HomeMy Public PortalAbout5918 TEMPLE CITY BLVD_Certificate of Occupancy APPLICATION F OC x PANCY INSPECTION
COUNTY OF LOS ANGELES
'L) APPLICANT, TO FILL IN (Print or'type only) DEPARTMENT OF COUNTY ENGINEER
BUILDING � BUILDING AND SAFETY DIVISION
ADDRESS
D � BUI.LDING
AM
CITY L _ yQ ZIP %' ADDRESS 8
SIZE OF LOT `i v� N0, OF BLDGS. LOCALITY
NOW ON'LOT
NEAREST
TRACT BLOCK LOT NO. CROSS ST.
TEL ASSESSOR
OWNER • C NO.p � �� DISTRICT TYPE MAP BOOK I PFIRE CE ED BYAGE ARCEL. _
ADDRESS �' d� 0 CONST. ZONE
rJ / —3
CITY L ZIP /Q��1
a: tJ USE ZONE MAP
SIZE OF N0. OF N0Q d
EXISTING BLDG. , STORIES �Z/ SPECIAL.
CONDITIONS
PRESENT USE OF BUILDING( � `E,p.. BLDG. SETBACK FROM
CG7 V;g FRONT PROP. LINE OF (STREET)
HIGHWAY + YARD - TOTAL SETBACK FROM TYPE OF EXISTING
N0. PARKING FRONT PROP. LINE HIGHWAY WIDTH e
SPACF,6 PROVIDED + _ L
BLDG. SETBACK FROM
REASON FOR INSPECTION REQUEST SIDE PROP. LINE OF (STREET)
HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTINGY
SIDE PROP. LINE HIGHWAY WIDTH 0
V
�• 0 + -
CORNER CUTOFF YES NO
PROPOSED MAX, OCC, OCCUPANCY GROUP
AS VERIFIEDly� OCCUPANT
�� ,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LOAD
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT. EXIT HARDWARE:
NO. OF EXITS NO SPEC. KNOWL. ❑
SIGNATURE OF
PANIC DEVICES ❑
APPLICANT OAWA M -141_� -
_ PARKING
ADDRESS r` SPACES REQ'D PROVIDED
Aw
ZIP
PHONE !
MAKE CHECKS PAYABLE TO:
HARVEY T. BRANDY COUNTY ENGINEER DATE BY
/ " A.PPLICATI"ON VALIDATION . CK. M.O. CASH
_ 7.9`1 A.NOtf• 19.4 0.0 - tt' .� d AW
16AG62-CE992 12-73