HomeMy Public PortalAbout9328 BROADWAY_Certificate of Occupancy__ APPLICATION. FO CCUPANCY INSPECTION
FOR APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BU I LOINc /�� q Q / 7/,, BUILDING AND SAFETY DIVISION
ADDRESS r/J Or-/l Volt-i L BUILDING
CITY ✓ ZIP ADDRESS
NO. OF SLOGS. LOCALITY
SIZE OF LOT NOW ON LOT
dH /Yw _�7 NEAREST =PAGE
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BLOCK LOT N0./ / CROSS ST.
_ / ./ ([f—/ ASSESSOR
OWNER���//.' /`� M�L(/� NOL MAP BOOK PAGE PARCEL
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ADDRESS
-ADDRESS CONST. ZON
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CITY /J;J/I ZIP A
"� ZONE MP
SIZE OF R•L' NO. OF Z MA OC�p�O�J
EXISTING BLL' STORIES IJIJ SPECIAL
N' CONDITIONS
PRESENT USE OF ti DING BLDG. SETBACK FROM
FRONT PROP. LINE OF __!�—(STREET)
HIGHWAY } YARD o TOTAL SETBACK FROM TYPE OF E%I5TIN
FRONT PROP. LINE HIGHWAY WIOTH
N0. PARKING
SPACES PROV 0 + 2I-O� o O }
O
U
BLDG. SETBACK FROM �
REASON FOR INSPECTION REQUEST SIDE PROP. LINE OF (STREET) c
HIGHWAY } YARD v TOTAL SETBACK FROM TYPE OF WIDTH W
SIDE PROP. LINE HIGHWAY WIDTH a
CORNER CUTOFF YES NO
PROPOSED MAX. OCC. OCCUPANCY GROUP
AS VERIFIED OCCUPANT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LOAD
APPLICATION AND STATE THAT THE ABOVE IS COR- _ EXIT HARDWARE:
RECT.
N0, OF EXITS O NO SPEC. KNOWL. ❑
SIGNATURE OF I��C^ PANIC DEVICES E]APPLICANT ///_ ^"✓'✓�
�✓ 1 � �/� PARKING gEO'D PROVIDED =
ADDRESS Qj� SPACES •
ZIP F I �..�/ O �✓ ��IQ�/IC�//�iT 6.G^1//I.i�//__- _
PHONE
AIA KE CHECKS PAYA/iLE 7'O: V VVV
HARVEY T. BRANDT. COUNTY ENGINEER FINAL BY
DATE
APPLICATION VALIDATION Lcs. M.O. CASH
5 5 (i.,JAN 23 2,2 U 1 8.0-0 a
76A662-CE992 3/73 `^' r