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CERTIFICATE OF OCCUPANCY Ar 4,
CITY OF HUNTINGTON BEACH
Date
DEPARTMENT OF DEVELOPMENT SERVICES
Address 1015 (":SOrcTi a District
Business Name Tel.
Business Type ) TPTTrP "S"'AWT1f:TPMTT T'£)TT,E)T r, Occ.Group —1
BUILDING OWNER BUSINESS OWNERIMANAGER
Name L'corest Dunn Name S<a:ae
Home
Address16783 3each 331--yd. Address
City Huxitington 'Beach Tel, 5150--0322city Home Tel.
Construction_ No. of Stories Occupant Load Y;:/a Sprinklered
This Certificate of Occupancy DEPARTMENT OF DEVELOPMENT SERVICES
SHALL BE posted in a conspicuous place on y
the premises and shall not be removed ex-
cept by the Building Official. by
_DEVELOPMENT SERVICES
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/a APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
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DEPARTMENT OF DEVELOPMENT SERVICES v� Q
HUNTINGTON BEACH (PRINT OR TYPE ONLY) DATE
Address0 �J 1 District —
Business_Name Tel.
Business Type Occ. Group
ram- BUILDING OWNER BUSINESS OWNER/MANAGER
Name_ T�D2is5� Name Sf1�i'Ic
��� Home
Address_/S� /cYFi ! Address
City— Tel._Mduz City Home Tel.
THIS USE WOULD BE DESCRIBED AS:
❑ NEWLY CONSTRUCTED BLDG. 2 CHANGE OF OWNER ❑ CHANGE OF OCCUPANT
19 EXISTING BUILDING ❑ CHANCE OF USE ❑ ADDITIONAL OCCUPANT
Indicate former use, it any c Occupancy Gr Div,
SQUARE FT. OF BUILDING TO BE OCCUPIED �`� Aj ` r
(FOR OFFICE USE ONLY) ZONING P 3 4 _ 4 SlP
SUPPLEMENTAL INFORMATION
C.•I)PANCY GROUP PLAN CHECK NO, NO. PARKING SPACES
OCCUPANT LOAD PERMIT NO. HEALTH DEPT. APPROVAL
NO. OF STORIES ADMIN. ACTION UTILITIES RELEASED
CERTIFICATE OF OCCUPANCY FEE g
APPROVED BY DATE CHANGE OF USE OR OCCUPANCY FEE $
TOTAL $
75-039REV.