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HUNTINGTON BEACH
Business Licen
Business Addr(
Business Owne
Business Name
Business Type
CERTIFICATE OF OCCUPANCY 020 0 dU -d-
CITY OF HUNTINGTON BEACH -
DEPT. OF PLANNING & BUILDING APPLICATION
714/536-5241
(3'd Floor — Must Apply In -Person)
Date �'�• �' `�
Zip Code N
Telephone Nt o. 4 �1' (6- SOS
Bus. Phone 1J�� -`A1,y'L
Prot)ertv Owner Information (required) Tenant/Emer enc Contact (required)
NameR.Name 11 Ae ro
Address Home Address 4U
City State/Zip CA City JWR W State/Zip
Telephone No. Telephone No.
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or Existing Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner /Change of Occupant ❑Change of Use ❑Additional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity turned on? Yes No
■ Is the building sprinklered? Yes No
■ Will operations produce dust/wood shavings or similar material? Yes[] No/
�
■ Will operations involve the repair or replacement of automobile parts Yes D NON(/ If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? YesQ No
■ Will the busi s be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes DNo
■ Will there be storage racks, gondolas, or shelvi g exceeding 5feet 9 inches in height? Yes DNoiz/
■ The following best describes my operation: V Office Only ❑ Retail Sales ❑ Medical/Dental
❑ Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food
(describe process and end product)
Other (describe)
For Qf
ficial Use Only
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied:
Bldg. Permit #
Area:
Area:
Area:
No. of Stories:
Entitlement #:
P1nr Initials:, Date: i ,6 I Plan Chkr Initials
Conditions of Approval or Other Notes:
Occ Load:
Occ Load:
Occ Load:
TIF Review: Y/ N
Zoning:
Date: Insp Initials: Date:
Inspection Date: