HomeMy Public PortalAbout9015 GARIBALDI AVE_Certificate of Occupancy__ APPLICATION FOR OCCUPANCY NINSPECTION
FOR APPLICANT TO FILL IN (Print or type only)
LES
DEPARTMENT OF COUNTY ENGINEER
BUILDING BUILDING AND SAFETY DIVISION .
ADDRES �
BUILDMG� l� /tai
CITY ZIP ADDRESS / /?
SIZE OF LOT N0. OF BL GS. % LOCALITY
NOW ON LOT
NEAREST
TRACT BLOCK LOT NO. O CROSS 8T.
ASSESSOR
OWNERA NAL' MAP BOOK PAGE PARCEL
+ ` L DISTRICT TYPE FIRE P D BY
ADDRESS ' ` _ CONST. ZONE `
WA v$
CITY LITV ZIP /-7 P USE ZONE MAP
SIZE OF NO, OF
NO. a
EXISTING BLD STORIES -J� SPECIAL
CONDITIONS
PRESENT USE OF ILDING BLDG. SETBACK FROM
FRO PROP. LINE OF (STREET)
GHWAY } YARD - TOTAL SETBACK FROM TYPE OF -TIN
NO. PARKING FRONT PROP. LINE HIGHWAY WIDTH
SPACES PRO ED }
BLD CK FROM
REASON FOR INSPECTION REQUEST SIDE PROP. L (STREET)
HIGHWAY } YARD - TOTAL SETBACK TYPE OF IST1N p
SIDE PROP. LINE HIGHWAY WIDTH C�
.} - uJ
CORNER CUTOFF YES NO a
� to
Z_
PRQPO D MAX. OCC. P OCCUPANCY GROUP
ED
AS VERIFIOCCUPANT
IHEREBY 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 0 PANIC DEVICES ❑
APPLICANT
ADDRESS PARKING REQ'O PROVIDED
SPACEO
SPACES
r
ZIP
n �7Yyf 1
6i` 7 17�
MAKE CHECKS PAYABLE TO:
HARVEY T. BRANDYCOUNTN (NEER FINAL / 7 BY
DATE —/ c --
APPLICATION VALIDATIONCK. M.0.. CASH
32 59'"_ a " 0 3 0-.0 0 .e%
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