HomeMy Public PortalAbout4935 ENCINITA AVE_Certificate of Occupancy__ I
APPLICATION FO CUPA CY INSPECTION
APPLICANT TO FILL IN (Print or type only)
FOR APPL COUNTY OF LOS ANGELESDEPARTMENT OF COUNTY ENGINEER
BUILDINGc�C����ii. BUILDING AND SAFETY DIVISION
ADDRESS h' >y
_ _ BUILDING
CITY %fI�FJL c• LT`O ZIP C�`=� 20 '�, ADDRESS
SIZE OF LOT NO. OF SLOGS. v 'F LOCALITY
NOW ON LOT
: NEAREST
TRACT BLOCK LOT NO.. CROSS
ASSESSOR-
TEL
SSESSOR
TEL.,�'���jj / MAP BOOK PAGE PARCEL
OWNER .QL /f.t � NO .Gr3�`"�G,�I DISTRICT TYPE FIRE PROCES D BY
ADDRESS "7�3� 7�ll,��C C 1 FY 4 1--vP ��� fj CONST. ZONE� \
CITY 'b /�7Lr= �' �Y ZIP 9! 0 USE ZONE MAP��
J �,
SIZE OF N0. OF NO.
EXISTING BLDG, /Roc) YP f,y f. STORIES / �� SPECIAL
CONDITIONS
PRESENT USE OF BUILDINGcSj4.0 BLDG, SETBACK FROM "
•'t{ .J FRONT PROP. LINE OF -(STREET)
TOTAL SETBACK FROM TYPE OF EXISTING
NOPARKHIGHWAY + YARD = FRONT PROP. LINE HIGHWAY WIDTH
. I -
SPAC PROVNGIDED +
O
BLDG. SETBACK FROM
REASON FOR INSPECTION REQUEST 7'SIDE PROP. LINE OF (STREET)
_ HIGHWAY + YARD - TOTAL SETBACK FROM TYPE OF XISTIN
(' C-•+ _ Si>NG55 SIDE PROP. LINE HIGHWAY WIDTH
+ _ W
O.
CORNER CUTOFF YES NO y
7i
PROPOSED MAX. OCC, C> OCCUPANCY GROUP
AS VERIFIED OCCUPANT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LOAD
APPLICATION AND STATE THAT THE ABOVE IS COR-
EXIT HARDWARE:
R ECT.
NO. OF EXITS NO SPEC. KNOWL. ❑
SIGNATURE OF
PANIC DEVICES ❑
APPLICANT
PARKING REQ'D PROVIDED
ADDRESS SPACES
/•
ZIP9090
�' ,:'a cA'� prsr,
- PHONEVy ' � 7/ogre
AtAtiE CHECKS PAYABLE TO: s
HARVEY T. BRANDY COUNTY ENGINEER FINAL,%"2 s iq, ',,BY .�
- DATE �r✓�� �/ d aid '
APPLICATION VALIDATION CK. M.D. CASH
76A662-CE992 12-735,2"r' -5 -0 D J •V 0 A!:Jb
8: AUG ;'