HomeMy Public PortalAbout5610-5618 1/2 ROSEMEAD BLVD_Certificate of Occupancy__ APPLICATION F R OCCUPANCY INSPECTION
BUILDING A SAFETY DIV(
k UK APPLICANT O F N BUILDING
(Print or type only) ADDRESS
B LOING LOCALITY
DDRESS 6 A
CITY _ ZIP / 7 0 0 CROSS
NEA SST
• NO OF BLDGS ASSESSOR
SIZE OF LOT G 7�L1(, NOW ON LOT MAP BOOK PAGE PARCEL
// DISTRICT TYPE FIRE P D BY
38 Y BLOCK LOT /3 CONST ZONE
-5-4, S
U O
WNER 14f
S NEL USE ZONE MAP
NO O
'DRESS C-3 SPECIAL
CONDITIONS
CITY ZIP SLOG SETBACK FROM
SIZE OF NO OF FRONT PROP LINE OF (STREET)
EXISTING BLDG STORIES NI GHW AY } YARD = TOTAL SETBACK FROM TYPE OF EXISTING
ESENT USE OF BUILDING / - FRONT PROP LINE HIGHWAY WIDTH
} _
rSIDE
SETBACK FROM
tEEASON
PARKING ROP LINE OF (STREET)
ACES PROVIDED TOTAL SETBACK FROM TYPE OF XISTIN SAY } YARD = SIDE PROP LINE HIGHWAY VIIOTH �
_ rO.
FOR INSPECTION REQUEST } yWy
CORNER CUTOFF YES NO fn
Z
OCCUPANCY GROUP
AS VERIFIEDa-2, OCCUPANT
LOAD
EXIT HARDWARE
PROPOSED MAX OCC
NO OF EXITS NO SPEC KNOWL ❑
I HEREBY ACKNOWLEDGE THAT I HAVE READ HIS PANIC DEVICES ❑
APPLICATION AND STATE THAT THE ABOVE I COR-
RECT PARKING
SPACES REO'D DL PROVIDED D
F
SIGNATURE OF DATE o 0 0
PPLICANT
A0DRES ' Within thescope of this ulspec
tion the Building Official may
approve minor corrections or
alterations of an existing struc
ZIP ture Involving work of a build Permit Fee
ing plumbing mechanical or
electrical nature Issuance Fee
S Total Fee
I , s APPLICATION VALIDATION CK M 0 CASH
teAssse-crssan 11/76 4 6 0?MAY 16 4 0 D A 0 ♦go
78488'2-CEW 11!78 '
APPLICATION FOR OCCUPANCY INSPECTION {I
COUNTY OF LOS ANGELES IJ
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
(Pnnt or type only)
BUILDING
ADDRESS �/v �+
ADDflESS LOG`LITY
NEAREST
CITY E ZIP CROSS ST
NO OF BLDGS ASSESSOR
SLZE OF LOT NOW ON LOT MAP BDOK PAGE PARCEL
I9-1 RIC I TYPE FIRE PROCESSED BY
TRACT BLOCK LOT NO `I CONST
OWNER S. '511.4 &4 ND NOP
ADDRESS a 3 SPECIAL
CI,ry ZIP CONDITIONS
BLDG SET BACK FROM
SIZE OF NO OF FRONT PROP UNE OF (STREET)
EXISTING BLDG STORIES
HIGHWAY + YARD TOTAL SET BACK FROM TYPE MSnNG
PRESENT USE OF BUILDING FRONT PROP UNE HIGHWAY
MDTiY WIDTH
Y
+ a
O
BLDG SET BACK FROM U
NO PARKING SIDE PROP UNE OF (STREET) Z
SPACES PROVIDED
HIGHWAY + YARD= TOTAL SET BACK FROM TYPE OF EXISTING
SIDE PROP UNE HIDHWAY
WIDTH F-
U
REASON FOR INSPECTION REQUEST O 0 �// + a
CC
/J a4lv u<5/NO'S CORNER CUTOFF YES NO 2
OCCUPANCY GROUP OCCUPANT
AS VERIFIED LOAD
EXIT HARDWARE
PROPOSED MAX OCC NO OF EXITS NO SPEC KNOWL ❑
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PANIC DEVICES ❑
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT /�(� SPACIFN.SG REQ'Dr_� PROVIDED
SIGNATURE OF /���/y//
APPUCANi FINAL FID lLi�7
ADDRESS O� A � � ATE7
LWithin the scope of the eepection
the Buldnu Offaal rrey sppt �� CC.����
21P
bd�O moor correcooro « sretans of
/ lean mmtnp avuc[ure Involvtry work
PERMIT FEE
of a buddnp, dumdnp rneUrenlral
PHONE,73�'� 0>9 or ekcmml ream ISSUANCE FEE
TOTAL FEE
APPLICATION VALIDATION CK M0 CASH
1 4ArZSEP 2V 4 G 0