HomeMy Public PortalAbout5544 PERSIMMON AVE_Certificate of Occupancy__ APPLICATION -FOR OCCUPANCY INSPECTION
BUILDING AND.SAFETY DIVISION
FOR APPLICANT TO FILL INLDING' f
(Print or type only') RESS
BUILDING ALITY
ADDRESS, ,
� REST
CITY /Lj� /+• ZIP /� SS ST.
r C•N0. OF BLDGS. ESSOR
SIZE OF LOT K ��/r NOW ON LOTP BOOK PAGE PARCEL
TRICT TYPE FIRE PR BY
TRACT f 36/�? BLOCK - LOT NO71
�7 Q� CONS G� ZONE_
_J TEL USE ZOONE kNO.
OWNERY��h �r r NE67 A
//66 �ADDRESS �L%0+` )99,-'s yy�yy��yl U� CIAL
DITIONS
CITY /0` ZIP `7190 BLDG, SETBACK FROM
SIZE OF C NO. OF FRONT PROP. LINE OF (STREET)
EXISTING BLD ST S HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTIN
FRONT PROP. LINE HIGHWAY WIDTH
PRESENT USE OF BUI G
BLDG. SETBACK FROM
N0. PARKING SIDE,PROP. LINE OF (STREET) d
SPACES PR D TOTAL SETBACK FROM TYPE OF XISTIN . C.
HIGHWAY + YARD = SIDE PROP. LINE HIGHWAY WIDTH p
C
+ ' =
REASON FOR INSPECTION REQUEST C�
a
CORNER CUTOFF YES NO co
OCCUPANCY GROUP
t - I7 Q-/( AS VERIFIED ��f/—"_ OCCUPANT
LOAD
EXIT HARDWARE:
:Wvo4 PROPOSED MAX. OCC. NO SPEC. KNOWL. ❑
NO. OF EXITS
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS PANIC DEVICES ❑
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT. PARKING
SPACES REQ'D PROVIDEDFINAL
�.
SIGNATURE 0 DATE �z�� / BY
APPLICANT
ADDRESS S Within the scope of this inspec-
tion the Building Official may
�� j,� •�iapprove minor corrections or
alterations of an existing struc-
zIP
�1 /�Q� ture involving work of a build- Permit Fee 30
1.�Q/�/•' Q ing, plumbing, mechanical or
electrical nature. Issuance Fee'
PHONE Total Fee ,
T L !7 � (p APPLICATION VALIDATION CK. M.0. CASH
78A682C-CE982B 11/75 4 `nj,t-1 BE 7
G-2 D 3 -0
'0 0 •�V