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HomeMy WebLinkAbout15061 Springdale St - CofO (39),5i7 /1411v Certificate of Occupancy No. ONO- OND\_0 Obi, 'M Xe) 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 (3'd Floor - Must Apply In -Person) Date 2011t Zip Code O/ Telephone No. Bus. Phone Property Owner Information (required) Tenant/Emergency Contact (require L�/0d) Name e1 LG Name&2V j9y11Knf7Aj1t- Bi Address 1/l e ( l') Home Address A"" City State/Zip Z10 City MK tate/Zip Lf_,62 _ Telephone No. •� �1' �/V� ZZ��j Telephone No. 7 I - W'� Me THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or I( Existing Building CHECK ALL THAT APPLY: ❑ Change of Property Owner ■ Indicate former type of business Change of Occupant ❑ Change of Use ❑ Additional Occupant ■ Are you requesting that the electricity be turned on? Yes ONO ■ Is the building sprinklered? Yes ONo❑ ■ _ Will operations produce dust/wood shavings or similar material? YesON7 ■ Will operations involve the repair or replacement of automobile parts Yes ONoX components repaired or replaced. ■ Does the operation involve the use of welding or open flame? Yes ONo ■ Will the business be a drinking, dining or assembly use with an occupant loaf Yes ONo� ■ The following best describes my operation: )7 Office Only 0 Retail Sales ❑ Restaurant/Take Out Food ❑ Warehouse /Manufacturing/Distribution (describe process and end product) ❑ Other (describe) For Official Use Onl Occ Group: Occ Group: Occ Group: Total Sq Ft Occupied:, Bldg. Permit # Area: Area: Area: No. of Stories: Entitlement #: Plnr Initials: Pyk Date: 1 Plan Chkr Initials: Date: Conditions of Approval or Other Notes: ©ffll,=W-offtw -No c.or- o. ftezt'b Inspection Date: If yes: Describe the of more than 50 persoris? ❑ Medical/Dental Occ Load: Occ Load : Occ Load: TIF Review: Y Zoning: C�- Insp Initials: Date: (G:Building/Forms/document id goes here)