HomeMy Public PortalAbout4522 TEMPLE CITY BLVD_Certificate of Occupancy__ APPLICATION FOR OCCUPANCY INSPECTION
' FOR APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING 4522 TEMPLE CITY BLUDiREAR BUILDING AND SAFETY DIVISION
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SIZE OF LOT 720 SQ. 11• NOWDON LOTS LOCALITY
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BUILDINGnFETCH IN TipBli�T BLDG SETBACK FROM
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ICE VACANT HIGHWAY } YARD = TOTAL SETBACK FROM TYPE OF EXISTINJ
NO PARKING FRONT PROP LINE HIGHWAY WIDTH
SPACES PROVIDED
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BLDG SETBACK FROM
REASON FOR INSPECTION REQUEST SIDE PROP LINE OF (STREET) O
APPLICATION FOR BUSINESS LICENSE HIGHWAY } YARD = TOTAL SETBACK FROM TYPE OF %ISTIN Ci
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CORNER CUTOFF VES NO N
PROPOSED MAX OCC OCCUPANCY GROUP
AS VERIFIED � OCCUPANT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LOAD
APPLICATION AND STATE THAT THEIABOVE IS COR- EXIT HARDWARE
RECT
NO F EXITS O NO SPEC KNOWL ❑
SIGNATURE O,,Ov�Ad PANIC DEVICES ❑
APPLICANT
PARKING REO,D o PROVIDED O
ADDRESS 4522 TEMPLE CITY BLVD SPACES
TEMPLE CITYiCALIF ��3 /ID 7—
zip.
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zip. 91780
PHoN4434866
MAKE CHECKS PAYABLE TO
HARVEY T BRANDY COUNTY ENGINEER I FINAL �9�16 BY
DATE
APPLICATION VALIDATION CK M 0 CASH
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