HomeMy Public PortalAbout9241 BLACKLEY ST_Certificate of Occupancy__ 76A66Z-CE992A- 477 �
APPLICA, ®N F ®CC6�A' NCY WSPECTI®N
' K COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
(Print or type only) ADDRESS /
BUILDING
ADDRESS LOCALITY
CITY ' _ C _
Wti VZIp NEAREST tQ�
l � QlJ CROSS ST
' ASSESSOR
SIZE OF LOT-/ x ! NO OF BLDGS NOW ON LOT MAP BOOK PAGE PARCEL
V / a
DISTRICT TYPE FIREPR SED B
TRACT // 2� BLOCK LOT O I CONST ZONE
OWNER _ TEL , y ' �/-1L�/{
USE ZONE MAP
_
NO
ADDRESS v ��k `/
Y I SPECIAL
CONDITIONS
CITY I '% ZIP _ BLDG SET BACK FROM
SIZE OF NO OF FRONT PROP LINE OF (STREET)
EXISTING BLDG STORIES '
HIGHWAY + YARD - TOTAL SETBACK FROM TYPE OF 'WIDTH
WIH
PRESENT USE OF BUILDIN - FRONT PROP LIFE HIGHWAY WIDTH
BLDG SETBACK FROM
NO PARKING SIDE PROP LINE OF (STREET)I Q
SPACES PRO ED
HIGHWAY + YARD= TOTALSET BACK FROM TYPE OF IXLSrWG V
SIDE PROP LINE HIGHWAY WIDTH
O
REASON FOR INSPECTION REQUEST +
w
CORNER CUTOFF YES NO a
OCCUPANCY GROUP
AS VERIFIED OCCUPANT
LOAD
EXIT HARDWARE
PROPOSED MAX OCC
NO OF EXITS NO SPEC KNOWL ❑k
'I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PANIC DEVICES ❑
APPLICATION AND STATE THAT'THE ABOVE IS COR-
RECT PARKING'
SPACES REQ'D� PROVIDED ,
` SIGNATURE OF
APPLICANT FINAL ./ B
DATE T
ADDRESS 1
Within the scope of this Inspec-
�ition the Building Official may
-� LV approve minor corrections or
ZIP alterations of an existing struc-
ture involving work of a build- PERMIT FEE
Ing, plumbing, mechanical or
PHONE96 V`✓� lectrical nature ISSUANCE FEE / '
.2 TOTAL FEE /�/
APPLICATION VALIDATION <�.. ---__M o CASH
091s €? .3.6j: a 61. 0a �