HomeMy Public PortalAbout4502 FIESTA AVE_Certificate of Occupancy__ APPLICATION FOR CCUPCY INSPECTION
FOR APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING bZ BUILDING AND SAFETY DIVISION
ADDRESS
BUILDING
CITY ZIP ADDRESS
SIZE OF LOT /p �• NO. OF BLDGS. / LOCALITY
NOW ON LOT
�.s NEAREST
LOT NO.7 O CROSS ST.
TRACT /7 BLOCK
G� ASSESSOR
OWNER /e/2� Y7`•7 S/V%9 1' NEL. -<0 27 DIISTRMAPOICT TYPE OK PFIRE P BY
A,CEL
ADDRESSCONST. ZONE
CITY ZIP USE ZONE MAP
SIZE OF NO. OF N0, d / _5
EXISTING BLD STORIES SPECIAL
CONDITIONS
PRESENT USE OF ILDING BLDG. SETBACK FROM
FRONT PROP. LINE OF (STREET)
HIGHWAY } YARD = TOTAL SETBACK FROM TYPE OF EXISTIN
NO. PARKING FRONT PROP. LINE HIGHWAY WIDTH
SPACES PRO ED
BLDG. SETBACK FROM
REASON FOR INSPECTION REQUEST SIDE PROP. LINE OF (STREET) p�
O
A, HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF XISTIN V
7 6I� 1j�j��"^G p ��� SIDE PROP. LINE HIGHWAY WIDTH
LLJ
CORNER CUTOFF YES NO fn
Z
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
PARKING
ADDRES i'J SPACES REQ'D PROVIDED
5"77a
ZIP D
PHON2 i:7-
MAKE CHECKS PAYABLE TO:
HARVEY T. BRANDY COUNTY ENGINEERJ FINAL eY ��+2.d-�
DATE
T�_--
APPLIC TION`VALIDATIO CK. 0,. CASH
76A662-CE992 9/74 u
3 0.0 0 ��'J