HomeMy Public PortalAbout5464 BALDWIN AVE_Certificate of Occupancy__ 76A662-CE992A- 4/77
APPLICATION FOR OCCUPANCY INSPECTION
- COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION q
F FOR APPLICANT
pe o FI LL IN BUILDING
(Print or type only) I ADDRESS
BUILDING LOCALITY d�
ADDRESS,,
CITY teta_-,.,'(„rNEAREST
_c—)-'� / ZIP ( C� 1 CROSS ST. oily
SIZE OF L.OYYT-1'�,T�.,4[L ®S' NO. OF BLDGS. ASSESSOR
NOW ON LOT i MAP BOOK PAGE PARCEL
( DISTRICT TYPE FIRE rSSEID)BY�
TRACT _ s� 7 BLOCK LOT NO. � CONST ZO
OWNER R(i4, _ TEL.�,f (� J_
��24'1J/ N0. 7 `��ll `�� IUSEZONE NOP rJCC�/U I
ADDRESS 54 /y 1-v SPECIAL
CITY ZIP •��/�J'✓ CONDITIONS
BLDG.SET BACK FROM
SIZEOF NO.OF FRONT PROP. LINE OF (STREET)
EXISTING BLG, (STORIES
�. HIGHWAY + YARD TOTAL SET BACK FROM TYPEOF IX,.,, .G
PRESENT USE OF BL.' DING FRONT PROP.LINE HIGHWAY WIDTH
BLDG.SET BACK FROM
NO. PARKIN - SIDE PROP.LINE OF (STREET)(
SPACES P,, VIDED O
+
HIGHWAY + YARD — TOTAL SETBACK FROM TYPEOF ExLMNG V
M�' — SIDE PROP. LINE HIGHWAY WIDTH
O
REASON FOR INSPECTION REQUEST + U
w
CORNER CUTOFF YES NO
E;
OCCUPANCY GROUP
AS VERIFIED OCCUPANT
[Y fU LOAD
EXIT HARDWARE:
PROPOSED MAX. OCC. NO SPEC. KNOWL.
I NO.OF EXITS � ❑
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS �I PANIC DEVICES ❑
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT.
.I PARKING REQ'D PROVIDED
SPACES
SIGNATURE OF �>^J
APPLICANT / FINAL
J DATE
ADDRESS
5— j C 0—A.I I ��45
^lam/ Within the scope of this inspec-
tion the Building Official may /
approve minor corrections or
ZIP C alterations of an existing struc-
ture involving work of a build- PERMIT FEE L
ing, plumbing, mechanical or
PHONE 4 electrical nature. ISSUANCE FEE
7 I
TOTAL FEE
APPLICATION VALIDATION CK. M.O. <"CASH''