HomeMy Public PortalAbout5404 TEMPLE CITY BLVD_Certificate of Occupancy__ 1
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APPLICATION FOR OCCUPANCY'sINSPECTION
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
\ `k BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
(Print or type only) ADDRESS SAfQ d4� 61
BUILDING LOCALITY
ADDRESS //// �
CITYNEAREs
_je /E �\ 1 ZIP CROSS ST 0�(�(,(„(/
SIZE OF LOT ( NO OF BLDGS ASSESSOR
!s MAP BOOK PAGE PARCEL
NOW ON LOT 3
DISTRICT TYPE FIRE P OCE D BY
TRACT BLOCK I�OIg[y}s CONS Z02
OWNER T TEL �}
v �o O USE ZONE MAP
NO a Q Q
ADDRESS G 2SPECIAL
�a NDITION$
CITY i ZIP y/ BLDG SET BACK FROM
SIZE OF NOOF FRONT PROP LINE OF (STREET)
EXISTING SLOG STORIES
HIGHWAY + YARD = TOTALFRONT PROP
FROM TYPE A oa DTH
PRESENT USE OF BUILDING FRONT PROP LINE HIGHWAY vnoiR
+ -
BLDG SET BACK FROM
NO PARKING SIDE PROP LINE OF (STREET)1
SPACES PROVIDED
HIGHWAY + YARD - TOTALSIDE PROP LINE
TYPE OF o..T.a
- SIDE PROP LINE HIGFNJAV w1CiM .L
O
REASON FOR INSPECTION REQUEST +
W
CORNER CUTOFF VES NO
OCCUPANCY GROUP
AS
AS VERIFIED :f'q OCCUPANT
LOAD
CSCy�Y(� EXIT HARDWARE
PROPOSED MAX OCC
NO OF EXITS NO SPEC KNOWL ❑
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS PANIC DEVICES, ❑
APPLICATION AND STATE THAT THE ABOVE IS COR
RECT
PARKING
SPACES REQ DPROVIDED
SIGNATURE OF 1 / �A / FINAL
APPLICANT l..0 �C ,' t Lr 7f BV
DATE �C
ADDRESS
Within the scope of this Inspec
Ilan the Building Official may
approve minor corrections or
/ ZIp o O alterations of an existing strut
lure Involving work of a build PERMIT FEE
mg, plumbing mechanical or
PHONE • leWcal nature ISSUANCE FEE
_yy N TOTALFEE (10
1 APPLICATION VALIDATION CK Mo CASH
J O O N N
10 O O N :l:-
CH
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