HomeMy Public PortalAbout9616 LOWER AZUSA RD_Certificate of Occupancy__ APPLICATION FO OCCUPANCY INSPECTION
BUILDING AND SAFETY DIVISION
APPLICANTFOH FILL IN BUILDING
ADDRESS
(Print or type only)
BU DING O! LOCALITY
DRESS 9(O/�o $.� -S•a a� NEAREST rt 24
OF
CITY ,e ZIP CROSS ST
N OF BLDGS ASSESSOR
SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT TYPE FIRE IP�)EQBY
TRACT /aQ 9 8 BLOCK LOT NO 7J jr-' 013 DISTRICT
CONST S/ b0
OWNER 0 / IfSlq C W NOL USE ZONE MAP 11^ 015 15
/A• N O O'
DRESS - v SPECIAL
CONDITIONS
CITY (V 6a I ZIP BLDG SETBACK FROM ,
SIZE OF 9 NO OF FRONT PROP-LINE OF (STREET)
EXISTING BLDG STORIES HIGHWAY } YARD = TOTAL SETBACK FROM TYPE OF ISTIN
FRONT PROP LINE HIGHWAY1 WIDTH
PRESENT USE OF BUILDING
/1 v S T V BLDG SETBACK FROM
NO PARKING SIDE PROP LINE OF (STREET)
SPACES PROVIDED TOTAL SETBACK FROM TYPE OF X111 TING
HIGHWAY + YARD = SIDE PROP LINE HIGHWAY WIDTH C
�G�...
EASON FOR INSPECTION REQUEST + yVj
i a
CORNER CUTOFF YES NO Cn
OCCUPANCY GROUP ® OCCUPANT
AS VERIFIED
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 C� PROVIDED
FINAL !�/ BY
SIGNATURE OF� +�r�--- DATE
PPLICANT
ADDRESS " Within the scope of this inspec-
tion the Building Official may
,41
approve minor corrections or
alterations of an existing struc- f
ture Involving work of a build- Permit Fee 7 , ZIP Ing, plumbing, mechanical or
� a electrical nature Issuance Fee
PHONE
Total Fee ,
APPLICATION VALIDATION CK M 0' CASH
7GA66IC-CICS928 11/75 2 i 7910-MAY 140 'D -0 Q AM