HomeMy Public PortalAbout9102 HERMOSA DR_Certificate of Occupancy__ 76A662-CE992 11/75
APPLICATION FOR O CUPANCY INSPECTION
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR;APPLICANT TO FILL IN BUILDING
(Print or type only) ADDRESS "
BUILDING 1/Oz �S� LOCALITY - r
ADDRESS
CITU rL ZIP-9i7�0 NEAREST
CROSS ST.
SIZE OF'LOT
SSOR
�� t �.S—i/ t NOW ON LOTNO.OF S I MAP BOOK PAGE PARCEL
77 DISTRICT TYPE FIRE PPOCESSW BY
LOT NO
TRACT SCO. BLOCK . S7� CONST. Z
" a /9NET
OWNER gee`N L. 2 Jn'f, 24. us
/.(•:' EOL (`US NE MAP
NO. C
ADDRESS o ,yP.c',a�osA on. 3 SPECIAL `
CONDITIONS
CITY le e;7, ZIP 91 IfO BLDG.SET BACK FROM -
SIZE OF I ND.OF FRONT PROP. LINE OF (STREET)
EXISTING BL TORIES
HIGHWAY + YARD = TOTAL SET BACK FROM TYPE EXISTING
PRESENT.USE OF B ING - FRONT PROP. LINE HIGHWAY WIDTH }
a
BLDG.SET BACK FROM U
NO.'PARKING SIDE PROP.LINE OF (STREETI Z
SPACES PR 1 ED O
HIGHWAY + YARD— TOTAL SET BACK FROM TYPE OF EXISTING
SIDE PROP. LINE HIGHWAY1 WIDTH U
W
REASON FOR INSPECTION REQUEST + d
rte• ;
C& % ` CORNER CUTOFF YES NO ?
i . _ o ' OCCUPANCY GROUP
AS VERIFIED OCCUPANT
LOAD
EXIT HARDWARE: ,
PROPOSED MAX.OCC. ❑
' NO.OF EXITS � NO SPEC.KNOWL.
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PANIC DEVICES ❑
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT. PARKING SPACES : REQ'D� PROVIDED
SIGNATURE 0 J �'7
APPLICANT FINAL '���(�/ BY /
t DATE
ADDRESS . /¢VU
Within the scope of this inspection
the Building Officialmay approve
ZIP minor corrections or alterations of -
an existing structure involving work PERMIT FEE ZJ '
of a building, plumbing, mechanical
PHONE or electrical nature. ISSUANCE FEE
TOTAL FEE ' v
APPLICATION VALIDATIONCK. M.O. CASH
62'1'�SEP 622 D 3.0..00Ags