HomeMy Public PortalAbout4905 ENCINITA AVE_Certificate of Occupancy__ 78 A862-CE992A-477
APPLICATION FOR 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
¢90�
BUILDING ' z - LOCALITY �l�y
ADDRESSNEAREST
CITY t�+ �l -ZIP f OO CROSS ST �. 4
O OFBLDGS ASSESSOR
SIZE OF LOT / /OOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT TYPE FIRE PROCESS D BY
TRACT ! LOCK LOT NO � CONST — Z22-
� � /�
J►L/^
t TEL`
OWNER 1 ZNO USE ZONE MAP
NO L
ADDRESS /I/,—/ SPECIAL
CONDITIONS-
CITY a ZIP - BLDG SET BACK FROM
SIZE OF NO OF / FRONT PROP UNE OF (STREET)
EXISTING BLDG STORIES
ING
HIGHWAY + YARD = TOFRON PROP LINE TAL SET BACK OM HIGHWAY HWAY E OF EX
PRESENT USE OF BUILDING
+ r= _ ,S L.OG (00
BLDG SET BACK FROM (STREET) C
NO PARKING /7 SIDE PROP LINE OF
SPACES PROVIDED G
-HIGHWAY + YARD= TOTAL SET BACK FROM TYPE OF E]KLSTQJG V
SIDE PROP LINE HIG.AY wmrrl Z
O
REASON FOR INSPECTION REQUEST + w
CORNER CUTOFF YES NO coo
d
Z
OCCUPANCY GROUP
AS VERIFIED OCCUPANT
LOAD
EXIT HARDWARE
PROPOSED MAX OCC
NO OF EXITS NO SPEC KNOWL ❑
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PANIC DEVICES ❑
APPLICATIO STATE THAT THE ABOVE IS COR-
ECT
PARKING
SPACES REQ'D� PROVIDED
SIGNATUR OF tI's B�
APPLICANT FINAL _ d� 7�
DATE t
ADDRESS
a Wi[hin the scope of this inspec-
tioli the Building Official may
approve minor corrections or
' - ZIP /J alterations of an existing struc-
r / O tuna involving work of a build- PERMIT FEE 154
Ing, plumbing, mechanical or
PHONE ele�-tncal nature ISSUANCE FEE
TOTAL FEE
APPLICATION VALIDATION CK M O CASH
` '6-5-1Ci1AY 46 2,06 1.0•0A