HomeMy Public PortalAbout4937 ENCINITA AVE_Certificate of Occupancy__ I
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APPLICATION FO�06PA"NC INSPECTION
f7bH'APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING �/ I. 3 7 E• 7A A - BUILDING AND SAFETY DIVISION
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ADDRESS 6 fLJ
r� BUILDING � 7�
CITY TC C 17 ZIP g i 7 q ADDRESS
SIZE OF LOT NO OF BLOGS o LOCALITY
NOW ON LOT —"
NEAREST
TRACTi BLOCK LOT NO CROSS ST
ASSESSO
OWNER C- A P S-t NEL MAP BOOK PAGE PARCEL
FS V i ti+K DISTRICT TYPE FIRE ROCESSE BY
ADDRESS /$35 �� �- pir
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CITY -�-/ J Y bk4E: 7—rt �� rt
CITY
17 'UUSSEE7 ZONE- MAP /
SIZE OF NO OFNO
EXISTING BLDG STORIES J SPECIAL
CONDITIONS _
PRESENT USE OF BUILDING �, BLDG SETBACK FROM
FRONT PROP LINE OF (STREET)
TOTAL SETBACK FROM TYPE OF EXISTIN
No P�:KNGHIGHWAY + YARD = FRONT PROP LINE HIGHWAY WIDTH q
NO PARKING �V[
-SPC PROVIDED
BLDG SETBACK FROM
REASON FOR INSPECTION REQUEST SIDE PROP LINE OF (STREET)
HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF ISTING W
V SIDE PROP LINE HIGHWAY WIDTH
LAJiA
+ = Z
CORNER CUTOFF YES NO
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 OF EXITS NO SPEC KNOWL El
SIGNATURE 0
PANIC DEVICES ❑
APPLICANT
PARKING REQ'D PROVIDED o
ADDRESS r'" O SPACES
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MARL CHECKS PAYABLE TO
HARVEY T. BRANDY COUNTY ENGINEER FINAL / J JCi+ 6Y ATE //
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APPLICATION VALIDATION CK M 0 CASH
70212IDV 104 .00Al--d
76A662-CE992 I2-73 `
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