HomeMy Public PortalAbout5820 ENCINITA AVE_Certificate of Occupancy__ C'
APPLICATION FOR CCUP Y INSPECTION
FOR APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING ESI/ /N�YpF� BUILDING AND SAFETY DIVISION
ADDRESS �{. ' /� �j ''7
NG
CITY 7�lrm �E err ZIP /��r/b AD REISS �JQO2U
SIZE OF LOT NO. OF BLOGS. LOCALITY
NOW ON LOT
wj_�.y ^ NEAREST
TRACT/�ti 6 / BLOCK 0 N -/_ CROSS ST.
S ASSESSOR
OWNERM,q �� /�.y���• TEL. MAP BOOK PAGE PARCEL
A a 7S 0' ILOG.
ICT TYPE FIRE ED S�
ADDRESS Q D �. S7 CONST. ZONE a
07
CITY GL�2o - ZIP 9/-J�pONE MAP
SIZE F NO OFN0.
66
EXISTI BLDG. DRIESa SPECIAL
CONDITIONS
PRESENT US BUILDING BLD?' SETBACK FROM
PROP. LINE OF (STREET)
AY } YARD v TOTAL SETBACK FROM TYPE OF EXISTING
NO. PARKING FRONT PROP. LINE HIGHWAY WIDTH
SPACES PROVI
SETBACK FROM
R ASON FOR INSPECTION RE ST SIDE PROP. LINE OF (STREET) CD
HIGHWAY } YARD o TOTAL SETBACK FROM YPE OF XISTIN U
SIDE PROP. LINE HI AY WIDTH O
} = V
W
a
CORNER CUTOFF . Y'ES
PROPOSED MAX. OCC. OCCUPANCY GROUP _�J
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
o PARKING REO'D PROVIDED
L76
S / . � _ / SPACES
fj a
ZIPIV
PH ON E27�//
MAKE CHECKS PAYABLE 7'0: /
HARVEY T. BRANDY COUNTY ENGINEER FINAL ` BY N
DATE '/- / '2S _
APPLICATION VA LI.DATION CK. M.O. CASH
7swssrcEesz9/76 3 1 5 MAR �5 2 2 U
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