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HUNTINGTON BEACH
CERTIFICATE OF OCCUPANCY 20_�j _
CITY OF HUNTINGTON BEACH -
DEPT. OF PLANNING & BUILDING APPLICATION
714/536-5241
(3rd Floor — Must Apply In -Person)
Business License #
a
Date
Business Address
1 -1 S
Zip Code_
Business Owners Vme .,1�L
Telephone No.-T
Business Name�a
' 5
Bus. Phoned
Business Type
p,2
Propert caner Information (re uired)
Name M (� �.�,(r
Tenant/Emer enc
Contact (required)
Address
1 ,
O'-j
Name
Home Address
v
City �i��
State/Zip a. Cityc, GA" State/Zip
Telephone No.
�.� • `j� - 3 Qd
Telephone No.
C�
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or KExisting Building
CHECK ALL THAT APPLY: �
❑ Change of Property Owner )�Chajqe of Occupant kj ]C Chan of Use ❑Additional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity be turne on? Yes❑ No
■ Is the building sprinklered? Yes No
■ Will operations produce dust/wood shavings or similar material? Yes❑ Nof�
■ Will operations involve the repair or replacement of automobile parts Yes No
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Y%13 V ❑
■ The following best describes my operation: ❑ Office Only ❑ Retail Sales
❑ Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food
,( escribe process at
ther (describe)
Area: :0 rj_M
If yes: Describe the
❑ Medical/Dental
Occ Load: I +L.
Occ Load
Occ Load:
TIF Review: Y
Zoning: S
Plnr Initials: Date: 10 2A �1 Plan Chkr Initials: Cs�Date: 6 �-101 Insp Initials: Date:
For Official Use Only
Occ Group:_ A-2-
Occ Group:
Occ Group:
Total Sq Ft Occupied:
Bldg. Permit #
Conditions of Approval or Other Notes:
Inspection Date:
AD /
Area:
Area:
No. of Stories:
Entitlement #: