HomeMy WebLinkAbout15121 Graham St - CofO (24)APPLICATION FOR CERTIFICATE OF OCCUPANCY
• CITY OF HUNTINGTON BEACH J/O /
�NrrvczaH MACHDEPARTMENT OF COMMUNITY DEVELOPMENT /
(PRINT OR TYPE ONLY) - DATE
Address �%�/2/y�i/i� ' %T '/vZ'
District
Business Name_2/�N�ur2?r��6 _ Tel.
Business Type �`��j�(/ir�G%%�rL/t
Occ. Group.
BUILDING OWNER BUSINESS OWNER/MANAGER
Name 4/' %'�f�� ��AI/A,'/ NameHome
_ �• �• ���%1%�iU
Address�_/ (/✓ Y ��/� `✓t%!s/1/� ��y 1� Address_�J7 /1j
City—L(�c�W �� /J �1� Tel b .� Q7 '� /5114A / X1 / �fY 7 � 99 ti
City Home Tel.
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THIS USE WOULD BE DESCRIBED AS: I
❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER ❑ CHANGE OF OCCUPANT
EXISTING BUILDING ❑ CHANGE OF USEADDITIONAL OCCUPANT
Indicate former use, it any L� Occupancy Gr Div.
SQUARE FT. OF BUILDING TO BE OCCUPIED / !
"• ••••^••••y�l• ,11 nle %,uue aeciion Iu.oulrequires fire extinguisher selection and distribution per the
National Fire Protection Association pamphlet 10 (see reverse side).
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:RAFFIC IMPACT FEE
DATE PAIR v 1 O O dC�✓
AMOUNT RECEIVED
NAME
SUPPLEMENTAL INFORMATION (FOR OFFICE USE ONLY) ZONING—
OCCUPANCY GROUP PLAN CHECK NO. NO PARKING SPACES
OCCUPP'JT LOAD PERMIT NO. HEALTH DEPT- APPROVAL
NO. OF STORIES ADMIN. ACTION UTILITIES RELEASED
CERTIFICATE OF OCCUPANCY FEE g
APPROVED BY DATE CHANGE OF USE OR OCCUPANCY FEE g
TOTAL $
75-039 Rev. 1/97 I
COMMUNITY DEVELOPMENT
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