HomeMy Public PortalAbout4811 DOREEN AVE_Certificate of Occupancy__ APPLICATION FOR OCCUPANCY INSPECTION
FOR APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING BUILDING AND SAFETY DIVISION
ADDRESS -'
Bu=
CITY ZIP ADDRESS •'
SIZE OF LOTNO. OF SLOGS. LOCALITY
SO )07 NOW ON LOT O { L
NEAREST I- .
TRACT I`� r BLOCK LOT 110. 1& CROSS ST.
ASSESSOR
OWNEA rL�tlJj u.retahi ,i I O. TEL.%;a1&-$`S�6 MAP BOOK PAGE PARCEL
a C NO. DISTRICT TYPE FIRE PROCESSED BY
ADDRESS /01
DDRESS , y'� CONST. ZONE
CITY Al-cad/GT/ ZIP USE ZONE MAP
SIZE OF N0. OF NO.
EXISTING BLDG. ORI ES �/ SPECIAL
CONDITIONS
PRESENT USE OF BUILD G BLDG. SETBACK FROM
FRONT PROP. LINE OF (STREET)
TOTAL SETBACK FROM TYPE OF EXISTING
NOHIGHWAY + YARD = FRONT PROP. LINE HIGHWAY WIDTH
. PARKING
SPACES PR )DEO
BLDG. SETBACK FR
REASON FOR INSPECTION REQUEST - SIDE PROP. LINE OF (STREET) �••
TOTAL SETBA OM TYPE OF XISTIN
- II HIGHWAY + YARD =
SIDE PROP. LINE HIGHWAY WIDTH U
ch eeh
+hernpi-ed ;h - o
E !piltay IF, U
CORNER CUTOFF YES NO d
y
Z_
PROPOSED MAX. OCC. OCCUPANCY GROUP
' AS VERIFIED OCCUPANT ,
LOAD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT. EXIT HARDWARE:
N0. OF EXITS NO SPEC.,KNOWL. ❑
SIGNATURE OF -
❑
APPLICANT .n J. �2b
PANIC DEVICES
/ PARKING
ADDRESS SPACES REOoDPROVIDED
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MAKE CHECKS PAYABLE 7'O:
HARVEY T. BRANDY COUNTY ENGINEER FINAL RY
DATE
APPLICATION VALIDATION CK. M.O. CASH
7SA662-CE99Z 8/75
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