HomeMy Public PortalAbout9405 BLACKLEY ST_Certificate of Occupancy__ 76A662 CE992(REV 11178)2/79 / Q
APPLICA�n N FO CCUPANCY I PE TION
COUNTY OF LOS ANGELES • BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING ��
ADDRESS
BUILDING
ADDRESS4 L '' LOCALITY
CITY —7�—ZnC l T f P NEAREST
r /�JJ NO OF BLD, CROSS ST
SIZE OF LOT /_� � (- T NOW ON LOT ASSESSOR
C(� c, MAP BOOK PAGE AR EL
TRACT iA 8 OC�K+ / LOT NO DISTRICTT, TYPE FIRE P D BY
OWNERtq 1'J O►'l - J USlw1.
ADDRES59 Qr�CIfC�P USEZONE MAP
/1 /
NO
CITY TPG►t IP ` T �(e/,4- 'SPECIAL
SIZE OF �(/tiaRe NO OFA' J � CONDITIONS
EXISTING BLDG '9 P� Y ��-� STORIES /
b OCCUPANCY GROUP
PRESENTUSE / AS VERIFIED OCCUPANT
OF BUILDING.�G VLH S 6C{ ` LOAD 9
9
EXIT HARDWARE
NO PARKING NO OF EXITS NO SPEC KNOWL ❑
SPACES PROVIDED «/,-S
PANIC DEVICES ❑
REASON FOR / PARKING 'REQ'D PROVIDED
INSPECTION REQUEST nAIIII .P f' l' SPACESDATE /
o FINAL
a
PERMIT Within the scope of this In
FEE ' pectlon the Building Official may
ISSUANCE approve minor corrections or
FEE alterations of an existing struc
TOTAL ture Involving work of a building,
' PROPOSED MAX OCC FEE plumbing, mechanical or elec
tncal nature
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
APPLICATIO AND STATE THAT THE ABOVE IS APPLICATION VALIDATION
CORRECT
SIGNATURE OF
PERMITTEE
ADDRESS / R 0 9 6 3 A
^ TEL
CITY NO # 00,0022
BLDG SETBACKFROM FRONT
'
PROP LINE qE OF f (STREET) L 0 O'6 1.0 0
HIGHWAY + YARD - TOTALSETBACK
M EXISTING PROPLINEHIGHWAYY TYPE OF WIDTHO O o61,009
+ - 0626-80
BLDG SETBACK
FROM SIDE
PROP LNE OF (STREET)
HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
SIDE PROP LINE HIGHWAY WIDTH
®S
.N
76A662-Ge99275
APPLICATIONFO OCCUPANCY INSPECTION
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
15 0A
CITY
T n = NEAREST
ZIP CROSS ST
NO OFBLDGS ASSESSOR
SIZE OF LOT 02� NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT TYPE FIRE P ED BYt
TRACT BLOCK LOT NO CONST ZONE
OWNER NOLX
NE NAP
ADDRESS / (7
i �
CONDITIONS
CITY ZIP BLDG SET BACK FROM
SIZE OF NO OF FRONT PROP LINE OF (STREET)
EXISTING BLDG STORIES HIGHWAY + YARD = TOTAL SET BACK FROM TYPE OF EXISTING
FRONT PROP LINE HIGHWAY WIDTH
PRESENjUSE OF BUILDING
}
+ - a
C
BLDG SET BACK FROM U
NO PARKING SIDE PROP LINE OF (STREET) z
SPACES PROV D
= TOTAL SET BACK FROM TYPE EXISTING C
HIGHWAY + YARD
SIDE PROP LINE HIGHWAY WIDTH �
L
RE ON FOR INSPECTION REQUEST + - d
Cr
je- CORNER CUTOFF YES NO z
f OCCUPANCY GROUP OCCUPANT
AS VERIFIED LOAD
- EXIT HARDWARE
PROPOSED MAX OCC NO OF EXITS NO SPEC KNOWL ❑ i
1
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 40 z 40,
FINAL
DATE
ADDRESSiTy
,fJ c
V Illddd.� sf"
•
Within a scope of this Inspection
the Building Official may approve `I
minor corrections or alterations of
ZIP
an existing structure Involving work PERMIT FEE 3o
of a building, plumbing, mechanical
PHONE or electrical nature ISSUANCE FEE
TOTAL FEE
APPLICATION VALIDATION CK M 0
5,7 1r'-rkPP 8 2 2 ® 3 0.0 0 A�m
62,