HomeMy WebLinkAbout1010 California St - CofOAPPLICAT20N FOR CERTIP167; &OP OCCUPANCY r
CirV nf. Hein inQtor_ Seach DenarhmPnt nf`Anilriiiio [`nmm��fi�t`v`tts+vsainnman
FOR APPLICAN'. TO FILL IN (Print or type only) DATE & If7
pplication,is hereby made for a Certificate of Occupancy for a:
T If
D9scr. ibe Busin ss Use
To be known as
/ gov �,.me of Business
.ocated t
f Business Address
714
aNlIGD �. /,'crcNSo/v .2X)2 /&;7"y�C'�
Name: BUILDING MIER fAddress City zip Phone No.
THIS USE WOULD BE DESCRIBED AS:
lD Newly Constructed Building ® Change of Owner (` Change of Occupant
JW Existing Building Chance of Use AOditional Occupant
Indicate form--r use if any
Name: BUSXMZSS OWNER Residence Address City V
Phone No. - Business:/w�t�/G Rc!gidence:^^
NOTICE, 1. Occupancy of any building is prohibited and a bu-;iness license will not be
iastied until they building has been inspected and a Certificate of Occupancy
is issued.
2. No electrical service will ere re'Leased for any existing buildini4 until the
(} service has ,been inspected and certified safe. All applicarts"for occupancy
in an exi.sdn' g' "building are required to schedule an electrical "i•7ise up"
inspection iti .'the Aepartment of Building and Commenit'y Development .at the
time this application is filed.
3. CHANGE OF OCCUPANCY OR USE INSPECTION PER. Whenever it 'is necessary to make
l'
•ins}^,ction'of a building or premises' in order ,to dktermifie if. a change may
be aiade in 'the character of occupancy or use of the b tiding' or premises
which would place the'builditig in a diffenent•'divisioW of the same .group of
occupancy or in a dif�ere"nt group of occupancy, a change Gf occupancy
inspection fee of $25.00 shall be pa- d to the �".try.
(FOR OFFICE USE OiMY)
SUPPLEMENTAL INFORMATION
Sq. ft. of building _ P;an Check No.
Occupancy U'ro ,„ _ Permit Ne .
Occupant Load _ _ Adkiii. 'Action _
ho. of St^',ies No. Parking Spaces
Health Dept. Appraval
Utilities Release.
Y
APP. RO BY Tt,
Gf�C.G-.j CERTIFICATE OF FEE $
t ( 7 `, 030) ' `.CHANGa?. OF OCCUPANCY OR USE INSPECTION _ FEE Y
y i+aF. yi �'r4,•y" :f�:_ `1 .�•`iA'`-- y ,li�:.f:.". bi yr. ,�j .. 1..1 t�,.. y1 0' '•t• .•.j X�•`: r_