HomeMy Public PortalAbout5202 PERSIMMON AVE_Certificate of Occupancy__ 7BA662-CE99211/75
APPLICATION I ®CCU NCY INSPECTION
r COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
(Print or ty nly) ADDRESS ,�
[BUILDING
ADDRESS
Z
'%20
@� LOCALITY
CITY Zip NEAREST
CROSS ST.
SIZE OF LOT NO.OF BLDGS. ASSESSOR
0 � NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT TYPE FIRE PR SED BY
TRACT BLOCK - LOT NO.7,7 CONST. ZONE
/ TEL. TD 1v �Ly
OWNER SE ZONE NOS
J
ADDRESS �C/ SPECIAL
CITY ZIP / CONDITIONS
BLDG.SET BACK FROM
SIZE OF NO.OF FRONT PROP.LINE OF (STREET)
EXISTING BLDG. STORIES TOTAL SET BACK FROM TYPE OF EXISTING
PRESENT USE OF BUILDING HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH
+ -
- I
BLDG.SET BACK FROM
NO.PARKING SIDE PROP.LINE OF (STREET) ;
SPACES PROVID
HIGHWAY + YARD= TOTAL SET BACK FROM TYPE EXISTING
SIDE PROP.LINE HIGHWAY WIDTH
I
REASON FOR INSPECTION REQUEST + =
I
CORNER CUTOFF YES NO
J �• < <� OCCUPANCY GROUP
AS VERIFIED OCCUPANT
L��j LOAD
EXIT HARDWARE:
PROPOSED MAX.OCC. NO.OF EXITS NO SPEC.KNOWL. ❑
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PANIC DEVICES ❑
APPLICATION ND STATE THAT T ABOVE IS COR-
RECT. PARKING
SPACES REQ'D PROVIDED
SIGNATURE 0' 1
APPLICANT �.• 'V V�'� FINAL BY
V`
LATE
D Within the scope of this inspection <j`(��'U� ` L
M"-- the Building Official may approve
minor corrections or alterations of C/
ZIP an existing structure involving work
PERMIT FEE _ p
of a building, plumbing, mechanical
PHONE or electrical nature. ISSUANCE FEE
TOTAL FEE
`APPLICATION VALIDATION CK. M.O.
SH
9 2 8&APR 27 22 1) 3C).0 0 •=d
�i vfi