HomeMy WebLinkAbout15077 GOLDEN WEST - CofO (4)I
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APPLICATION FOR CERTIFICATE OF OCCUPANCY
R CITY OF HUNTINGTON BEACH
F-IL9 DEPARTMENT OF DEVELOPMENT S".RVICES j Ll
HUNnNGTON HFACH
(PRINT OR TYPE ONL' DATE +
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Address r J -v 7 7 Z�,) �f r=� ! c,— i
' . �- L, // / /'� District
Business Name - '.G_ Ct'j '—i I i� ! l�fpt% r� , � S ILL TeL "
R.isiness Type Occ. Groin
p BG.LOIN G t:WNER Ci. MERWANAGER
Name
Address �cF i /
_ ,/ Address
City {1 � / C Tev� - 2 %7
�C'Ity_W�
THIS USE :'+OULD r_� DESCRIBED AS. II
f CI MV—Y CONSTRUCTED BLDG. CHANGE OF OWNER CHANGE OF OCCUPANT
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'EXISTING BUILDING CHANGE OF USE ADDITIONAL OCCUPANT
Indicate former use, if any Occupancy Gr. Div.
(FOR OFFICE JSE ONLY)
SUPPLEMENTAL INFORMATION
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SQUARE FT. OF BUILDING !2 PLAN CHECK NO. NO. PARKING SPACES
OCCUPANCY GROUP' - PERMIT NO, ��_ 'HEALTH DEPT. APPROVAL
OCCUPAN`r LOAD _�_ ADMiN, ACTION UTILITIES RELEASED .-''2/�—
NO. OF STORIES�
O`�`f CERTIFICATE OF OCCUPANCY FEE
APPROVED BY DATE CHANGE OF OCCUPANCY FEE �
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TOTAL $ _
75-039REV, f c`IwI"',s t ✓I.. ;
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