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APf'L ICATION±FOR CERTFi CATE'OF'OCCUPANCY
CITY OF HUNTINGTON BEACH
NUNr1NGTON 91 C11 DEPARTMENT OF DEVELOPMENT SERVICES
(PRINT OR TYPE ONLY)
FER 3 - wo
DATE
J �1 ) �
Address c7 CC ( ! 1�o r a J a
- F"ff-1f 7(, 4istrict
Business Name
Business Type
BUILDING OWNER
Name Do-JI -) K r'- r'•1,-�/i� :£
Address
City �. r� y06 tr Tel.
THIS USE WOULD BE DESCRIBED AS:
NEWLY CONSTRUCTED BLDG.
EXISTING BUILDING
Indicate former use, if any
Tel.
Occ. Group
OWNER/MANAGER
Name —P.� 7-4 A.'
Address ST sV —2 IOy 2
City i'�.��''^%7r�!?f P,E,�Cf -C 1LCGTeI�Z1 I�E,44-"r��`t/�I
0 CHANGE OF OWNER
CHANGE OF USE
CHANGE OF OCCUPANT
ADDITIONAL OCCUPANT
Occupancy Gr. Div.
a s..
i�OT CE: 1. Occupancy of any building is prohibited and a business license will not be issued until'tlte building
has been inspected and a certii`icati: of occupancy is issued.
2. 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' inspection in'the Department of Development Services at the time this applica-
tion IsIiled.
3. Change `bf occupancy or use inspection fee, Whenever it is necessary to mate inspection'of a'biiild
;.
Q, ing or premises in order to determine if a change may be made in`T6 character of occupancy`&' iise
of .he building or premises which would place the building in a different division 'of the same g b�o
6 (� of occu ricy or in a different group of occupancy, a change of occupancy inspection fee of $36.00
l s6If%e paid tdthe city.
4. HuAlfn64on Beach Fire'Code Section 10.208 requires that 6640ing numbers" '6itbe a minimum
of four (4) inches In height with one half (Y2' inch stroke,'and of a contrasting color from the back-
grou.nd,_ These numbers must be posted on your building in a location hit is visible from the street.
6. Huntington Beach Fire Coda Section A0.301'requires fire extinguisher selection and distribution
per the National Fire Protection Association pamphlet 10 (see reverse side).
.j /%.S _6
SUPPLEMENTAL INFORMATION
SQUARE FT. OF BUILDING
OCCUPANCY GROUP f
OCCUPANT LOAD
NO. OF STORIES
9) 7'
APPROVED BY ATE
(FOR OFFICE USE ONLY)
PLAN CHECK NO. _ NO. PARKING SPACES
PERMIT NO. _ _ HEALTH DEPT. APPROVAL
ADMIN. ACTION UTILITIES RELEASED
CERTIFICATE OF OCCUPANCY FEE
CHANGE OF OCCUPANCY FEE
TOTAL
7"39 REV. DEVELOPMENT SERVICES