HomeMy WebLinkAbout15131 Triton Ln - CofO (65)1)�
714/536-5241
APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH - DEPT. OF BUILDING & SAFETY
(3rd Floor — Must Apply In -Person)
Business License #�"�`��'' \
Business Address tZ>N. LAND U i 1-F—) ( R
usiness Owners Name
Business Name
Business Type 00P(G13L;rj NC=,
in760
Date 4-r2o/06
Zip Code a'2.�4'+q
Telephone No.C114�0-&V-0
Bus. Phone
Property Owner. Information (required) Tenant/Emergency Contact (required)
Name N Name DIGSWaJE j�\/A-LA- IGTU
Address !?,D, X 1 R 7 Home dress _1(. LN :*-(1
Cit)SryBfa�}- State/Zip CA- qOZ+Z Cit � � N State/Zip CAg1Z(QAq
Telephone No. �'7(l(-� $qq rL�� Telephone No. 7 14-) 6�0 —af
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or /19- Existing Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner \ Change of Occupant ❑ Change of Use [I Additional Occupant
■ Indicate former type of business/ '' 6;91 M
■ Are you requesting that the electricity be turned on? Yes 0No❑
■ Is the building sprinklered? Yes No
• Will operations produce dust/wood shavings or similar material? YesE]No�
■ Will operations involve the repair or replacement of automobile parts Yes QNoA If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes QNo9
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes QNo
■ The following best describes my operation: Xl Office Only ❑ Retail Sales ❑ Medical/Dental
❑ Restaurant/Take Out Food ❑ Warehouse /Manufacturing/Distribution
(describe process and end product)
❑ Other (describe)
For Official Use Only
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied:
Bldg. Permit #
Plnr Initials: Date:
913
Inspection Date:
Area:
Area:
Area:
No. of Stories:
Entitlement #:
0/tlan Chkr Initials
Notes:
Occ Load:
Occ Load:
Occ Load:
TIF Review: Y� / N
Zoning: t1.
Date: Insp Initials: Date:
(GSuilding/Forms/document id goes here)