HomeMy Public PortalAbout5837-5839TEMPLE CITY BLVD_Certificate of Occupancy In
APPLICATION FOR PA Y INSPECT10'
ON. '
FOR APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES s
DEPARTMENT OF COUNTY ENGINEER
FBN BUILDING AND SAFETY DIVISION
BUILDING
ZIP1� QADDRESSLOT //_s NO. OF BLDGS. LOCALITY
t7 NOW ON LOT
_ NEAREST
TRACT BLOCK b. CROSS ST..,
T. _
�y AS'SESSOR
OWNER (®"
TEL.. MAP BOOK PAGE PARCEL
C-• ' A NO. DISTRICT TYPE FIRE8C-ESSED BY
ADDRESS o�� /• _ CONST. ZONE
d v [iLu..C�i �/
-:CITY ZIP USE-ZONE MAP
SIZE OF N0. OF NO.
EXISTING BLDG. STORIES 0 �v SPECIAL
CONDITIONS-
PRESENT_ USE'OF BUILDING BLDG. SETBACK FROM
FRONT PROP. LINE OF (STREET)
HIGHWAY t YARD = TOTAL SETBACK FROM TYPE OF EXISTIN
N0. PARKIN FRONT PROP. LINE HIGHWAY WIDTH c
SPACFS PROVIDED + = Lt
BLDG. SETBACK FROM
REASON FOR INSPECTION REQUEST SIDE PROP. LINE OF (STREET) F
HIGHWAY F YARD = TOTAL SETBACK FROM TYPE OF XISTIN JiIIA 0
SIDE PROP. LINE HIGHWAY WIDTH
V
+ _
CORNER CUTOFF YES NO
PROPOSED MAX. OCC. OCCUPANCY GROUP
AS VER.IFI'EDF � OCCUPANT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LOAD
APPLICATION AND STATE THAT THE ABOVE IS COR- EXIT HARDWARE:
R ECT.
N'0. OF EXITS NO SPEC. KNOWL. ❑
SIGNATURE OF r PANIC DEVICES ❑
APPLICANT Q
ADDRESS /O PARKING REQ'DPROVIDED
(� SPACES
F�
ZIP 9/73 3 "
PHONE
MAKE CHECKS PAYABLE TO:
HARVEY T. BRANDY COUNTY ENGINEER FINAL BY
DATE /
APPLICATION VALIDATION CK. M.0. CASH
4;4::S i�Jllili :1 0 -� .`7 G d�d
16A662-CE992 I2-73