HomeMy WebLinkAbout15061 Springdale St - CofO (51)Certificate of Occupancy No. 0201 D 0014 11
0
"
714/536-5271
Business Licen
Business Addrf
Business Owne
Business Name
Business Type
APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH — DEPT. OF BUILDING & SAFETY
0`1 Floor - Must Apply In -Pe
Date
Zip Code
Telephone No.
Bus. Phone
PropertyPropeLty Owner Infor on (required) Tenant/Emergency Contact (required)
Name S� , � 0����E S Name -Al
Address ZZ egrzeAe S Home Address f o Cos i ,O S
City /,4fth State/Zip G14 4*Z g dQ City Cag-,r.4 A State/Zip e�4 fz eZ7'
Telephone No. `ff ZSo ylo U Telephone No. �f� e33 -?1? ]�? Y)
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or xisting Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner hange of Occupant ❑ Change of Use ❑ Additional Occupant
■ Indicate former type of business_
■ Are you requesting that the electricity Ke turned on? Yes ❑ El No [A--
■ Is the building sprinklered? Yes R15-0 No ❑
■ Will operations produce dust/wood shavings or similar material? Yes❑ ❑NoO-,-'
■ Will operations involve the repair or replacement of automobile parts Yes ❑ ❑No 5?� If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes ❑ El No 0�
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes �No ❑ �
■ The following best describes my operation: Ce'Oftice Only ❑ Retail Sales ❑ Medical/Dental
❑ Restaurant/Take Out Food ❑ Warehouse /Manufacturing/Distribution
(describe process and end product)
❑ Other (describe)
For O(f cial Use Only
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied:
Bldg. Permit #
Area:
Area:
Area:
No. of Stories:
Entitlement #:
Plnr InitD
• Date: Plan Chkr Initials:
Conditions of Approval or Other Notes:
Inspection Date:
Occ Load:
Occ Load:
Occ Load:
TIF Review: Y/
Zoning:
Date: Insp Initials: Date:
(G:Building/Forms/document id goes here)