HomeMy WebLinkAbout101 Main St - CofO (60)0
J�
HUNTINGTON BEACH
Business License #
Business Address_
Business Owners I`
Business Name h I
Business Type . l 6
CERTIFICATE OF OCCUPANCY 020__j� - O
CITY OF HUNTINGTON BEACH —
DEPT. OF PLANNING & BUILDING APPLICATION
714/536-5241
(3'd Floor — Must Apply :In -Person)
Date R-
Zip Code c ��
Telephone No.YA/- T6 q -0
;Bus. Phone 71y/ 3%JE- 26()
ProveProvertv Owner Information (re uirgd) Tenant/Emergency Contact (required)
Name cue n) e ✓ o i ell C- Name l i 1 J � S0
Address `` C i2c Home ddress 7�'
City �li7ile r) F6d State/Zip G �;Z� City // i�c' i 1 c State/Zip
Telephone No, �/ 1'� �?�`f Q� `%� Telephone No.C/,)
THIS USE WOULD BE DESCRIBED AS: �
❑ Newly Constructed Building or WE"xisting Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner ❑Change of Occupant ❑ Change of Use Additional Occupant
■ Indicate former type of business— o/) i e5 irL /-1w yh1-b/Z-ok?1,:-
■ Are you requesting that the electricity turned o YesO NOD
■ Is the building sprinklered? Yes N
Will operations produce dust/wood havings or similar material? Yes❑
■ Will operations involve the repair or replacement of automobile parts Yeso
No9---*",�/
NoCIf yes: Describe the
components repaired or replaced. el
■ Does the operation involve the use of welding or open flame? YesO No
■ Will the businebe a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes []NoZ
■ The following best describes my operation: Mice Only ❑ Retail Sales ❑ Medical/Dental
❑ Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food
(describe process and end product)
Other (describe)
For Official Use Onl
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied:
Bldg. Permit
Area: Occ Load:
Area: Occ Load
Area: Occ Load:
No. of Stories: TIF Review: Y/ N
Entitlement #: Zoning: SQ�—GZ
Plnr Ini.tials�_ Date: (�Zq-�u Plan Chkr Initials: Date: Insp Initials: Date:
Conditions of Approval or Other Notes:
Inspection Date: