HomeMy Public PortalAbout4819 TEMPLE CITY BLVD_Certificate of Occupancy__ ' . APPLICATIO FOR CCa
UP CY INSPECTION
FOR APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUI LDINc BUILDING AND SAFETY DIVISION
A ODRE55
BUILDING
CITY
�jtrr�-c Q/' ZIP 9i 7g� ADDRESS / I i
SIZE OF LOT J NO OF BLDGS LOCALITY
s(1 1 �' D NOW ON
/�,, sw NEAREST
TRACT BLOCK OT N CROSS ST
41. ASSESSOR
OWNER /�/���y"y OO -
TEL MAP BOOK - PAGE - PARCEL
r/ DISTRICT TYPE FIRE CES D BY
ADDRESS ' 06,
06, CO ZONIf E
CITY pq,y�,y ZIP USE ZONE MAP O /
SIZE OF o Ii ND OF NO �J
EXISTING BLDG O .{ c, SPECIAL
CONDITIONS
PRESENT USE OF BUILDING �i4d/D• BLDG SETBACK FROM
FRONT PROP LINE OF (STREET)
HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF ISTIH
NO PARKING
FRONT PROP LINE HIGHWAY WIDTH
SPAC PROVIDED
BLDG SETBACK FROM
REASON FOR INSPECTION REQUEST SIDE PROP LINE OF (STREET)
HIGHWAY + YARD - TOTAL SETBACK FROM TYPE OF %ISTIH
SIOE PROP LINE JHIGHWAYJ WIDTH
+
CORNER CUTOFF YES NO '
A�
PROPOSED MAX OCC OCCUPANCY GROUP
AS VERIFIED OCCUPANT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LARD
FT
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECTEXIT HARDWARE
NO OF EXITS NO SPEC KNOWL ❑
SIGNATURE OF
PANIC DEVICES ❑
APPLICANT
PARKIN
ADDRESS ; / i SPACES • REO D D PROVIDED D
ZIP
__7/ PHONE
MARL CBEC&S PAYABLE TO
HARVEY T BRANDT, COUNTY ENGINEER FINAL �J/ BY
((( APPLICATION VALIDATION CK M D CASH
�{/. 7 7 4nypy 12 4 u D O 58
76A662-CE992 12-73 I _ �