HomeMy WebLinkAbout15051 Goldenwest St - CofO (5)Business Licen
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Business Name
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j Certificate of Occupancy No. 02009-19&p
APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH — DEPT. OF BUILDING & SAFETY
(3'd Floor - Must Apply In -Person)
Date
Zip Code �; y
Telephone No. _3It) 459 e)_3 '
Bus. Phone 3/o 6s d 3srSr
Property, Owner Information (required) Tenant/Emer enc Contact (required)
Name I -% 'Vmp&r-he,3 Name J9,M e
Address 31 Home Address 1 D�
City Icy n p State/Zip qz City j4 p StatelZip
Telephone No. � qq tj� j 8 q0 Q Telephone No. flu 10) W 9
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or fit] Existing Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner ❑ Change of Occupant 0 Change of Us Addition ccupant
■ In'dicate former type of business
■ Are you requesting that the electricity be turned on? Yes ONO(
■ Is the building sprinldered? Yes ONo❑
■ Will operations produce dust/wood shavings or similar material? YesON619
■ Will operations involve the repair or replacement of automobile parts Yes ONo 5( If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes ONO IT
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes ONo 41
■ The following best describes my operatio �anu
nl ❑ Retail Sales 0 Medical/Dental
❑ Restaurant/Take Out Food ❑ Warehousturing/Distribution
(describe process and end product)
❑ Other (describe)
For Official Use Onl
Occ Group:
Oce Group:
Occ Group:
Total Sq Ft Occupied:
Bldg. Permit #
Area:
Area:
Area:
No. of Stories:
Entitlement #:
Plnr Initials: Date:Q,'q`Qj• Plan Chkr Initials: Date:
Occ Load:
Occ Load:
Oce Load:
TIF Review: Y/ N
Zoning:
Insp Initials: Date:
Conditions of Approval or Other Notes:
0WIL6 U5t; Pe2Wt��-V ; �OFcLe'b- OPT=lCam. �yo coeo ptw�D
Inspection Date:
(G:Building/Forms/document id goes here)