HomeMy Public PortalAbout5350 ENCINITA AVE_Certificate of Occupancy__ APPLICATION F R OCC ANCY INSPECTION �]
FOR APPLICANT TO FILL IN (Pant or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING _ .f _ BUILDING AND SAFETY DIVISION
ADDRESS
BUILDING
CITY C ¢ ZIP / �� ADDRESSxe
SIZE OF LOT NO. OF BLOGS. LOCALITY
7� x ,� NOW ON LOT
NEAREST
TRACTy BLOCK LOT NO. CROSS ST.
'moi ASSESSOR
MS..
W FR !` TEL. MAP BOOK PAGE PARCEL
NO. Z��L'8�G3E DISTRICT TYPE FIRE PROCESS D BY
ADDRESS3_�0 en` �� Sr � v CONST. ZONE
/Uo
CITY /'�f ZIP 11,7 tJ U ZONE I MAP
SI Z Ce NO. OF NO
EXISTIN DG. ST S -f SPECIAL
CONDITIONS
PRESENT USE OF LDING BLDG. SETBACK FROM
9` FRONT PROP. LINE OF (STREET)
TOTAL SETBACK FROM TYPE OF EXISTING
HIGHWAY } YARD =
N0. PARKINFRONT PROP. LINE HIGHWAY WIDTH
G
SPACES PRO D } _ d
O
V
BLDG. SETBACK FROM
REASON FOR INSPECTION REQUEST SIDE PROP. LINE OF (STREET) CD
F-
TOTAL SETBACK FROM TYPE OF XISTIN V
HIGHWAY } YARD = W
ww`` / SIDE PROP. LINE HIGHWAY WIDTH N
/Y��
R 5
CORNER CUTOFF YES NO
PA z: O 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-
RECT. EXIT HARDWARE:
NO. OF EXITS NO SPEC. KNOWL. ❑
SIGNATURE OF
PANIC DEVICES ❑
APPLICANT
IPREQ'D PROVIDED
ADDRESS SPACES
ZIP
PHONE
MAKE CHECKS PAYABLE TO:
HARVEY T. BRANDT• COUNTY ENGINEER FINAL
DATE
APPLICATION VALIDATION CK. M.0. t<A '�H
5 5 7 JUN 17 2 2 08.0 0 ,9
76A662-CE992 3/73