HomeMy WebLinkAbout101 Main St - CofO (77)-LA2PLICATION FOR CERTIFICATE OF OCCUPANCY
i2ITY OF 11-MdTINCy' TON BEACH - DFPAR AIENT OF B fJILDDTG & SAFETY
cr< (3"f Floor--Mzist Apply Itc-Pei-so3z)
Business License # Date �J
Address r`1�•'�'Ot'2 j (�.� J� J +2iTT�i� S('t e i 4-t 7� "� j,4C,
Business Name 44- z- " C3 Telephon � j
Business Type ) U 'CTLST.V6 -3 c0A-.'s0L--rAvF
/� Property Owner lnfo: rmation Business 0�vneerr
Name A 6 0 E.C. Apt u1 `, d &Ez � 1�z ✓�'d �:7 CO Name d fist
Address l _ ► 5 7� HorneAddress
City) 72-&o Gjel. .("p!3-G-7_City —j= K,,� - 5.Z& Tel
THIS USE WOULD BE DESCRIBED AS;
®Netivly Constructed Building or aExistin; Building
CHECK ALL THAT APPLY:
C> Change of Owner Change of Occupant ❑Change of Use ❑Additional Occupant
Indicate former use, if any . C
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 ❑ No
Operations will product dust/wood shavings or similar material? Yes ❑ No
ll involve the re p
air or replacement of automobile ,arts Yes ❑ 10
Operationswill. p p
If yes: Describe the components repaired or replaced.
Does the operation involve the use of,,velding or open flame? Yes ❑ No
The business is dLinl(ing, dining or assembly use that will result in an occupant load
of more than 50 persons. Yes ❑ No
The following best describes my operation:
OfficeOnly ❑Retail Sales ❑Medical/Dental ❑Restaurant/ Take Out Food ❑Warehouse
❑Manufacturing/Distributi.on (describe process and end product)
Other 'describe
_ Vrz2`t s3 v�rW "�kv; r'v CC�SyLT'4,.�7-
!Office Use Only. -
Zoning: � � . Sq Ft Occupied: Oce Group; Oce Load: {
it 9 Stories_ Parting Spaces; TIF Review: Y/ N Aint Pa dS:
3T Paid BEFORE Final hspe- on i
Building Permit Entitlement
i, Comments:
;= ofO m!
Plaluiei InWads: Bldg/Plan Checker Initials: C