HomeMy WebLinkAbout15071 GOLDEN WEST - CofO (2)APPLICATION FOR CERTIFICATE OF OCCUPANC`!
CITY OF HUNTINGTON BEACH
DEPARTMENT
OF DEVELOPMENT SERVICES
HUNnNGTON BEACH
(PRINT OR TYPE ONLY) DATE
Address rZ 1 h`t�it 1'I 't -
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Tel. i` i,4 �%
x Business Name
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/ . - Occ. Group Z`
Business Type
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BUILDING OWNER
BUSINESS OWNER MANAGER
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Name _ /) t 0
Name
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Address' W i i aC3 L ;1
Address . is
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City
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THIS USE WOULD BE DESCRIBED AS:
NEWLY CONSTRLI^TED BLDG.
CHANGE OF OWNER CHANGE OF OCCUPANT
s EXISTING BUILDING
L +NGE OF USE ADDITIONAL OCCUPANT
Occupancy Gr. Div. `�_ — --
Indicate former use, if ary
i
SQUARE FT, OF SUILDING TO BE OCCUPIED
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(FOR OFFICE. USE ONLY)SUPPLEMENTAL INFORMATION ZONING —
OCCUPANCY GROUP _ PLAN CHECK NO. _- NO. PARKING, SPACES
OCCUPANT LOAD — PERMITNO. HEALTH DEPT. APPROVAi. —
NO. OF STORIES ADMIN. ACTION ILITIE %D 4
r
CERTIFICATE OF OCCUPANCYFEf� $
APPROVED BY
DATE CHANGE OF USE OR OCCUPANCY FEE S--- -
_
TOTAL
75.039 REV. 70