HomeMy Public PortalAbout5812-5814TEMPLE CITY BLVD_Certificate of Occupancy APPLICATION FOR OCCUPANCY INSPECTION
FOR APPLICANT TO FILL IN (P.rint or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
o BUILDING ,S$ `4, ,•��� �� G �IVo�- / BUILDING AND SAFETY-DIVISION
ADDRESS
CITY1-7p, BUILDIN.
Te—IKP It- CL ZIP q p Q ADDRESS
SIZE OF LOT NO. OF SLOGS. LOCALITY
NOW ON LOT
tt NEAREST
TRACT /n BLOCK LOT�W.�� 'CROSS ST,
``�� 'ASSESSOR'
OWNER $+1� SQrrJ�t� N�L'2,4s¢) MAP BOOK PAGE PARCEL
O / DISTRICT TYPE FIRE SED B
ADDRESS 5612. -Te-mPIM C-L ISLVA— CONSTZONE
.
CITY
Tek'plL Cl 61VOL ZIP Oil Z$D USE ZONE MAP
SIZE OF _ N0. OF � NO. T! - '
"
SPECIAL
EXISTING BLDG. STORIES 1��2— CONDITIONS
PRESENT USE OF BUILDING BLDG. SETBACK FROM
FRONT PROP. LINE OF (STREET)
HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING
NO. PARKING FRONT PROP. LINE HIGHWAY WIDTH
SPACES PROVIDED i +
BLDG. SETBACK FROM
EASON .FOR INSPECTION REQUEST SIDE PROP. LINE OF (STREET) a
C
HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF XISTIN Q:
SIDE PROP. LINE HIGHWAY WIDTH
_ C
Li
4
CORNER CUTOFF YES NO
. Z
• PROPOSED MAX. OCC. OCCUPANCY GROUP
AS VERIFIED T�?i OCCUPANT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LOAD
APPLICATION AND STATE THAT THE'ABOVE IS COR- EXIT HAR
RECT. DWARE:
NO. OF EXITS. NO SPEC. KNOWL. ❑
SIGNATURE OF 6, p/. PANIC DEVICES ❑
APPLICANT Qi n
PARKING
ADDRESS REQ'D o
q61� f- �.v� SPACES PROVIDED
P"61 "CAL I
ZIP 6��IV
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PHONE
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HAR"tt�l(�—BfZti4N —EN�fntEER FINAL �/1 BY "i
DATE r/T'
APPLICATION VALIDATION CK. M.q. CASH
905ft 2940 0 .00a
76A662-CE992 9/74
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