HomeMy Public PortalAbout5676 ROSEMEAD BLVD_Certificate of Occupancy__ APPLICATIONFO , CCUPA CY INSPECTION
'OR APPLICANT TO FILL IN (Print or type only)' COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING ;7G �L BUILDING AID TY DIVISION
ADDRESS (p
CITY j' e llz'P Sd ;ADORES G
rc. NO. OF BLDGS. LOCALITY
SIZE OF LOT NOW ON LOT L
NEAREST
TRACT BLOCK LOT NO. CROSS ST..�
ASSESSOR
OWNERTEL. (� MAP BOOK PAGE' PARCEL
�f NO. / DISTRICT TYPE FIRE ED BY
ADDRESS &4 14,"044oklO — CONS ZONE, (I J;�, �i�_
CITY f ZIP 'C � USE ZONE NOP`/ r'O /J`
SIZE OF N0. OFy
EXISTING BLDG. STORIES -]` SPECIAL
CONDITIONS
PRESENT USE OF BUILDINGi // BLDG. SETBACK FROM
FROPT PROP. LINE OF (STREET)
TOTAL SETBACK FROM TYPE OF EXISTING
HI HWAY t YARD = FRONT PROP. LINE HIGHWAY WIDTH
SPA
N0.C PARKIPRNGOVIDEDl.PAvJ/ Q Q
+ _
E
BLDG. SE Q
REASON FOR INSPECTION REQUEST SIDE PROP. LINE OF (STREET)
HIGHWAY t YARD = TOTAL SETBACK FROM E OF XISTIN
SIDE PROP. LINE HIG Y WIDTH E
f
CORNER CUTOFF YES NO
PROPOSED MAX. OCC. OCCUPANCY GROUP
AS VERIFIED OCCUPANT "
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LOAD
APPLICATION AND STATE THAT THE ABOVE IS COR- EXIT HARDWARE:
R ECT.
NO. OF EXITS NO SPEC. KNOWL. a❑
SIGNATURE OF
PANIC DEVICES ❑
APPLICANT
PARKING REQ'D PROVIDED D
ADDRESS /^-7/ -/7 SPACES
ZIP
PHONE .
=MAKE CHECKS PAYABLE TO:
HARVEY T. BRANDY COUNTY ENGINEER FINAL _ �-.� _ eY ( ��F,z�� f
DATE
APPLICATION VALIDATION CK. M.O. CASH
+6A662-CE992 12-73 0 5 AMAR 5 4••U 1) .0