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"Iff APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
RTfVIMVT OF COMMUNITY DEVELOPMENT
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Address District
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Business Name_ SY1i�' { _ �L 'L �I (7T%_ (.j-�- Tel
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Business Type L Occ. Group -'
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BUILDING OWNER BUSINESS OWNERIMANAGER
NameAy. t CSY- ` Name -
Home Y1
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Address N O t�. i o � Address
City ��? � ` Tel City Home Tel R:
THIS USE WOULD BE DESCRIBED AS;
NEWLY CONSTRUCTED BLDG, LJ CHANGE OF OWNER C❑ CHANGE OF OCCUPANT
' EXISTING BUILDING 0 CHANGE OF USE D ADDITION O
Indicate former use, if any ` Occupancy Grv,
SQUARE FT. OF BUILDING TO BE OCCUPIED s- CA
NOTICE: 1, Occupancy of any building is prohibited and a business license will not be issued until the building has been
inspected and a certificate of occupancy is issued.
2. Ne electrical service will be released for any existing building until the service; has beef inspected and
certified safe. AU applicants for occupancy in an existing building are required to sch viu{e an 91"6trical
" 'fuse up' inspection in the Department of Community Development at the time this application is filer',
3, Change of occupancy or use inspection fee. Whenever it is necessary to make inspection of a bulidir,g or
premises in ordeeto determine If achange may be made in the characterof occupancy or use of the building"
or premises whichwould place the building in a different division of the same group of occupancy or in a
different group of occupancy, a change of occupancy inspection fee of $ shall (7-k
be paid to the city: ;
�4. Hunt{nugton. Beach Fire Code Section 10.208 requires that building numbers must be a minimum offour(�,;
inches in height with one half (t/i) inch stroke, and of a contrasting color from the background, 7nes�
numbers must be posted on your building Ina location that is visible From the street,
` 5, Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection and distribution per the "
National Fire Protection Association pamphlet 10 (see •everse side).
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TRAFFIC+ K. CT F'EB
DAT-I PAID_
'AMOUN EIVED
NAME (FOR OFFICE USE OI'aLY) ZONING
OCCUJJANGY GROUP PLAN CHECK NO NO PARKING SPACES .�,.�.
OCGUPANT LOAD PERMIT NO HEALTH DEPT APPROVAL
NO. Li) STORIES" ADMIN. ACTION _ UT!!.ITIES RELEASED
CERTIFICATE OF OCCUPANCY FEE
g�`
APPROVED BY DATE CHANGE OF USE OR OCCUPA14CY FEE S
TOTAL
` COMMUNITY DEVE` OPMENT
76-D39 Rev.1/0,