HomeMy WebLinkAbout15102 Bolsa Chica St - CofO (22)CERTIFICATE OF OCCUPANCYt-
/� CITY OF HUPl11N(MIN GFACH 'Ito
DEPARTMENT OF f3U1LDING Y+ COh1MUNITY L'f VELOF'h1ENT
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MAX11,1U1,1 OCCUPANT LOAN PERMITTED
Notire ,� John F• l)eht•±Itc r,........... „1
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APPLICATION FOR CERTIFICATE OF OCCUPANCY �j; f :!/
City of Huntington Beach Department of Building b Community Development
FOR APPLICANT TO FILL IN (Print or type only) DATE
Application is hereby made for a Certificate of Occupancy fnr a:
OcgYP n-gy. Gr. Div.
Describe Business Use `
To be known as / o,c ,/ ,;,'.
flame of Business --`�
Located at ! `�/ ��• i� . f I.
Business ddress
- s
BUSINESS OWNER Residence ddress C,ty 1� dip
Phone No. - Business: ��` - Residence:
ame:
BUILDING 04NER--
THIS USE WOULD BE DESCRIBED AS:
[�] Newly Constructed Building
[] Existing Building
Indicate former use if any _
Address 'City .� _ .-Z �` Bone tlo.
J-] Change of C-vvner �_] Change of Occupant
Channe or ;'se ` ] Additional Occupant
' Occu any. Gr. _ Div. _
OTICE: 1. Occupancy of any bui ing is proiib�ited end a business�licen'se wi-IT not Tes-I sued
until the building has been inspected and a Certificate of Occupancy is issued. _
_ „n2. No electrical service will be released for any existing building until the
service has been inspected and certified safe. All applicants for occupancy
� in an existing building are required to schedule an electrical "fuse up"
v �? inspection in the Department of Building and Carmunity Development at the time
u-) this application is filed.
d C - 3 a CHANGE OF OCCUPANCY OR USE INSPECTION FEE. Whenever it is necessary to make
:Dinspect•_on of a building or premises in order to determine if a change may
:� ba made in the character of occupancy or use of the building or premises which
-1 �- would 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
$30.00 shall be paid to the City.
(FOR OFFICE USE ONLY)
SUPPLEMENTAL INFORMATICN
MW
Sq. ft. of building_ - y_ — Plan Check No.
Occupancy Group _ _ Permit No. - _ _ -- - --- ------
Occupant Load 1 -�- Admin. Action
No. of Stories_ _`— No. Parking 5pac—es
Health Dept.
_ APPROVED _ Utilities Released ti ,' -~ 7 -
BY DHiE --
CERTIFICATE OF OCCUPANCY FEE $ 6.00
CHAf!GE OF OCCUPANCY OR USE INSPECTION FEE
(JI75-039) TOTAL'S ---