HomeMy Public PortalAbout9651 OLIVE ST_Certificate of Occupancy__ APPS ICATION FOR OCCUPANCY INSPECTION
FQR APPLICANT TO FILL IN (Print or type only)- COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING (]e BUILDING AND SAFETY DIVISION a
ADDRESS �-11
CITY ZIP '• 7 0 BUILDING 4C
ADDRESS
SIZE OF LOT NO. OF BLDGS. LOCALITY �^ $
NOW ON LOT Z
TRACT BLOCK LOT NO. NEAREST
CROSS ST. . r+
ASSESSOR
O*NER TEL MAP BOOK PAGE PARCEL
N0. 1?6 DISTRICT TYPE FIRE PROCESSED BY
ADDRESS
' CONST. ZONE
41TY. ZIP Q D. USE ZONE MAP
1 NO. Q
SIZE OF ✓ N0. OF
EXISTING BLDG,, STORIES SPECIAL
CONDITIONS
PRESENT USE OF BU ING BLDG, SETBACK FROM
FRONT PROP. LINE OF (STREET)
HIGHWA + YARD = TOTAL SETBACK FROM TYPE OF EXISTING
N0. PARKING
FRONT PROP. LINE HIGHWAY WIDTH
SPAC PROVIDED (a
BLDG. SETBACK FROM
REASON 176R INSPECTION REQUEST SIDE PROP. LINE OF (STREET) �-
HIGHWAY + YARD - TOTAL SETBACK FROM OF XISTIN
? SIDE PROP. LINE HIGH W WIDTH d
V.
' + - v
CORNER CUTOFF YES NO
PROPOSED MAX. OCC. OCCUPANCY GROUP .
AS VERIFIED OCCUPANT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LOAD
APPLICATION AND STATE THAT THE ABOVE IS COR- EXIT HARDWARE:
R ECT.
NO. OF EXITS NO SPEC. KNOWL. El
SIGNATURE PANIC DEVICES• ❑
APPLICANT
ADDRESS {� * PARKING REQ'D PROVIDED
SPACES
ZIP
• 'PHQN
MAKE CHECKS PAYABLE TO: //•
HARVEY T. BRANDY COUNTY ENGINEER DFINAL
ATE / 6Y t
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APPLICATION VALIDATION M.O. CASH
I 1,8.0..O'd.
I6A662-CE992 12-73 - �'�• . .SEP.. 12 2.: �.
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