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APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
DEPARTMENT OF DEVELOPMENT SERVICES
HUNTINGTON BEACH IFRINT OR TYPE ONLY) DATE
Address
I/f i �` k k District
Business Name � Tel.
Business Type
/i E$�Q ailiigL !E Ertl �✓1G G(N /T S 1 , ;:,• Ct r r: tt ; Ji Occ. Group
BUILDINC OWNER OWNER/MANAGER
Name 17 ` CA1pgRA_ G _7 6-y? Name
Address r' ` //? �' ��� 9'4r Address
Chy _ 6*6i %dq /�� ' _._ Tel. '60Y"City _ Tel._
THIS USE WOULD BE DESCRIBED AS.
F1 NEWLY CONSTRUCTED BLDG. CHANGE OF OWNER CHANGE OF OCCUPANT
19 EXISTING BUILDING CHANGE OF USE ADDIT,::NiAL OCCUPANT
Indicate former use, if any Occv—ancy Gr. Div.
NOTICE: 1. Occupancy of any buili;:aq is prohibited and a business license will not be issued until the building
has been inspected and a certificate of occupancy is issued.
2. No electrical service will be released for any existing building until the service has been inspected
and certified safe. All applicants fo° occupancy in an existing building are required to schedule an
electrical 'fuse up' inspection in the Department of Development Services at the time this applica-
tion is filed.
3. Change at occupancy or use inspection fee. Whenever it is necessary to make `nspection of a build-
ing or premises in order to determine if achange may be made in the character of occupancy or use
of the building or premises which would 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 $30.00
shall be paid to the city.
4. Huntington Beach Fire Cade Section 10.208 requires that building numbers must be a minimum
of four (4) inches in height with one half (%) inch stroke, and of a contrasting color from the back-
ground. These numbers must be posted on your building in a 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 reverse si �� 2 , ,.
(FOR OFFICE USE UNLY)
SUPPLEMENTAL INFORMATION
SQUARE FT. OF BUILDING _ PLAN CHECK. NO. _ N0. PARKING SPACES
OCCUPANCY GROUP _ _ PERMIT NO. _ HEALTH DEPT. APPROVAL
OCCUPANT LOAD ADMIN. ACTION UTILITIES RELEASED
NO. F STORIES
T CERTIFICATE OF OCCUPANCY FEE $ �3
L�
APPROVED BY i, DATE CHANGE OF OCCUPANCY FEE $"
TOTAL
Tf VjP/. y, (� � � �..• J
.1
f
75-039 REV.