HomeMy WebLinkAbout15011 GOLDEN WEST - CofO (3)r
�
i
F
f'
r
UTILT.Y R E L E A S E
I
USE
ADDRESS
EXISTING BUILDING
NEW BUILDING
F
'
�.
POWER POLE.
TEMP. WORK WITH POWER
1. Plumbing Inspector Clear
DATE
2. Electrical Inspector Clear
'
DATE
h.
UTILITY RE EASE AUTHORIZED
BY LAND US
t
DATE
GAS U ELECTRIC
j
UTILITY CO1*,A1Vi NOTIFIED
d
9fe�'�,/
DATE
)
(#715-007
a �
f w
k
i
l
r
HUNnNGTON BEAU
DATE
Address --0%/' t!'—Q�. f/�GrSrfd;f.+�d'r//�kP4/ �i'
�' District _
Business Name TeJ
I.
Business Type VON L 'rS Occ. Group. ,zw/.
/ BUILDING OWNER
p OWNER/MANAGER
Name i Nam. _ `j / A) WNA-%J ^ 1
Address % Address _ 16 4-'y-f,� FT;AAI
City !y%N� .��. �% Tel, city 5�p_]
rA f 1 A 017- Te1.$�2—t83 0
THIS USE WOULD BE DESCRIBED AS:
NEWLY CONSTRUCTED BLDG. CHANGE OF OWNER CHANGE OF OCCUPANT
' EXISTING BUILDING CHANGE OF USE F] ADDITIONAL OCCUPANT
Indicate former use, if any t !� D P —Occupancy Gr. Div.
APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
DEPARTMENT OF DEVELOPMENT SERVICES
(PRINT OR TYPE ONLY)
(FOR OFFICE USE ONLY)
SUPPLEMENTAL INFORMATION
XY
SQUARE FT. OF BUILDINGt �
PLAN CHECK NO,
NO, PARKING SPACES
OCCUPANCY GROUP
PERMIT NO.
HEALTH DEPT. APPROVAL 31
OCCUPANT LOAD_ 3C�
ADMIN. ACTION
UTILITIES RELEASED
NO. OF STORIES
CERTIFICATE OF OCCUPANCY FEE
APPROVED BY y DATE
CHANGE OF GOCUPANCY FEE
TOTAL
$
$'• c✓LS
75039 REV. DEVELOPMENT SERW.:ES