HomeMy WebLinkAbout15182 Bolsa Chica St - CofO (7)Certificate of Occupancy No. 0200 !--�
APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH — DEPT. OF BUILDING & SAFETY
18 - A
714/536-5241 (3'd Floor —Must Apply In Person) b
Business License # l Date
Business Address_ f � 1 c-�,Z.,ip Cod -
Business Owners Name �if t elephone T46.��-�
Business Name c� Bus. Phone
Business Type L.
Property Owner Informa 'on (ire uire�� J Tenant/Emer enc Contact(required)
Name Name r
Address HomeAddress' Z29=c r�
City J�q�State/Zip City ate/Zip
Telephone No. Telephone No. ��22
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or Existing Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner ❑ Chan e of Occupant ❑ Change of Use ❑ Additional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity b urned on? Yes[] No
■ Is the building sprinklered? Yes o❑
■ Will operations produce dust/wood shavings or similar material? Yes[.]
■ Will operations involve the repair or replacement of automobile parts Yes If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes QNo
■ Will the business be a drinking, dining or assembly u e with an occupant load of more than 50 persons?
Yes 0 No t/
■ The follA ng best describes my operation: Office Only ❑ Retail Sales ❑ Medical/Dental
❑ 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: Date: 3 DIPlan Chkr Initials: Date:
Conditions of Approval or Other Notes:
Inspection Date:
Occ Load:
Occ Load:
Occ Load:
TIF Review: +Y/ N
Zoning: 4 L,
Insp Initials: Date:,
(G:Building/Forms/document id goes here)