HomeMy Public PortalAbout10929 FREER ST_Certificate of Occupancy__ r APPLICATION FOR OCCUPANCY INSPECTION
MA APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDINGBUILDING AND SAFETY DIVISION -
ADDRESS ll 0
BUILDING
CITY ZIP ADDRESS
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SIZE OF LOT . OF BLDGS, / LOCALITY
NOW ON LOT
NEAREST
TRACT O BLOCK LOT N CROSS ST,
18 1 ASSESSOR
OWNER 4 • TOL'. MAP BOOK PAGE PARCEL
DISTRICT TYPE FIRE p ES D BY
ADDRESS - CONST. ZONE
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CITY L{1� ZIP / D USE ZONE MAP�D
SIZE OF NO. OF NO.
EXISTING BL STORIES6-,-I SPECIAL
COND TIONS
PRESENT USE 0ILDING BLD SETBACK FROM
FROYT PROP. LINE OF (STREET)
HIG WAY + YARD - TOTAL SETBACK FROM TYPE OF EXISTING
NO. PARKING FRONT PROP. LINE HIGHWAY WIDTH
SPACES P IDED +
BLDG. SETBACK FROW
REASON R INSPECTION REQUEST SIDE PROP, LINE OF (STREET)
HIGHWAY + YARD = TOTAL SETBACK FROM TY OF KIST1NGO
SIDE PROP. LINE HIGH Y WIDTH CS
+
CORNER CUTOFF YES NO
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PROPOSE AX. 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. ❑
SIGNATURE OF PANIC DEVICES ❑
APPLICANT
ADDRESS � et,/y� SPACES PARKING REQ'D PROVIDED
PHONEL.(�Lz-7
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MAKE CHECKS PAYABLE TO: `��r
HARVEY T. BRANDY COUNTY ENGINEER DFINALATE . �! BY
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APPLICATION VALIDATION (CK.- M.D.. CASH .
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