HomeMy Public PortalAbout5526 ROSEMEAD BLVD_Certificate of Occupancy__ rawsa:-ccpce-4/71
APPLICATION FOR OCCUPANCY INSPECTION
FOR APPLICANT TO FILL IN BUILDING
(Print or type only) ADDRESS
91
IDRESS LDING LOCALITY If
CITY ZIP O NEAREST
CROSS ST
SIZE OF LOT NO OF BLOGS ASSESSOR
NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT TYPE FIRE PR ESS BY
TRA '/ K LOT rJO� Q O CONST V ZONA
OWNER � NOL -L1 USE ZONE MAP
C �J1
oj�D
/9 N
DRESS /S' ,s — 3 SPECIAL
CITY / ZIP O CONDITIONS
L BURG SET BACK FROM
517E OFNO OF FRONT PROP LINE OF (STREET)
EXISTING BLDG STORIES
HIGHWAY + YARD —_ TOTALSEr BACK FROM TYPE OF WIT
RESENT USE OF BUILDING FRONT PROP LINE HIGHWAYvnpr-
CK
NO PARKING SIDE PROP ELAINE OFFM (STREEI�1 0
SPACES PROVIDED 8
HIGHWAY + YARD- TOTASIDRACK FROM HIGEOAFV xma
UNE
C
R ASON FOR INSPECTION REQUEST +
d
CORNER CUTOFF YES NO =
10, OCCUPANCY GROUP
AS VERIFIED OCCUPANT
LOAD
EXIT HARDWARE
PROPOSED MAX OCC NO OF EXITS NO SPEC KNOWL ❑
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS PANIC DEVICES ❑
APPLICATION AND STATE THAT THE ABOVE IS COR
RECT
PARKING REQ-0� PROVIDED
S PPLICA RE OF
SPACES
PLICA NT FINAL By
DATE Q- B
ADDRESS
Nrthln the scope of this mspec
tion the Building Official may
approve minor corrections or
Zip /72"1 alterations of an existing strut
v tura involving work of a build PERMIT FEE
mg Plumbing mechanical or
PHONE e-ectrical nature ISSUANCE FEE
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f� • • OTI�L FEE
APPLICATION VfcblD M N • M D CASH
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APPLICATION FO CUPANCY INSPECTION
FOR APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
F ILDINGDDRESS 2(o BUILDING AND SAF DIVISION
m OurBUILDING
CITY ZIP ( ADDRESS
SIZE OF LOT NO OF BLOCS LOCALITY
NOW ON LOT
NEAREST
T BLOCK LOT NO O CROSS ST
ASSESSOR
OWNER ! ha
, C -0� ' MAP BOOK PAGE PARCEL
�'�0 DISTRICT TYPE FIRE PR ED BY
ADDRESSS. 1-5-0
CONST ZONA
CITU ZIP 111901-
NO USE ZONE MAP
SIZE OF / OF NO Q
EXISTING BLDG C10 �` STORIES (f-.3 SPECIAL
CONDITIONS
PRESENT USE OF BUILDING TIAPEW1
BLOC SETBACK FROM
FRONT PROP LINE OF (STREET)
1 �' HIGHWAY } YARD = TOTAL SETBACK FROM TYPE OF ISTIH
NO PARKING FRONT PROP LINE HIGHWAY WIDTH
SPACES PROVIDED
BLDG SETBACK FROM yy
REASON FOR INSPECTION REQUEST SIDE PROP LINE OF (STREET) pp„
HIGHWAY } YARD = TOTAL SETBACK FROM TYPE OF ISTIN U
510E PROP LINE HIGHWAY WIDTH
O
f l + _
CORNER CUTOFF VES NO Z
PROPOSED MAX OCC OCCUPANCY GROUP
AS VERIFIED r� OCCUPANT
I
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LOAD
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT EXIT HARDWARE
NO OF EXITS NO SPEC KNOWL ❑
SIGNATURE OF
` PANIC DEVICES ❑
APPLICANT
l ADDRESS ^ O, PARKING SPACES REO 0 O PROVIDED
O�
W C
ZIP ,
PHONE eV
rr
33 7-6 v
SIA KC CHE PAYABLE T
HAR Y T BRA DT COUNT ENGINEER FINAL BV
DATE D
APPLICATION VALIDATION CK M O CASH
4649 MW 184,0 0 .00 �
7BAE62-C699:en.
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