HomeMy Public PortalAbout5826 TEMPLE CITY BLVD_Certificate of Occupancy__ ' r
76A662-CE992-4/77
APPLICATION FOR OCCUPANCY INSPECTION
L
FOR APPLICANT TO FILL IN V BUILDING
(Print-or type only) ADDRESS �✓p� ,I�J `�/`'
BUILDINGDRE$S Y V LOCALITY e� .
1J` �
CITY ei Zlpo NEAREST
CROSS ST.
SIZE OF LOT NO.OF BLDGS. ASSESSOR
NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT TYPE FIRE PR SS BY
TRACT BLOCK LOT NO CONST ZON
OWNERIA 14&0 NOL , `7 USE ZONE MAP
NO.
DDRESS C� �) L
S ' SPECIAL
�L CONDITIONS
TY ZIP BLDG,SET BACK FROM
SIZE OF NO.OF ��yy FRONT PROP.LINE OF (STREET)
EXISTING BLDG. STORIES oC,
HIGHWAY + YARD= TOTALSEr BACK TYPE OF �DsrwC+
PRESENT USE OF BUILDING FRONT PROP.LINE HIGHWAY WIDTH
+ ( _
BI OG SET BACK FROM C
NO.PARKING SIDE PROP.LINE OF (STREET)) c
SPACES PROVID
HIGHWAY + YARD= TOTAL SEP BACK FROM TYPE OF OCIsraNCi C
SIDE PROP. LINE HIGHWAY WIDTH
f
R ON FOR INSPECTION REQUEST + _
0
CORNER CUTOFF YES NO.
CT" r a
OCCUPANCY G ROUP OCCUPANT
CJI_ c", A5 VERIFIED. �'L LOAD
EXIT HARDWARE:
PROPOSED MAX.OCC. NO.OF EXITS NO SPEC. KNOWL. ❑
•
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PANIC DEVICES ❑
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT.
PARKING: REQ'D PROVIDED
SPACES
SIGNATURE OFIN B
A LICANT o G FINAL 3-�1..-2el BY
DATE /
ADDRESS 3 t � '� G OVA
Within the scope of this inspec-
CZ9. tion the Building Official may
approve minor corrections or
ZIP C� `� / alterations.of an existing struc-
ture involving work of a build- PERMIT FEE
ing, plumbing, mechanical or
PHONE r� electrical nature. ISSUANCE FEE
TOTAL FEE
APPLICATION VALIPATJO NgK. M.O. CASH
(V o D IV
N C "o CA
o o _-1
�7 0 4-- O
'O o O .b
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