HomeMy Public PortalAbout5811-5811 1/2-5813TEMPLE CITY BLVD_Certificate of Occupancy (2) 76A662-CEM 11n5
-'<APPLICATION FOR OCCUPANCY INSPECTION
COUNTY OF LOS ANGELES
` DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
(Print or type only) ADDRESS
q
A
DDRESS '-5
- BUILDING LOCALITY
NEAREST
ZIP t�b CROSS ST.
SIZE OF LOT NO.OF BLDGS. .7 ASSESSOR
NOW'ON LOT MAP BOOK PAGE PARCEL
DISTRICT TYPE FIRE PROCESSED BY
TRACT �� BLOCK LO 0 6" .,Q CONST. ZONE
• Cir
OWNER '
TEL , G�1 `[�
0Q O'I_LI D USE ZONE NO.
a
ADDRESS_,i,'eI ft Dkf et SPECIAL
C ZIP otn CONDITIONS
BLDG.SET BACK FROM
SIZE OF NO.OF FRONT PROP.LINE OF (STREET)
EXISTING BLDG. , STORIES TOTAL SET BACK FROM TYPE OF EXISTING
HIGHWAY + YARD FRONT PROF.LINE HIGHWAY WIDTH
PRESENT USE OF BUILDING
+ _ 0
C
BLDG.SET BACK FROM IL
NO.PARKING SIDE PROP.LINE OF (STREET) 2
SPACES PROVIDED
HIGHWAY + YARD= TOTAL SET BACK FROM TYPE OF EXISTING
SIDE PROP.LINE HIGHWAY WIDTH F
C
REASON.FOR INSPECTION REQUEST + - U
I U
CORNER CUTOFF YES NO e
OCCUPANCY GROUP L OCCUPANT
AS VERIFIED —Zi LOAD
EXIT HARDWARE:
PROPOSED MAX.OCC. NO.OF EXITS NO SPEC.KNOWL. ❑
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PANIC DEVICES E3APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT. PARKING : REQ'D� �R0VIDED=
IGNATURE O SPACES
APPLICANT FINAL BY
ADDRESS Ct
DATE
Within the scope of this inspection
the Building Official may approve
minor corrections or alterations of
ZIP G 1 1 �D an existing structure involving work PERMIT FEE
of a building, plumbing, mechanical
PHONE,246 SJ or electrical nature. ISSUANCE FEE
TOTAL FEE
APPLICATION VALIDATION CK. M.O. CASH
467; Jlii_ 8 4 0 B .C10. ABS