HomeMy Public PortalAbout4359 TEMPLE CITY BLVD_Certificate of Occupancy__ r �'
APPLICATION FOR CUP A CY INSPECTION
FOR APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDIIv
NG 3s T�YI /e B� BUILDING AND SAFETY DIVISION
A ODRE SS
BUILDING
CITY _6t14 e e , ZIP A ADDRESS
SIZE OF LOT NO OF BLDGS / v LOCALITY
NOW ON LOT
NEAREST
TRACT BLOCK LOT NO CROSS ST
ASSESSOR
OWNER r- i/ L r =_NOL Ff_q1/ DISTRICTTYPETYPE PIg,gGS ED BY ARCEL
ADDRESS 7 /'- ` �ros �D O CONST / ZONE
CITY Ole �< ZIP d USE ZONE MAP✓r/�_ _
SIZE OFn NO OF
NO
E%ISTING BLDG Qt/ STORIES SPECI
CON OI TIONS
PRESENT USE OF BUILDING BLDG SETBACK FROM
FRONT PROP LINE OF (STREET)
HI WAV + YARD = TOTAL SETBACK FROM TYPE OF EXISTING1d
NO PARKING FRONT PROP LINE HIGHWAY WIDTH A
SPAC PROVIDED VT•
BLDG SETBACK F
REASON FOR INSPECTION REQUEST S1DE PROP LINE OF (S TREETI
HIGHWAY + YARD = TOTAL SET ROM TYPE OF XISTIN
SIDE PROP LIN IGHWAY WIDTH 0.
N
+ _ 'l
CORNER CUTOFF YES NO
PROPOSED MAX OCC OCCUPANCY GROUP
AS VERIFIEDOCCUPANT
_
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LOAD
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT EXIT HARDWARE
NOSPEC KNOWL ❑
NO OF EXITS
t ` PANIC DEVICES
SIGNATURE OF ❑
APPLICANT LGL
PARKING REO`O D PROVIDED D
ADDRESS T �' � SPACES
D
ZIP 1g17v
PHONE',.��
elAAt (HEC" PAIABLE TO
HARVEY T BRANDY COUNTY ENGINEER FINAL BV r
DATE L
APPLIdTIA VALIDATION CK M 0 CASH
i
76A662-CE992 12-73 2,5 ,8i4 0LI;4,:;b-4 U U ,0 0 �y�y