Loading...
HomeMy Public PortalAbout___ 78A662 CE992 477 APPLICATION FOR OCCUPANCY INSPECTION FOR APPLICANT TO FILL IN BUILDING (Print or type only) ADDRESS ��;ele7l BUILDING �(�ii/ �/ /1r,yam. LOCALITY ADDRESS 7 7r/7/V '4 rA G— T✓r(/G p CITYIEO� (,�� NEAREST ZIP ?/?O Q CROSS ST SIZE OF LOT {� NO OF BLDGS / ASSESSOR yV /r�D NOW ON LOT MAP BOOK PAGE PARCEL DISTRICT PE FI RE S�� 1,ONST ZON P CE SED BY : iLTRACT 90 �� BLOCK LOT NO � F OWNER AJ/ NOL U ZQNE MAP �/Z? NO � l ADDRESS *f/f( SPECIAL CONDCITY���f� ` 4 ZIP�f/7Ba BLDG SETBACK IOM NS SIZEOF OF G7 FROM PROP LINE OF r r (STREET) EXISTING BL STORIES HIGHWAY + YARD= TOTAL SET BACK FROM" TYPE OF IXWwG PRESENT USE OF ILDING FRONT PROP LINE HIGHWAY WIDTH + — BLDG SETBACK FROM NO PARKING SIDE PROP LINE OF (STREET)l c SPACES PR DED E. HIGHWAY + YARD— TOTALSETP BACK FROM TYPE A WIDTH — SIDE PROP UNE HIGHWAY w�orH O REASON FOR INSPECTION REQUEST t + — W a CORNER CUTOFF YES NO r OCCUPANCY GROUPla-3 OCCUPANT AS VERIFIEDLOAD, EXIT HARDWARE PRO SED MAX OCC NO OF EXITS NO SPEC KNOWL ❑ I HER Y ACKNOWL E TH T I HAVE READ THIS PANIC DEVICES ❑ APPLIC TION ANDS ATETH T THE ABOVE IS COR RECT PARKING SPACES REQ D PROVIDED Sl(.NATU APPLICANT FINAL DATE � ADDRESS 1(Q/� �� (J Within the scope of this inspec T / tion the Building Official may ZIP :approve minor corrections or Iterations of an existing struc ture involving work of a build PERMIT FEE r mg plumbing mechanical or PHONE Selectrical nature ISSUANCE FEE C;2 7 63pp 37 t TOTAL FEE APPLICATION VALIDATION CK C11-9 ` 304�l�11G 1522 D � 'P L,102