HomeMy Public PortalAbout5921 1/2-5923 SULTANA AVE_Certificate of Occupancy__ �aM APPLICATION•-FOR OCCUPA Y INSPECTION , .
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BUILDIN D SAFETY DIVISI
R ANT TO FILL IN BUILDING
(Print or type only) ADDRESS
FADD�R�E$S
.�. �/ (��� LOCALITY
v '
NEAREST
,— ZIP 17910 CROSS ST.
NO. OF BLDGS. ASSESSOR'
[TRACT
E OF LOTOO X 6 Z NOW ON LOT MAP BOOK PAGE. PARCEL
V DISTRICT TYPE FIRE OCE E0.BY
BLOCK % LOT NO3. o � CONS ZOER TEL.
F /H NO N0USE ZONE MAP
N0. oZ� G
ADDRESS ..2 ,e SPECIAL
CONDITIONS
CIT :, /L /T'�T _ ZIP /•rf'r_14 BLDG. SETBACK FROM
SIZE OF /C C N FRONT PROP. LINE OF (STREET)
EXISTING BL oZ.Z TORIES HIGHWAY + .YARD = TOTAL SETBACK FROM TYPE OF EXISTIN
FRONT PROP. LINE HIGHWAY WIDTH
PRESENT USE OF BU ING
t = '
BLDG. SETBACK FROM-
NO. PARKIN SIDE PROP. LINE OF (STREET)
SPACES OVIDEDTOTAL SETBACK FROM TYPE OF XISTIN C.
HIGHWAY } YARD = SIDE'PROP. LINE HIGHWAY WIDTH in
C
+ C
REASON FOR INSPECTION REQUEST u
O
CORNER CUTOFF YES NO v
OCCUPANCY GROUP
T . L"•L' ED
�' AS VERIFIED OCCUPANT
LOAD
EX'I•T HARDWARE:
PROPOSED,MAX. OCC. NO SPEC. KNOWL.
NO. OF EXITS -
IHEREBY ACKNOWLEDGE THAI I HAVE READ-THIS PANIC DEVICES [_1APPLICATION AND STATE THAT THE A90VE IS COR-
RECT. PARKING REQ-0
PROVIDED
SPACES '
FINA7L ,v l !
SIGNATURE OF DATE f �" BY 3
` APPLICANT
ADDRESS Within,the scope of this inspec-
tion the.Building Official may
approve minor corrections or
/6_7 /¢�� alterations of an existing struc-
ture involving work of a build- Permit Fee U
zIP ing, plumbing, mechanical or
electrical nature. Issuance Fee
PHONE p/;O/y
p� Total Fee
_ APPLICATION VALIDATION`M.O.. CASH
•
�Y� "- 3 •� O ®�
.76A662C-C.E992B 4 f/75 1' :v O-l r"-T