HomeMy Public PortalAbout4814 AGNES AVE_Building_8/15/1978_convert garage back to original use 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