HomeMy Public PortalAbout6361 SULTANA AVE_Certificate of Occupancy__ �,,APPLICATION FO' CCUPAI�CY -INSPECTION
FOR APPLICANT TO FILL IN (Print or type only) ICOUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING 3(o l � Sup„f�r7 BUILDING AND SAFETY DIVISION
ADDRESS
BUILDING
CITY Cd'j ZIP ADDRESS 01.
SIZE OF LOT } �/ N0. OF BLDGS. LOCALITY ��
:i 7 7f ' NOW ON'LOT
pa�.+y SLS NEAREST
TRACT. BLOCK �” LOT NO p�0,�(o CROSS ST. ��rNCy� ( l
OWNER TEL. Q / MAP BOOK 3$°� PAGE I PARCEL
dG C•G IQ�rN0�0 -rOZs� DISTRICT TYPE FIR PROCES B
ADDRESS CONST Onr
-r� (�
CITY � / C ZIPS 7Q� fERONE MAP
SIZE OF L� NO. OF v J NO.
EXISTING BLDG. STORIES / SPECIAL
CONDITIONS
PRESENT USE OF BUILDING BLDG. SETBACK'FROM
FRONT PROP. LINE OF (STREET)
HIGHWAY + YARD - TOT SET ACK FROM TYPE OF EXISTIN
NO. PARKI G F ROP. HIGHWAY WIDTH
SPACES PROVIDED + -
BLDG. SETBACK FR /
REASON FOR INSPECTION REQUEST SIDE PROP. LINE 0 (STREET)
TOTAL SETBACK FROM TYPE OF EXISTINGC
HIGHWAY + - SIDE PROP. LINE HIGHWAY WIDTH C
CORNER CUTOFF YES NO - a
u,
PROPOSED MAX. OCC. OCCUPANCY GROUP
SAS VERIFIED OCCUPANT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LOAD
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT. EXIT HARDWARE:
NO. OF EXITS NO SPEC, KNOWL.'
E
SIGNATURE OF
�j PANIC DEVICES 0.
- G/
APPLICANT
ADDRESS PARKING REQ'D PROVIDED
p SPACES
Z 1 P
PHONE
MAKE CHECKS PAYABLE TO: _
xe V, Ulm
HARVEY T. B.RANDT COUNTY ENGINEER FINAL BY �1' / ,/�
DATE tJ Ll
APPLICATION VALIDATION CK.V.M•o• CASH
5.9 4v0_AUG 1122 -u 3 0.0 0 �.W$
76%A662-CE992 8/76