HomeMy Public PortalAbout5925 TEMPLE CITY BLVD_Certificate of Occupancy__ 76AG62-CE992-4/77
APPLICATION FOR OCCUPANCY INSPECTION
FOR APPLICANT TO FILL IN BUILDING
(Print or type only) ADDRESS
BUILDINGT-,y
-ADDRESS `( LOCALITY
CITY T.�9 NEAREST
ZIP 9/780 CROSS ST.
SIZE OF LOT �7 1 7 j NO.OF BLDGS. ASSESSOR11
o� NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT ITYPE FIRE p4eCtfSED BY
TRACT C2_� / BLOCK LOTNO. A U� COf iz Z
ONE
''vv 11��✓✓ r _/ c ��
OWNER �.A4*R v1j' NOL �S' USE ZONE NOAP p v7
ADDRESS C_L SPECIAL
CITY ZIP CONDITIONS
o Me BLDG.SET BACK FROM
SIZE OFNO.OF FRONT PROP.LINE OF (STREET)
EXISTING BLDG. /0O STORIES
HIGHWAY + YARD= TOTAL SET BACK FROM TYPE OF IXISi6dG
RESENT USE OF BUILDING FRONT PROP.LINE HIGHWAY WIDTH
+ -
CA BLDG.SET BACK FROM
NO. PARKING SIDE PROP.LINE OF (STREET)) i
SPACES PROVIDED I
HIGHWAY + YARD- TOTAL SET BACK FROM TYPE OF IXISING .
SIDE PROP. LINE HIGHWAY WIDTH
t
R ASON FOR INSPECTION REQUEST + - L
L
CORNER CUTOFF YES NO S
Gr'l�J ��131fV�P
OCCUPANCY GROUL!� OCCUPANT
AS VERIFIED LOAD
EXIT HARDWARE:
PROPOSED MAX.OCC. NO.OF EXITS NO SPEC. KNOWL. E]
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PANIC DEVICES ❑
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT.
PARKING :
SPACES REQ'D PROVIDED=
�
SIGNATURE OF BY %I
-APPLICANT FINAL y
DATE ��.+� a' �� •_
RESS o /) -
v /�/q/ Within the scope of this inspec-
77c" tion the Building Official may
approve minor corrections or
ZIP alterations of an existing struc-
ture involving work of a build- PERMIT EE
Ing, plumbing, mechanical or
PHONE electrical nature. ISSUANC E
o�
[TOTAL FIE
APPLICATION VALID109V 'SCK. M.O. CASH
e o
IU e O N
C� ao
o . o (V
'O o O
NIS