HomeMy Public PortalAbout9816 LA ROSA DR_Certificate of Occupancy__ 76AW2-CE992 11/75 1
APPLICATION FOR OCCUPANCY INSPECTION
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT FILL IN BUILDING /) n
(Print or typee only) ADDRESS' `�� �t7.�. Gc C-%
BUILDING �—
ADDRESS. e LOCALITY
NEAREST
CITY •�"� ZIP CROSS ST. G CJ (CW,,
SIZE Of LOT �;.( NO.OF BLDGS. ASSESSOR + c �y
T - NOW ON LOT MAP BOOK J p PAGE 1PARCEL .
DISTRICT TYPE FIRE - PROCESSED BY
.TRACT - BLOCK LOT NO. r- CONST. ZON
OWNER TEL.,
/t 7lI L t1P NO. _ US Z—ONOP - .'7 C7 /1 .
ADDRESS : L- (��fl SPECIAL
CONDITIONS
CIN reZIP BLDG,SET BACK FROM '
SIZE OFCG' NO.OF FRONT PROP. LINE OF ISTREETI
EXISTING BLDG. < < STORIES TOTAL SET BACK Ffl OM TYPE OF ExIsnNG
HIGHWAY + . YARD = FRONT PROP. LINE HIGHWAY WIDTH
to
PRESENT USE OF BUILDING
= d
0
BLDG.SET BACK FROM U
NO.PARKING SIDE PROP. LINE OF ISTREETI
i SPACES PROVIDED Z
HIGHWAY + YARD TOTALS ETBACK FROM TYPE OF EXISTING C
SIDE PROP.LINE HIGHWAY WIDTH F
U
+ w
REASON FOR INSPECTION REQUEST zor oA - d
N
ff } CORNER CUTOFF VES NO Z
.I� OCCUPANCY GROUP OCCUPANT
AS VERIFIED LOAD
� EXIT HARDWARE:
PROPOSED MAX.OCC. ,NO.OF EXITS E NO SPEC.KNOWL. ❑
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PANIC DEVICES ❑
APPLICATIONAND STATE THAT THE ABOVE IS COR-
RECT. PARKING . REQ'D PROVIDED
SPACES .'
SIGNATURE OF
APPLICANT Al FINAL- DATE --/J 77 BY� `
ADDRESS
Within the scope of this inspection
irVl� ..Q
the Building Official may approve
minor corrections or alterations of
ZIP ..1'(o an existing structure involving work
PERMIT FEE
/ of a building, plumbing, mechanical
PHONE�S6-
b , or electrical nature. ISSUANCE FEE -
TOTAL FEE d (�
APPLICATION VALIDATION CK. M.O. CASH
5,414fiSEP 1 22 d � U.� 0 a 3
p _