HomeMy Public PortalAbout9860 VAL ST_Certificate of Occupancy__ 76A6U-CEN2 1 im -
APPLICAeNa?7® ®CCT CY INSPECTION �1
- `' COUNTY OF LOS ANGELES IJ
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING r
(Print or type only) ADDRESS l! •
BUILDING `
ADDRESS O �$ / LOCALITY
/p L4�LLr
CITY v ZIPY NEAREST
U CROSS ST.
SIZE F LO _ NO.OF BLDGS. ASSESSOR
NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT TYPE FIRE P B
dVY
TRACT BLOCK LOTO. /d T CONSZONE
OWN TEL. `
.. N0. - USE ZONE NOP U3
ADDRESS dW D Z� PECIAL
�BETBACK
ONDITIONS
CITY ZIP /7�d BLDG. FROM
SIZE OF 0.OF FRONT PROP.LINE OF (STREET)
EXISTING BLD STORIES TOTAL SET BACK FROM TYPE OF EXISTING
PRESENT USE OF BUI G
HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH
>
0
+ = C
BLDG.SET BACK FROM C
NO.PARKING SIDE PROP.LINE OF (STREET) . e
SPACES PR ED C
HIGHWAY + YARD= TOTAL SET BACK FROM TYPE OF EXISTING
f SIDE PROP.LINE HIGHWAY WIDTH
L
REASON FOR INSPECTION REQUEST
+ —
G
CORNER CUTOFF YES NO
OCCUPANCY GROUP7j; OCCUPANT
AS VERIFIED LOAD
EXIT HARDWARE:
PROPO ED 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
SPACES REQ'D PROVIDED
SIGNATURE
APPLICANT FINAL
(�
ADDRESS• JU f Je
DATE BY
S� //� Within the scope of this inspection
the Building Official may approve
minor corrections or alterations of
ZIP �(1 an existing structure involving work
PERMIT.FEE
of a building, plumbing, mechanical
PHONE or electrical nature. ISSUANCE FEE
TOTAL FEE
APPLICATION VALIDATION
714 1:Z:RR.. 15 .2.2 e: 3 0.0-0 Ass