HomeMy WebLinkAbout15061 Springdale St - CofO (72)41M APPLICATIONFOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH !
DEPARTMENT CIF COMMUNITY DEVELOPMENT DATE
HUNPNGTON aA01 (,PRINT OR TYPE ONLY)
Address
District
I ` T4-1
Business Name. S�Z '
Business Typed��-�—��— Occ. Group.
BUILDING OWNER r , l BUSINESS OWNEERIrM-A'NAGER
- --
Name_. c�t ' n ^
Address._ �J �f tJ Y� -1�^�_—[�_.� Address
ity. J�� 3�1;" L 1 ii--�. e�LHome7el
Z L\ City d
THIS USE WOULD BE DESCRIBED AS:
El NEWLY CONSTRUCTED BLDG. u CHANGE OF OWNER El CHANGE OF OCCUPANT
EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT
ndicate former use, if any Occupancy Gr. Div.
SQUARE FT. OFBUILDIN,-, TO BE OCCUPIED fi
TP.AFFIC IMPACT FEE
111 RATE PAID
AMOUNT RECEIVED
NAME
(FOR OFFICE USE ONLY)
ZONING ---
SUPPLEMENTAL INFORMATION
OCCUPANCY GROUP-
PLAN CHECK NO.
NO PARKING SPACES
HEALTH DFPT APPROVAL 1
OCCUPANT LOAD
_ PERMIT NO. —
ADMIN. ACTION
UTILITIES RELEASED
NO. OF STORIES - --
i
CERTIFICATE OF OCCUPANCY FEE
$
DATE CHANGE OF USE OR OCCUPANCY FEE $
APPROVED BY
TOTAL
I
75.039 Rev. 11 /90
COMMUNITY DEVELOPMENT