HomeMy Public PortalAbout5831 SULTANA AVE_Certificate of Occupancy__ APPLICATION FOR OCCUPANCY INSPECTION Ifl
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN [AR
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(Print or type only) S c:1 3 l
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ADDRESS J�J/ /f✓. SUC%fyN.�
CITY �� ZIP 9�, �� NEARENEARET.
Pt
N0. OF BLDGS. OR
SIZE OF LOT y� NOW ON LOT OKPAGE PARCEL
CT TYPE FIRE PROC SEDTRACT '' /' BLOCK LOT NO./ OCONST.V ZONV .�_TEL.OWNER NJC� NE MAP -yNO. O /ADDRESSC19 j/j p SPECIAL
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GCONDITIONS
CITY /Cm 7tc L/T ZIP _Y �O O . BLDG. SETBACK FROM
SIZE OF a• NO. OF f FRONT PROP. LINE OF (STREET)
EXISTING BLDG. STORIES ( HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTIN FRONT PROP. LINE HIGHWAY WIDTH
PRESENT USE OF BUILDING ` DOM .
t -
BLDG. SETBACK FROM
NO. PARKING SIDE PROP. LINE OF (STREET) n
SPACES PROVIDED TOTAL SETBACK FROM TYPE OF XISTIN Q
HIGHWAY t YARD = SIDE PROP. LINE HIGHWAY WIDTH p
C
= C
REASON FOR INSPECTION REQUEST + v
O
CORNER CUTOFF YES NO
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OCCUPANCY GROUP
AS VERIFIED I I OCCUPANT
LOAD
EXIT HARDWARE:
PROPOSED MAX, OCC. NO SPEC, KNOWL. ❑
NO. OF EXITS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PANIC DEVICES ❑
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT. PARKING
SPACES ' REQ-0 D PROVIDED O
A
FINAL /_ /J_, BY % "
SIGNATURE OF r I // DATEr : e'
APPLICANT0,62
ADDRESS 6WLA AID Within the scope of this inspec-
tion the Building Official may
aL L� r % approve minor corrections or
alterations of an existing struc-
zIP
C cture involving work of a build- Permit Fee U
/ ���• ing, plumbing, mechanical or
I electrical nature. Issuance Fee
PHONE ;I.'% ..
o�rrTr• Total Fee7 _
APPLICATION VALIDATIO M.O. CASH
76A662C-CE992B 11/75 -f' r [ � l � a. .
7 0 5 P�`w i.7 s., C � L L V.J V