES NO a'
Cr
Z
OCCUPANCY GROUP
AS VERIFIED OCCUPANT
LOAD
NONv' &fid .� EXIT HARDWARE:
PROPOSED MAX.OCC. NO SPEC. KNOWL.
NO.OF EXITS � ❑
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PANIC DEVICES ❑
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT.
PARKING :
SPACES REQ'D P OVIDED�
SIGNATURE O
APPLICANT FINAL y
DATE o-G-
ADDRESS
12-1- 2
Within the scope of this inspec-
tion the Building Official may
approve minor corrections or
ZIP alterations of an existing struc-
ture involving work of a build- PERMIT FEE
ing, plumbing, mechanical or
O
PHONE e�ctrijul nature. ISSUANCE FEE 7
6,4 °o aa°o�� TOTAL FEE /
C)'APl'LICAICON VALI TION CK. M.O. CASH
�7 o
O O N
O O O N
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