HomeMy WebLinkAbout15145 Springdale St - CofO (3)Certificate of Occupancv No. 02006,i nnb I De
APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH - DEPT. OF BUILDING & SAFETY
(3`d Floor - Must Apply In -Person)
Business License # A 2(o 8 ( 4 9 Date 11- 2 `f - 09
Business Address 15145 5P1L(A)&q .Lf Zip Code 0" (o 0
Business Owners Name ,SGorr JAc og.0 _ Telephone I\ o. R,�6 ,Pi3 --r'137
Business Name ZNi rxSr^sr-`E CQNN6-r—V (74omPgA/EN75. /A)C _ Bus. Phone BusinessType Sot CS o� t" frv4- b r3nwovTv/L
Property Owner Information (required) Tenant/Emergency Contact (required)
Name Voj DER f4ttre P-fA-L� Es a,► Ste Name SGorr ,fAC.O(�'S
Address 2-644 D LA ALAM CDA t- Vv iu-- 270 Home Address 15o Tnjrq (bo-ocA1 j! (1-D
City Mtss«arj Vt&-s-o State/Zip CA 92 F9 1 City Moo"imtJ$l State/Zip N,T 0100
Telephone No. y'(f 9 - 31(-9' 1 v 0 'telephone No. _ M6 -V5 - 54F31L
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or U Existing Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner [+`Change of Occupant ❑ Change of Use ❑ Additional Occupant
■ Indicate former type of business pFFr(
■ Are you requesting that the electricity be turned on? YesONo�
■ Is the building sprinklered? Yes ONo❑
■ Will operations produce dust/wood shavings or similar material? Yes0NoP--'1"
■ Will operations involve the repair or replacement of automobile parts Yes QNo Ll-"*' If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes 0No
Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes ONo V � �
■ The following best describes my operation: I,Utfice Only ❑ Retail Sales ❑ Medical/Dental
❑ Restaurant/Take Out Food ❑ Warehouse /Manufacturing/Distribution
(describe process and end product)
❑ Other (describe)
For Official Use Onl
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied:
Bldg. Permit #
Area:
Area:
Area:
No. of Stories:
Entitlement #:
Occ Load:
Occ Load:
Occ Load:
TIF Review: Y/ N
Zoning: :�L
Plnr Initials: Date: 12- t'l 111, Plan Chkr Initials: Date: Insp Initials: Date:
Conditions of Approval or Other Notes:
9110E -10 -ia ` rJ{ '(al fi-V ' '1Sl.D C, 0f' ►�- /
Inspection Date:
(G:Building/Forms/document id goes here)