HomeMy Public PortalAbout5520 MCCULLOCH AVE_Certificate of Occupancy__ 7BA662-CE99211n5 VaJ�e__•
APPLICATION FOR OCCUPANCY- INSPECTION .
f COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
Wrint or type only) ADDRESS —
BUILFADDRESS ,S M G (',fJL�/4G H- PC U �, LOCALITY
NEAREST 1 1. F
CITY 0.04 1 G(TY ZIP (It 7V' ICROSS ST.
SIZE OF LOT V1D �0 NO.OF BLDGS. ASSESSOR'
NOW ON LOT MAP BOOK PAGE PARCEL'
DISTRICT TYPE FIRE PR SSE BY '
TRACT &-)I B OCCK LOT NO. 's", 08 CONST. ZONE
OWNER &k/ DO,`� TEL
�p�1N0�6 ��0� USE ZONE MAP
O s —�
ADDRESS 2 etj6a'D0*4 ,,e_J SPECIAL
CIN (?+jj�N/�Q „p A- ZIP `7 CONDITIONS
�f 9'v BLDG.SETBACK FROM
SIZE OF NO. FRONT PROP:LINE OF (STREET)
EXISTING BLDG. RIES TOTAL SET BACK FROM TYPE OF EXISTING
HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH
PRESENT USE OF BUILDING ,
+ _
BLDG.SET BACK FROM
NO.PARKING SIDE PROP.LINE OF (STREET)
SPACES PR ED
HIGHWAY + .YARD= TOTAL SET BACK FROM TYPE EXISTING
SIDE PROP.LINE HIGHWAY WIDTH �
REASON SPECTION REQUEST + = C
CORNER CUTOFF YES NO
OCCUPANCY GROUPL OCCUPANT
AS VERIFIED T LOAD
EXIT HARDWARE:
PROPOSED MAX.OCC. NO.OF EXITS NO SPEC.KNOWL. ❑
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PANIC DEVICES ❑
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT. PARKING
SPACES REQ'D PROVIDED=
SIGNATURE OF
APPLICANT FINAL ? BY
DATE / /v;
ADDRESS W s ]_���Q/P�.
6 v�Nr�O�� Within the scope of this inspection
I the Building Official may approve
minor corrections or alterations of
ZIP Y /(y)kO an existing structure involving work
PERMIT FEE
Qf/ of a building, plumbing, mechanical
PHONE�p��V/`�p or electrical nature. ISSUANCE FEE
II TO FEE
A .�ICATION VALIDATIO CK. M.O. CASH
4 5 2-r"_AUG 26 2.2 D 3 0.0 0_&w