HomeMy Public PortalAbout5919 TEMPLE CITY BLVD_Certificate of Occupancy 76AG62-CE992-6/77
APPLICATION FOR OCCUPANCY INSPECTION
FOR APPLICANT TO FILL IN BUILDING /
(Print or type only) ADDRESS
BUILDING _ `
ADDRESS LOCALITY
c! !� .
CITY r / Ip. 96 7, NEAREST
(� CROSS ST.
SIZE.OF LOT NO.OF BLDGS. ASSESSOR
NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT TYPEFIRE PPI-713 BY
TRACT BLOCK LAT NO. CONS ZONE
OWNER /rJ TEL.
K/ NO: USE ZONE MAP
ADDRESS �/ 3 NO �00
SPECIAL
COND°ITIONS
CITY ZIP
BLDG.SET BACK FROM
SIZEOF NO,OF FRONT PROP.LINE OF (STREET)
EXISTING BLDG. STORIES
HIGHWAY + YARD= TOTAL SET BACK FROM TYPE OF IX DTH
PRESENT USE OF BUILDING FRONT PROP.LINE HIGHWAY WIDTH
BLDG.SETBACK FROM
NO. PARKING - SIDE PROP.)LINE OF (STREET)I, C
SPACES PROVIDED
HIGHWAY + YARD- TOTAL SET BACK FROM TYPE OF IXISIING C
SIDE PROP. LINE HIGHWAY WIDTH
_ F
REASON F INSPECTION REQUEST + G
0
CORNER CUTOFF YES NO
e
OCCUPANCY GROUP -� OCCUPANT
AS VERIFIED
LOAD
EXIT HARDWARE:
PROPOSED MAX.OCC. NO.OF EXITS NO SPEC.KNOW L. ❑
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PANIC DEVICES ❑
APPLICATION AND STATE THAT VE IS COR-
RECT.
Q PARKING:
SPACES REQ'D PROVIDED
SIGNATURE OF .��
APPLICANT E .v�-2— —// 1
.L / ! BY
DA
ADDRESS 3� .a
Within the scope of this inspec-
tion the Building Official may
approve minor corrections or
ZIP alterations of an existing struc-
ture involving work df a build- PERMIT FEE
zwor'53 nj, plumbing, mechanical or
PHONE 7''77 electrical nature. ISSUANCE FEE
TOTAL FEE
e
APPLICATION'VAr-IDATIONNo CK. M.O. CASH
— o o —
C)I 0 0 CA
0 0 N
OD. 0 d
NS