HomeMy WebLinkAbout101 Main St - CofO (27)Business Licen
Business Addr(
Business Owne
Business Name
Business Type
Name _
Address
City I
Telephone No.
o..02
APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH — DEPT. OF BUILDING & SAFETY
3rd Floor —Must Apply In Person) r[CLO
Date %
Zip Code _ C 2Cp
Telephone No.-1 V
Bus. Phone -7Ia . P--)
)rmatton (required) nant/Emer enc Contact (required)
nAl (1-0 Name --&o C(�
Home Address 2
State/Zip City \A-b State/Zipj -
Telephone No. CAq • 4952• 4y-(�l�j
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or Ci3' Existing Building
CHECK ALL THAT APPLY: /
El Change of Property Owner ❑ Change of Occupant ❑ Change of Use Additional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity e turned on? YesONo❑
■ Is the building sprinklered? Yes o❑
■ Will operations produce dust/wood shavings or similar material? YesONoLk
■ Will operations involve the repair or replacement of automobile parts Yes ONo CCU' If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes []No
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes ONo [R/' /
■ The following best describes my operation: W 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:P Date:,,9---�Plan Chkr Initials:
Conditions of Approval or Other Notes:
inspection Vate:
Occ Load:
Occ Load
Occ Load:
TIF Review: Y/ N
Zoning: �jA$--L' �—
Date: Insp Initials: Date:
NtiC-
Wilk
£S"1U
0
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