HomeMy Public PortalAbout9612 LOWER AZUSA RD_Certificate of Occupancy__ APPLICATI%BUILONG
R OCC" ANCY INSPECTION
AND SAFETY D ISION
FOR APPLICANT TO FILL IN BUILDING G
(Print or type only) ADDRESS G
BUILDING / D LOCALITY ,
-WOORESS (� (�(/ fv �,(�J
NEAREST
CITY / ' ZIP 7 CROSS ST
v NO OF BLDGS ASSESSOR
SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT TYPE IFIREE�DB
TRACT ' BLOCK L T NO �� •0 0 CONST ZONE
OWNER USE ZONAE P
NO
'ADDRESS , SPECIAL
CONDITIONS
CITY
BLDG SETBACK FROM
SIZE OF NO OF FRONT PROP LINE OF (STREET)
EXISTING BLDG STORIES HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING
FRONT PROP LINE HIGHWAY WIDTH
P ENT USE OF BUILDING
/� /� + _
�J � 4 /� BLDG SETBACK FROM
NO PARKING SIDE PROP LINE OF (STREET) C
SPACES PROVIDED TOTAL SETBACK FROM I TYPE OFXISTIN V
HIGHWAY + YARD = SIDE PROP LINE HIGHWAY WIDTH j=
CD
ON FOR INSPECTION REQUEST + W
0
CORNER CUTOFF YES NO to
OCCUPANCY GROUP
AS VERIFIED �'f, OCCUPANT
LOAD
EXIT HARDWARE
PROPOSED MAX OCC
NO SPEC KNOWL ❑
NO OF EXITS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PANIC DEVICES ❑
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT PARKING
SPACES • REQ'D OVIDED
om
_ FINAL ,,),X% 8Y
SIGNATURE OF DATE /
APPLICANT
ADDRESS Within the scope of this inspec-
tion the Building Official may
approve minor corrections or
alterations of an existing struc-
L ZIP ('i ture Involving work of a build- Permit Fee
d Ing, plumbing, mechanical or
electrical nature Issuance Fee
PHONE
Total Fee IF
APPLICATION VALIDATION CK M 0 CASH
3 2 ���R d9 4 u p .0 0 •:-�
76A663C-CB993B 11/73
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