HomeMy Public PortalAbout10750 FAIRVIEW AVE_Certificate of Occupancy__ 76A662-CE992A- 4/7i—" f:,
APPLICATION FOR OCCUPANCY INSPECTION
cl COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY"ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
(Print or type only) ADDRESS toY s 1,
ry
BUILDING /699-0 C. C fil n i �� LOCALITY
ADDRESS C ( (� T /l V
CITY 7--e1ndQ ZIP NEAREST
CROSS ST
SIZE OF LOT NO OF BLDGS / ASSESSOR
NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT YPE FIRE [Q2&_W.Coe'--L-
OWNER
ROCESSED B
Y
TRACT BLOCWT LOT N 6�� TONZSIZONEqQO ` TEL
NO USE ZONE MAP
NO �2 I
ADDRESS SPECIAL
CITY IP ' CONDITIONS rL 74 3$
BLDG SET BACK FROM �-+�,./
SIZE OF. NO OF FRONT PROP LINE OF RTI RL/00-UJ (STREET)
EXISTING BLDG �$a STORIES
HIGHWAY + YARD - TOTAL SET BACK FROM TYPE OF I EXISTING
PRESENT USE OF BUILDING FRONT PROP LINE HIGHWAY WIDTH
Le c-
BLDG SETBACK FROM
NO PAR NG SIDE PROP LINE OF (STREET)I a
SPACES PROVIDEDO
HIGHWAY + YARD- TOTAL SET BACK FROM TYPE OF EXISTING V
/t n C1 J,, 1e A n v�j0 - SIDE PROP LINE HIGHWAY WIDTH
r`X J cc 7 .C)'tl�-.CJS O
REASON FOR INSPECTION REQUEST + U
W
I CORNER CUTOFF YES NO01)
d
OCCUPANCY GROUP
AS VERIFIED OCCUPANT
LOAD
0 PIv M6,4 EXIT HARDWARE
PROPOSED MAX OCC NO OF EXITS NO SPEC KNOWL ❑
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PANIC DEVICES ❑
APPLICATION AND STATE THAT THE ABOVE IS COR
RECT
PARKING REQ'D� PROVIDED
SPACES
SIGNATURE
APPLICANT // d FATEL ������ BY
ADDRESS 0%
VV the scope of this inspec-
tiont
tion the Building Official may
approve minor corrections or
ZIP alterations of an existing struc-
ture Involving work of a build PERMIT FEE O � 7
Ing, plumbing, mechanical or �9c�
o Iv X# PHONE
�(/Jl /,) electrical nature ISSUANCE FEE
-� o of OCT lU V TOTAL FEE &j
4--- 01 01 ° OD APPLICATION VALIDATIONCK' M O CASH
-
�l O CD N CA
co O CD N p
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