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APPLICATION FOR CERTIFICATE OF OCCUPANCY 2
CITY OF HUNTINGTON SEACH
DEPARTMENT OF COMMUNITY DWELOPMENT
'HUNTNGION WAQi IAAINT DA TYPE Di'!L1'? - DATE ..
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8ustness Name_ _ �' %t � tL t�j ,iG' -- -- Te w_—) 99�'
Business Typf: �_ "� �c ' t c '! �z G Occ Group
BUILDING OWNER BUSINESS OWNEROMANAGER
Name _ Name—� 4e)74"7—/ c� '/ 74 rtC n?
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Address Address
city _ _ Te►. _ __ City t'lif I tome Tel.
THIS USE WOULD BE DESCRIBED AS:
NEWLY CONSTRUCTED BLDG. ,CHANGE OF OWNER CHANGE OF OCCUPANT
�kx STING BUILDING � CHANGE OF USE i _ I ADI)ITICNAL OCCUPANT
11dicate former use, if any _ , 4 Occupancy Gr
SO UARE FT. OF SUILDIW3 TO BE OCCUPIED
F, TRAFFIC IMPACT FEa
W I. PAID
AMOUNT RE0E# E
KAMe _ (FOR OFFICE USE ONLir�
OCCUPANCY GROUPPLAN CHECK NO NO PARKING SPACES
OCCUPANT LOAD r�r _ �4_ PERMIT NO � HEALTH LET PT APPROVAL
NO, OFSTORIES ADMiN ACTION _.,.. UTILITIES RELEMiEC1
CERTIFICATE OF OCCUPANCY FEE
APPFT(5WO BY DATE CHANGE C,I OF USE OR OCCUPANCY FEE $ -
TOTAL
7u gasr v;a s7 COMMUNITY DEVELOPMENT