HomeMy Public PortalAbout5110 SULTANA AVE_Certificate of Occupancy__ APPLICATION FO�UPANCY INSPECTION �]
FOR APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDINGBUILDING AND SAFETY DIVISION
ADDRESS
7NEAREST
NG //O -
CITY ZIP /'J Gs�
SIZE OF LOT �/ / / NO OF BLOC$ / TY
b NOW ON LOL�
T
¢�
TRACT �� ✓b'��- OCK LOT NO ST
ASSESSOR
OWNER TEL MAP BOOK PAGE PARCEL
NO DISTRICT TYPE FIRE P SED BY
ADDRESS �D�{ CONS ZONE N
CITY ZIP
ZONE MAP
SIZE OF NO OF NO
E%IS NG BLDG STORIES _L SPECIAL 17 1
CONDITION$
PRESEN SE OF BUILDING BLOG SETBACK FROM
FRONT PROP LINE OF (STREET)
HIGHWAY } YARD = TOTAL SETBACK FROM TYPE OF ISTIN
NO PARKIN FRONT PROP LINE HIGHWAY WIDTH
SPACES VIDED
} = d
O
U
BLDG SETBACK FROM �.
REASON FOR INSPECTION REQUEST SIDE PROP LINE OF (STREET) O
HIGHWAY } YARD = TOTAL SETBACK FROM TYPE OF�XISTING W
SIDE PROP LINE HIGHWAY WIDTH N
} = Z
CORNER CUTOFF YES NO
PROPOSED MAX OCC OCCUPANCY GROUP
AS VERIFIED OCCUPANT
`I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LOAD
APPLICATION AND STATE THAT THE ABOVE IS COR- EXIT HARDWARE
RECTa NO OF EXITS O NO SPEC KNOWL ❑
PANIC DEVICES ❑
SIGNAT
APPLI
PARKING REO ❑D PROVIDED D
ADDRESS/ ? SPACES
, r
op
61AKE CHECKS PAIAHLE 1O
HARVEY T BRANDY COUNTY ENGINEER FINAL BY
DATE JA -/
APPLICATION VALIDATION CK M D CASH
1 6 0«SEP 30 2 2 B IIp1I _ 1 8 0
76A662 CE992 3/73 y'