HomeMy Public PortalAbout6300 ROSEMEAD BLVD_Certificate of Occupancy__ APPL�CATION FOR OCCUPANCY iNSPECTION
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
(Print or type only) - ADDRESS
oO BUILDING LOCALITY
ADDRESS
NEAREST
CITY TeTp� (;_j t�y ZIP qLj_7-" _gROSS ST
NO OF BLOGS,
ESSOR
SIZE OF LOT NOW ON LOT MAP BOOK - PAGE PARCEL
DISTRICT ITYPE FIRE P OCESS D BY.
ICONST� ZONE �
BLOCK LOT NO lb`G
OWNERGVD COmm11. Pro S.OL 451-071 USE ZONE MAP - _
In
NO
ADDRESS C Arizona- Ave- #2 / �'Z SPECIAL -
l.. �CONOITIONS
�KTI
- Santa Monica, Ca.. ZIP 90401 BLDG, SETBACK:FROM
SIZE OF - _ NO.,OF FRONT PROP LINE OF _ (STREET)
EXISTING BLDG. - STORIES TOTAL SETBACK FROM TYPE OF EXISTING
HIGHWAY } YARD = FRONT PROP. LINE HIGHWAY WIDTH
RESENT USE OF BUILDING'
Vacant - BLDG SETBACK FROM '
a
NO PARKING' SIDE PROP LINE OF (STREET)' O
SPACES PROVIDEDU
HIGHWAY } YARD
• = TOTAL SETBACK FROM TYPE OF
SIDE PROP, LINE HIGHWAY WIDTH WIDTH CD
_ N
ASON FOR INSPECTION REQUEST } a
CORNER CUTOFF YES NO rn
Opening new business:
OCCUPANCY GROUP
AS VERIFIED OCCUPANT
Gam/
LOAD
EXIT HARDWARE
PROPOSED MAX. OCC. NO SPEC, KNOWL ❑
NO. OF EXITS.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PANIC DEVICES ❑
APPLICATIO AND STATE THAT THE'ABOVE IS COR- '
RECT.• PARKING
SPACES -REQ'D PROVIDED
FINAL BY
IGNAT F - DATE
APPLI
WE 628 I10S 011VOS Drive Within the scope of this inspec-
tion the Building Official may
Sari Gabriel Ca. approve minor corrections or
alterations of an existing struc-
ture Involving work of a build- Permit Fee
ing, plumbing, mechanical or
PHONE 287-85
electrical nature Issuance Fee
'
Total F�R
APPLICATION VALIDATION _K~o � o CASH
O ' O 'ft-T
76A662C-CE992B 11/75 `� O C] 07
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