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�• .APPLICATION .5.UR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
nc1' ,UEPARTN_IENt OF COMMUNITY DEVEL,OPMENI,'
HUNWA.TON HFAG7i
(PRINT OR TYPE GNL,Y) GATE
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Business 'No- e "� v l ' fQ, 5 / / irG�S _ Tel
dusiness'i e %!^I S Of Ucc Group--
BUILDING OWNER ((( BUSINESS OWNER/MANAGER
Name l idly)t>`�1 1��2y11�-�s_D( .�s2, (`tlj�}1 NarSie i� 0y /
Address I a I H I Y] JTI C ..---_I�,._ _ J ddress � 3 Z PlomeSou �'ld 6iG
city 4l1JL-Lnar_ �'_`u�f«g _rPl ��.i�t c :v-f�1 f 15'c /� Cal �2i�6 Home Tel _�11�893�y
i''HIS USti'NdULD'i E DESCRIBcO AS:.
J NON;L Y CONSTRUCTED BLDG CHANGE OF OWNER % J CHANGE OF OCCUPANT
L�1 E.ISTING 6144LDING 0 CHANGE 06 USE � APY'DITIONAL OCCUPANT
Indicate former use, if any Ch*upancV rar Div
SQUANP FT OF ;BUILDING TO BE OCCIJO'IED �.='0� 61 Sq
NOTICE: 1. Occupancy of any building is prohibited and abusiness license will not be issued until the building has been
inspected and a certificate of occupancy is issued
2. No electrical service will be released for any existing building until the service has been inspected and
certified saf- All applicants for occupancy w an existing building are required to schedule an electrical
'fuse up' inspection in the Department of community Development at the time this application is filed.
S. Change of occupancy or use inspection fee. Whenever it is necessary to make inspection of a building or
premises in order to d-lorm+ne if a change may be made in the character of occupancy or use of the building
` or premises which w uld place the building in a different division of the same group of occupancy or in a
different group of occupancy, a change of occupancy inspection fee of $ shall
be paid to the city.
4. Huntington Beach Fire Code Section 10.208 requires that building numbers must be a minimum of four (4)
inches in height with one half (1,2) inch stroke, and of a contrasting color from the background. These
numbers must be posted on your building in a location that is visible from the street.
5. Huntington Beach Fire Code Section 10,301 requires fire extinguisher selection and distribution per the
National. Fire FFoq(iIction A,0-sociation pamphlet 10 (see reverse side).
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NAME 1r J1di R~.: gr (rOjj OFFF,,.E USV.�Dt')!-Y)
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OCCUPANCY GROUP PLAN CHECK NO — NO PARKING SPACES
OCCUPANT LOAD _ PERMIT NO HFAI TH DEPT APPROVAL -
NO. OF STORIES -- ..-., A.DMIN ACTION-_____- UTILITIES RELEASED �—
CERTIFICATE OF OCCUPANCY FEE $ `
APPROVED BY DATE CHANGE OF USE OR OCCUPANCV'FEE $
' TOTAL
75-039 Rev. 1/97
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