HomeMy Public PortalAbout20134 GRAND AVE_Certificate of Occupancy__ Ta AJ/2-CttaaIA-4/77
APPLICATION FO OCCUPANCY INSPECTION
COUNTY QF LOS ANGELES
r„-• DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION u
FORPriTO FILL IN BUILDING
( ✓
(Printnt or or type only) ADDRESS �D "k �
BUILDING
ADDRESS LOCALITY
CITY 'T� '�' ZIP NEAREST _ r
CROSS ST. L(iC
NO.OF QLDGS. ASSESSOR
SIZE QF LOT p NOW ON LOT MAP BOOK PAGE' PARC>-1_
TRACT R - /
DISTRICT�(7 8 CONST IFIRE
� PR BY
OWNER TEL �1t
I.So rt
NO. Z NE MAP
NO. O
ADDRESS
�a ECIAL
ONDITIONS
CITY Ti �' ZiQ BLDG.SET BACK FROM
SIZE OF NO.OF } FRONT PROP.UNE OF OTPIEEM
EXISTING BLDG, STORIES
HIGHWAY + YARDS TOTAL SET BACK FROM TYPE OF nrnraa
O
PRESENT USE OF BUILDING. ` FRO NT PRP.LIE HIGFfAI1Y nnTH
BLDG SET BACK FROM ?.
NO. PARKING SIDE PROP•UNE OF (STREETS a.
SPACES PROVIDED 8
HIGHWAY + YARD TOTAL SET BACK FROM TYPE OF SIDE_
57DPROP. LINE HIGHNWY r�tt-t Z
CO
REASON FOR INSPECTION REQUEST
CORNER CUTOFF YES NO N
OCCUPANCY GROUP
AS VERIFIED OCCUPANT
'LOAD
EXITT-HARDWAREi
PROPOSED MAX.OCC
NO.OF EXITS NO SPEC. KNOWL ❑
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PANIC DEVICES ❑
APPLICATION ANp�STATE THAT THE ABOVE IS GOR-
-RECT. PARKING
SPACES REQ'DPROVIDED
SIGNATUREO
APPLICANTr BY
l '
ATE !� 7 l
ADDRESS ) ��
L• Within the scope of this Inspec-
�i/— tion the Building OVIGe1 may
approve minor Gorrectlons or
Zip /? goaitoratlons of an existrng struc-
tura Involving work of a build- PERMIT FEE
Inq, plumbing, mechanical or
PHONE o • n0sc"cal nature. ISSUANCE FEE
• • • No
-� • •• • N TOTAL FEE
PLIC ION VALIDATION cK. M.O. CASH
:a o Q N o,
-0 0 0 ry a
CH