HomeMy Public PortalAbout9264 WEDGEWOOD ST_Certificate of Occupancy__ 76A&2-CEs92 11n5
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APPLICATION FOR OCCUPANCY INSPECTION
,. COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN BUILDING
(Print or type only) ADDRESS ,
BUILDING
ADDRESS LOCALITY
CITY. ZIP NEAREST
CROSS ST.
SIZE OF LOT NO.OF'BLDGS. y ASSESSOR
NOW ON LOT pL� MAP BOOK PAGE PARCEL
DISTRICT TYPE FIRE �MCESSIP BY
TRACT �`J' BLOCK 0.� �. CONST. ZONE `a
TEL.
ONE MAP
N0. C� d
ADDRESSfig ', J SPECIAL
1 CONDITIONS
CITY'' ZIP BLDG.SET BACK FROM
SIZE OF I N F FRONT PROP.LINE OF (STREET)
EXISTING BLDG. ORIES TOTAL SET BACK FROM TYPE OF EXISTING
HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH
PRESENT USE OF BUILDING ,
C
BLDG.SET BACK FROM
NO.PARKING SIDE PROP.LINE OF (STREET) e
SPACES P DED
HIGHWAY + YARD= TOTAL SET BACK FROM TYPE OF EXISTING
SIDE PROP.LINE HIGHWAY WIDTH
REASON FOR INSPECTION REQUEST + = C
C
CORNER CUTOFF YES NO
L
OCCUPANCY GROUPLtT�j OCCUPANT
AS VERIFIED 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 OF /
APPLICANT BY
11
DATE �j -1D `77
ADDRESS �+
�l Within the scope of this inspection
Lezz
the Building Official may approve
ZIP minor corrections or alterations of
l10 an existing structure involving work PERMIT FEE
of a building, plumbing, mechanical 36
PHONE or electrical nature. ISSUANCE FEE
TOTAL FEE
APPLICATION VALIDATIO CK. M.O. CASH
5 4=$;i RPR 7 2.2 0 3 0.0 0.