HomeMy Public PortalAbout9240 GARIBALDI AVE_Certificate of Occupancy__ ` APPLICATION FOR OCCUPANCY INSPECTION
FOS APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING BUILDING AND SAFETY DIVISION
ADDRESS
BUILDING
CITY 90 ZIP ADDRESS
NO. OF BLDGON LOTS. LOCALITY
SIZE OF LOT l C�0 C NOW
W l NEAREST
TRACT BLOCK LOT N.O. jg/ "0" ST.
ASSESSOR
OWNER MAP BOOK PAGE (/ ,y�/ PARCEL
DISTRICT TYPE FIRE pRO�J BY
ADDRESS CONST. ZONE �
eivr�
CITY ZIP USE ZONE MAP
SIZE OFNO. OF f
NO.
EXISTING BLDG. 00✓r fr. STORIES '' ' SPECIAL
CONDITIONS
PRESENT USE OF BUILDING BLDG. SETBACK•FROM
FRONT PROP. LINE OF (STREET)
HIGHWAY } YARD = TOTAL SETBACK FROM TYPE OF ISTIN
NO. PARKING
FRONT PROP. LINE HIGHWAY WIDTH
SPACES PROVIDED
t =
BLDG. SETBACK FROM yy.,
REASON FOR INSPECTION REQUEST SIDE PROP. LINE OF (STREET)
= TOTAL SETBACK FROM TYPE OF ISTING
HIGHWAY + YARD S
SIDE PROP. LINE HIGHWAY WIDTH =
�-(J YYYJJJO
+ _
rLW
CORNER CUTOFF YES NO N
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:
N0. OF EXITS NO SPEC. KNOWL. ❑
SIGNATURE OF
PANIC DEVICES ❑
APPLICANT
ADDRESS PARKINGPACE3 REQ'D O PROVIDED D
3/ ` B
ZIP ��
.tla/
6��I 3� 3.o PHONE /}T/�f1j Gi Ry, �f • ��+^
MAKE CHECKS PAYABLE TO:
HARVEY T. BRANDY COUNTY ENGINEER FINAL BY
DATE
APPLICATION VALIDATION CK. M.O.. CASH
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