HomeMy WebLinkAbout10172 Adams Ave - CofO (3)APPLICATION FOR CERTIFICATE UF OCCUPANCY
CITY OF,HUNTINGTON BEACH - DEPARTMENT OF BUILDING & SAFETY
cr- e 'd Floor — Must Apply In -Person)
Business License li Date I • �`
Address 0I`7 (!Rg2.(g4R
Business Name l 4 l%( r5fj Ieplione 114 46. MS?p
Business Type 6Y LkrL a ea GG�5
Pro e Owner Information ' Busi ess Owner
Name 1 "� Name Ul. 1 dYI
Address Home ddress 511-S
City L� �► \ V l.11Acf ?.,ft.) Tel. ` ! • j 7k! • City Ct _ Tel. ,31 t f
THIS USE WOULD BE DESCRIBED AS: �"'"1 I)
❑Newly Constructed Building or A&Msting Building
CHECK ALL THAT APPLY:
❑Change of Owner Change of Occupant ❑Change of Use ❑Additional Occupant
Indicate former use, if any z�,O 4
Does the building have electricity? Yes'-- . No❑
If No, are you requesting that the electricity be turned on? Yes ® No ❑
The building is sprinklered? Yes ❑ - NotR"
Operations will product dust/*ood shavings or similar material? Yes ❑ No 4r
Operations will involve the repair or replacement of automobile parts Yes ❑ No -
If yes: Describe the components repaired or replaced.
Does the operation involve the use of welding or open flame? Yes El No
The business is drinking dining or assembly, use that will result in an occupant load
of more than 50 persons. Yes ❑ No
The following best* describe s my operation:
*ffice Only ❑Retail Sales ❑Medical/Dental ❑Restaurant/Take Out Food ❑ Warehouse
❑Manufacturing/Distribuiion (describe process and end product),
❑' Other (describe)
Office Use Only:
Zoning: r w Sq Ft Occupied Occ Group: Occ Load:
# Stories: Parking Spaces: TIF Review: Y/ N Amt Paid$:
Paid.BEFORE Fina� t inspection
Building Permit # -9 aooS- 10 12 03 Entitlement #:
Coinnlents:.
Pliitmer Blda/Plan Checker Initials: f0 #�