HomeMy Public PortalAbout9647 WEDGEWOOD ST_Certificate of Occupancy__ APPLICATION FOR OCCUPANCY INSPECTION ]
FOR APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING �� � ad BUILDING AND SAFETY DIVISION
ADDRESS f d BUILDING //'
CITY f LG 6/T �p ZIP ADDRESS %47
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SIZE OF LOT r� NO. OF BLDGS. LOCALITY
/� e
��2X�SO NOW ON LOT
NEAREST
TRACT Oes'2 BLOCK LOT NO. /4 CROSS ST. O e KW�S
- t7 7 1�// 'ASSESSOR
OWNER✓,40K 6/S DISTRICT TYPE PAGEMAP BOOK PARCEL
IPROCE D BYARCEL
ADDRESS Srl/�!EO CONST.V. ZONE
J
CITY ZIP �SF ZONE MAP �O
SIZE N NO. OF N0.
EXISTING B STORIES QO SPECIAL
CONDITIONS_.
PRESENT USE OF LDING BLDG. SETBACK FROM
FRONT PROP. LINE OF, (STREET)
HIGHWAY + YARD = TOTAL SETBACK F M TYPE OF EXISTING
N0. PARKIN FRONT PROP. :NE, HIGHWAY WIDTH
SPACES OVIDED +
BLDG, SETBACK FROM
REASON FOR INSPECTION REQUEST SIDE PROP. LINE OF (STREET) n
C
l
a,:?
1 HIGHWAY + YAR __ TOTAL SE ROM TYPE OF ISTIN C
(p SIDE P LINE HIGHWAY WIDTH p
C _ C
C
/D 1 +
-CORNS CUTOFF YES NO v
PROPOSED MAX. OCC. OCCUPANCY GROUP '
AS VERIFIED OCCUPANT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LOAD
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT. EXIT HARDWA�F2E:
_ '
- NO. OF EXITS NO SPEC. KNOWL.. ❑
SIGNATURE F ;
PANIC DEVICES ❑
APPLICANT -a
ADDRESS
PARKING REQ-0 O PROVIDED D
SPACES
y
s
' N-6. /BLOT PaA-n.• ��-r '• %�,..�---.e
ZIP /T 2717K No rwd2pr
PHONE -f f�•,xJ ._ ��
MAKE CHECKS PAYABLE TO: 6r+�V 4.� �'i'e �•.e..a
[HARVEY T. BRANDY COUNTY ENGINEER FINAL BY
DATE
APPLICATION VALIDATION .• CASH
58 833 D 30U'0.Q
76MQ-CE992 9/74 -