HomeMy Public PortalAbout4923 BALDWIN AVE_Certificate of Occupancy__ (2) wv S j
78A662 CE992 10 71 �
APPLICATION F OCCU CY IN
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUI LO NG /
ADDRESS �lw e
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
(Print or type only)
I'4/ DISTRICT NO PROC
ol
BU
ADDRESS V
LOT NO pQ?-t 0� 6 �, BLOCK USE ZONE NOP 0
PECIAL
TRACT 522-/ SIZE OF LOT 6 _ I CONDIITTIONS
/� TEL
OWNER IyVRRW.. -N O
�oses Rt BL SETBACK FROM
ADDRESS FR NT PROP LINE OF (STREET)
CITY.CI}a C /'t =[.r T PE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
HI HWAY WIDTH FROM C L
SIZE OF NO OF
EXIS BLDG STORI +
PRESENT US F BUILDING BLDG-SETBACK FROM (STREET)
SIDE PRO F
TYPE OF JEXISTING SETBACK HIGHWAY + - TOTAL
HIGHWAY WIDTH FROM C L
NO OF EXISTING BUILD( S
ON LOT AND USE + _
CORNER CUTOFF YES❑ NO ❑
NO PARKING V
SPACES PROV
OCCUPANCY GROUP ] a
v
PROPOSED USE OF BUILDING OCCUPANT LOAD a
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CO✓,gP—Gn TIO EXIT HARDWARE
No Spec Knowl ❑
Panic Devices ❑
PROPOSED MAX OCC NO OF EXITS
PARKING REQ D I� PROVIDED
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS SPACES
APPLICATION AND STATE THAT THE ABOVE IS COR
RECT
SIGNATURE OF
APPLICANT V/v'
ADDRESS
(�-t�v,
Q/f J 7 (? APPROVAL DATE INSPECTOR
ZIP SIGNATURE
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PHONE 2.bf 7��1 6 /1 FINAL APPROVAL
APPLICATION VALIDATIONCK0 CASH
576r--APR 1722A 1 8 0 0 ♦�36