HomeMy Public PortalAbout9723 WOODRUFF AVE_Certificate of Occupancy__ i
APPLICATIO FOOCCUPANCY INSPECTION
FOR APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING BUILDING AND SAFETY DIVISION
ADDRESS 7 3
BUILDING
CITY 'jf4 ZIP ADDRESS - �vJti{�/ /7-✓�
NO. OF BLDGS. LOCALITY
SIZE OF LOT
� b NOW ON LOT �c c
_ NEAREST /
TRACT V h~b/ BLOCK L�O�f N J� CROSS ST. ���,
✓ ASSESSOR
OWNER TEL. MAP BOOK PAGE PARCEL
N0. DISTRICT TYPE FIRE PR BY
ADDRESS N CONST,' ZONE
oP I
CITY ZIPZONE MAP-
NSIZE OF 0. OF0. Q
EXISTING BLD STORIES 2/ SPECIAL
CONDITIONS
PRESENT USE OF B ING BLDG. SETBACK FROM
F ONT PROP. LINE OF (STREET)
H HWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTIN
N0. PARKING
FRONT PROP. LINE HIGHWAY WIDTH
SPAC P IDED + _ 0
BLDG. SETB M
REASON FOR INSPECTION REQUEST SIDE PROP. LINE OF (STREET)
HIGHWAY +' YARD = TOTAL SETBACK FRO TYPE OF XISTIN c'
SIDE PROP. LINE WAY WIDTH F
+
CORNER CUTOFF YES NO
PROPOSED MAX. OCC. OCCUPANCY GROUP r�
AS VERIFIEDI OCCUPANT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LOAD
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT. EXIT HARDWARE:
NO. OF EXITS a NO SPEC. KNOWL. ❑
SIGNATURE OF
PANIC DEVICES ❑
APPLICANT l
ADDRESPARKING REQ'D O PROVIDED D
S SPACES
Talmole i• 7Z) Ar OCA
ZIP /7d V xc-t::a"A r
PHONQ -
MAKE CHECKS•PAYABLE TO:
HARVEY T. BRANDY COUNTYENGINEER FINAL BY
DATE _
APPLICATION VALIDATION CK. M.O. CASH
6 8.4.E SEP 16 2 2 1) 3 0.0 0 A9
I6A662-CE992 12-79 ..