HomeMy Public PortalAbout4520TEMPLE CITY BLVD_Certificate of Occupancy (2) r, APPLICATION FO_IR C9CCUPAfVCY INSPECTION
FOR APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING BUILDING AND SAFETY DIVISION
ADDRESS
J' E
CITY ZDDRESS
512E OF LOT NO OFOCALITYNOWONEARESTTRACT � BLOCK ROSS STSSESSOROWNER A /L f /�O w AP BOOK PAGE PARCEL
4 .41DISTRICT TYPE FIRE P D BY
ADDRESS CONCITY ZUSE ZONE MASIZE OF NO
EXISTINGBLDG . SPECIAL
CONDITIONS
PRESENT USE OF BUILDING r/�. BLDG SETBACK FROM
FRONT PROP LINE OF (STREET)
HIGHWAY } YARD = TOTAL SETBACK FROM TYPE OF ISTIN
NO PARKING FRONT PROP LINE HIGHWAY WIDTH
SPACES PROVIDED
} _
SLOG SETBACK FROM
REASON FOR INSPECTION REQUEST SIDE PROP LINE OF (STREET)
HIGHWAY } YARD = TOTAL SETBACK FROM TYPE OF ISTIN o
P101 ? eIle V/cG SIDE PROP LINE I HIGHWAY WIDTH S
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60
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CORNER CUTOFF YES NO - d
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2
PROPOSED MAX OCC OCCUPANCY GROUP � _
AS VERIFIED OCCUPANT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LOAD
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT EXIT HARDWARE
NO OF EXITS E] NO SPEC KNOWL ❑
SIGNATURE OF
PANIC DEVICES ❑
APPLICANT
ADDRESS ` /s PARKING SPACES REQ'D� PROVIDED
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PHON�W 76
MAKE CHECKS PAYABLE 70 '
HARVEY T BRANDY COUNTY ENGINEER FINAL, 7,� B4
DATE
APPLICATION VALIDATION CK M 0 CASH
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