HomeMy Public PortalAbout4834 CAMELLIA AVE_Certificate of Occupancy__ APPLICATION FOCCUPACY INSPECTION
FOR APPLICANT TO FILLJN (Pant or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING / BUILDING AND SAFETY DIVISION
ADDRESS `1,'
BUILDING
CITY / ZIP ADDRESS
/ NO. OF BLDGS. LOCALITY
SIZE OF LOd 47Y -71
T •o x %/) NOW ON LOT L a.
/` NEAREST , _
TRACT /(,/(� �i ' BLOCK LOT NOS CROSS ST.
1 /�. ASSESSOR y _—
OWNER ,G�� I TEL'.Zy �SJ� MAP BOOK PAGE PARC EL -
l/ //ll L/ NO. DISTRICT TYPE FIRE OC SED BY -
ADDRESS �•V �'A. ]i�[ CONS ZONE N
CITY ZIP U 9E. MAP
SIZE OF N0.0 � NO. C
EXISTING BLDG, STORIES J6 SPECIAL
CONDITIONS
PRESENT USE OF BUILDING / BLDG. SETBACK FROM
-- FRONT PROP. LINE OF (STREET)
TOTAL SETBACK FROM TYPE OF EXISTING
HIGHWAY ' } YARD = FRONT PROP. LINE HIGHWAY WIDTH d
N0. PARKING _ O
SPAC PROVIDED + O
99
BLDG. SETBACK FROM O
REASON FOR INSPECTION REQUEST SIDE PROP. LINE OF (STREET)
HIGHWAY + YARD = TOTAL SETBACK FROM F
YPE OF XISTIN W
510E PROP. LINE GHWAY WIDTH
N
+ - z
CORNER CUTOFF YES NO
PROPOSED MAX. OCC. OCCUPANCY GROUP
AS VERIFIED � OCCUPANT
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LOAD
APPLICATION AND THAT THE ABOE IS COR- -
RECT. EXIT HARDWARE:
NO. OF.EXITS NO SPEC. KNOWL. ❑
SIGNATURE OF
PANIC DEVICES ❑
APPLICANT "
ADDRESS - •A' PARKING • REQ'0 E=:] PROVIDED D
SPACES
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Y.'�.ns=X— ¢'�. vc--.,✓ TO pec-yr' '
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ALI KF_' CHECKS PA YA 13 LE TO:
HARVEY T. BRANDY COUNTY ENGINEER FINAL
DATE
APPL ATION VALIDATION CK. M.D. ASH
53' 8' '4UP 222 U 1 8.il0A
76 Afi 62-CE992 12-73