HomeMy WebLinkAbout15053 GOLDEN WEST - CofO (7)r
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P HUNTINGTON BEACH,
APPLIC.`MON FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH r
DEPARTMENT OF DEVELOPMEN i SERVICES 17 4tA,
(PRINrOR TYPE ONLY) • DATE
Address t C r , J (: -C`C-L� -!Yu, _. j ' S f j "� "�! z a ' District /
Bus:ness Name
Business Type ' ai7 r Y /� Occ. Group
e'er
7"1 BUILDING OWNP BUSINESS GWNER/MANAGER
FName--�fLSsS ,vG.FtJ�.�'��� NameY.itxcT�t n --
Address —� Address _—j_•7 q �-�-_ i
City Tel City �r _Home Tej(:Y-f 77/
THIS USE WOULD BE DESCRIBED AS:
v F , NEWLY CONSTRUCTED BLDG. CHANGE OF OWNER 0---CHAP4GE OF OCCUPANT
R fI5TING BUILDING eCHANGE OF! ISE ADDITIONAL OCCUPANT
g,.,.
Indicate former use, if any
f _ _�.� Occupancy Gr, Div..
SQUARE F-i OF BUILDING TO BE OCCUPIED /lam
(FOR OFFICE USE ONLY) .
SUPPLEMENTAL INFORMATION ZONING
OCCUPANCY GROUP _ PLAN CHECK NO. --NO. PARKING SPACES -
OCCUPAN'r LOAD ` - PERMIT NO. HEALTH DEPT. APPROVA
NO. OF STORIES ADMIN. ACTION UTILITIES RELEASED -1P�f �-�G� _✓
CERTIFICATE OF OCCUPANCY FEE $r �r
APPROVED BY DATE CHANGE OF USE OR OCCUPANCY FEET
TOTAL $ �• � 4 —
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75-039 REV. E 7 5 y 1
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