HomeMy Public PortalAbout5339 TEMPLE CITY BLVD_Certificate of Occupancy__ APPLICATION FO OCCUP Y INSPECTION
FOR APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING BUILDING AND SAFETY DIVISION
ADDRESS
BUILDING '
CITY ZI , ADDRESS
SIZE OF LOT NO OF BLOGS LOCALITY
OW ON LOT
NEAREST
TRA' BLOCK LOT NO s CROSS ST
ASSESSOR
OWNER NOL -��� DISTRMAP OICT TYPE FRE P EO BY OK PAGE ARCEL
ADORE S 5 A CONST ZO)
K OF>
CITY ZIP 7 /1
l/ USE ZONE k
P
SIZE OF NO OF
EXISTING BLDG STORIES ' ECIAL
NDITIONS
PRESENT USE OF BUILDING BLDG SETBACK FROM
FRONT PROP E OF (STREET)
HIGHWAY YARD = TOTAL SETBACK FROM TYPE OF EYISTINC
NO PARKING FRONT PROP LINE HIGHWAY WIDTH
SPACES PROVIDED
O
U
BLDG SETBA FROM �
REASON FOR INSPECTION REQUEST S10E PROP LINE (STREET) p
H
A/ HIGHWAY } YARD = TOTAL SETBACK FROM E OFAWIDTH
W
(/ SIDE PROP LINE HIG YN
+ = Z
CORNER CUTOFF / OCCUPANT
YES
NO
PROPOSED MAX OCC OCCUPANCY GROUP '—dam
AS VERIFIED
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 ❑
SIGNATURE OF PANIC [DEVICES ❑
APPLICANT
PARKING R
ADDRESS SPACES EO 0 PROVIDED
ZIP001z
PHONE
CX ,Iz1hC/ CIICCIS PAIABLC /0
HARVEY T BRANDY COUNTY ENGINEER FINAL BY
DATE y O --7
PPLICATION VALIDATION CK M o CASH
4a
,I4WR 322 0 1 8.00A98
76AB52 CE992 3/73 _