HomeMy Public PortalAbout9030 PENTLAND ST_Certificate of Occupancy__ APPLICATION FOR OCCUPANCY INSPECTION
FOR APPLICANT TO FILL IN (Pant or type only) COUNTY OF LOS ANGELES
DEPARTMEN COUNTY ENGINEER
[AUDDRESSILDING OI
BUILDING ND SAFETY DIVISION
UILDINGTY , `� ']f' DDRESSZE OF LO NOOCALITYNOEAREST
RACT / BLOCN' ROSS ST
SSESSOR
WNER AP BOOK PAGE PARCEL
TRICT TYPFp�� F��RE PR C ED BYADORES; CONSTCITY U NE MAP
SIZE OF ' NOEXISTING BL SPECIAL
CON OITIONS '
PRESENT USE OF LDING
BLDG SETBACK FROM
FRONT PROP LINE OF (STREET)
HIGH YARD = TOTAL SETBACK FROM TYPE OF EXISTING
NO PARKING
FRONT PROP LINE HIGHWAY WIDTH
SPACES PRQWItED
ITHIS
+ -
SETBACK FROM
REASON FOR INSPECTION REQUEST SIDE PROP LINE OF (STREET) 1
TOTAL SET CK FROM TYPE OF ISTIN U
_
HIGHWAY + YARD = SIOE PROP INE HIGHWAY WIDTH C
+ O
U
W
L
• CORNER CUTOFF YES NO �
PROPOSED MAX OCUPANCY GROUP
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AS VERIFIED OCCUPANT
I HEREBY ACKNOWLEDGE THAT I HAVE REALOAD
APPLICATION AND STATE THAT'THE ABOVE EXIT HARDWARE
COR-
RECT '
NO OF EXITS O NO SPEC KNOWL ❑
SIGNATURE OF
PANIC DEVICES ❑
APPLICANT
PARKING
ADDRESS SPACES
REO D D PROVIDED D
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MAKE CHECKS PA)ABLE TO
HARVEY T BRANDY COUNTY ENGINEER FINAL `� l?� By
DATE
APPLICATION VALIDATIO cK M 0 CASH
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