HomeMy Public PortalAbout9307 DAINES DR_Certificate of Occupancy__ ;1 APPLICATION FOR CC•UPA CY INSPECTION
FOF-rAPPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING (� -BUILDING AND FETY DIVISION
ADDRESS 7
_ BUILDING �
CITY ZIP i l�p�"z ADDRESS O
SIZE OF LOT �r _ NO. OF SLOGS.! �-- LOCALITY
O «. NOW ON LOT -
�{ NEAREST
Cy
TRACT 'tV.4 BLOCK LOT Nb.,i CROSS ST.
ASSESSOR
OWNER NOL' P MAP BOOK PAGE PARCEL
s--�✓1�.� {.� DISTRICT TYPE FIRE P EP BY
. ZO
AODRESS �3CJ Awe-A,4-'r P4 !�,.� 0Q CONSTNE
CITYZIP USE ZONE MAP
SIZE OF j�° NO. OF NO. ,
EXISTING BLDG. O x STORIES SPECIAL
CONDITIONS
PRESENT USE OF BUILDING kA.,rAi rS,4--';P f�,� _Zle BLDG, ETBACK FROM
{A ••/ FRON PROP. LINE OF (STREET)
�daC HIGH AY + YARD = TFRONT PROP.SETBACKTAL FROM TYPE OF
HIGHWAY EIWIDTH '
N0. PARKING
NG
SPAC PROVIDED
— da
BLDG. SETBACK FROM
REASON FOR INSPECTION REQUEST -a SIDE PROP. LINE OF `� (STREET)
HIGHWAY } YARD = TOTAL SETBACK FRO TY-PE QF XISTIN
SIDE PROP. LINE IGHWAY WIDTH
+ = W
CORNER CUTOFF YES NO H
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-
R ECT. EXIT HARDWARE: -
NO SPEC. KNOWL. ❑
NO. OF EXITS
SIGNATURE OF4 .
PANIC DEVICES ❑
APPLPARKINICANT i
ADDRESS / 6 , / .�_
SPACES REQ'D PROVIDED
zip 9'1'77 / Iti9 �, '►STI
PHONE '157/ 4 o
(/ MAKE CHECKS PAYABLE TO:
HARVEY T. BRANDY COUNTY ENGINEER 0��'FINAL BY
DATE
APPLICATION VALIDATION CK. M.0. CASH
76A662-CE992 I2-73