HomeMy WebLinkAbout15083 GOLDEN WEST - CofO3
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UTILITY R E L E A S E
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1. pLi brilg Ii*6dt Clear
DATE
2. Elect�rial Iri�s`pec''�r Clear
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DATE
Lf'PxDXtt A.h ,A C lZED` t
BY ` LAb
DATE
OAS � ELECM C _.
UTILITY COMP6TiIED
DATE
(#75 '007 )
APPI. CAVION VdR crRTtr cATR Or. oZ.'CiIPANCY
c� ty _ ld�i `&Codmurit',bey.,efutijtor. Beach tmeri"t: if `Fulo'
merit
FOR APPLTCANT`tb FILL IN '(Pr_irtt oz typednly) DATE -a`S
pplication is ' hereby made for 1 Certificate off: Occupancy for. a:
DescrAibe' iiuSihOss Use
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To be knottn as
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�Na�Yo.f Fiusmess
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Located at '" - - C 1 j �,
Business Address
Nate: RU DTgG OWNER 'Address CityZi P 6
p h %e - No . ,
T3 15 'USE WOW D `13E DESCRIBED AS':
't3et ly"Ccihstri3icted Bui 'di Lr Charitje of 'OiMer eha ige of bccup ni:
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acxzsti'r g Bi ildiri `Chhhge of Use A -lditidba-1 Occii`p
a'i�t
XMi&Ae lorit dr use if a y
FPelur
N"ame : 8f3S fESS GWNSiz R' sidehce Address zip
Zip
Ph6h'e No. giigr�ess : o /.,� �r f - J, � 'Residende :
NOTICE 3 l . Y .. v
Occtipa cy of any h ip ldih,4 is prof ab'ited'a d a bUsth'i s"s "] zceYise w= 11 ' bt`�be
issued 'ui"til the bvi i1di hc `has been inspected acid a Cekt fib 1:e `oaf -Occiipelnoy
'is issued.
2. No 'electrical serv3.ce will be released for any existifg bpi%din"°Yl the
service has been inspected and certified safe. All apil'ican`ts for occupaHcy
in anexisting biii?ding are regared to schedule an "electrical "i"fiise up"
ifi pection fi the Department 'of Btiildir g and ' Commuri'i'ty De elopmer t at the s
°� 4 time this application is filed. ,
3. CFINGE OF 4CCUPJ�NCX OR USE xNSpECTx6iv' FEF. Whenever it is necessary to make
inspert.icn`of a building or premises in order to deteriWi.`�e if a cha�i�je ma"y
be made i n the character: �6f occtipd tcy or use of the 'b`b ldfhg` or prom ises
which wdUl:d place the bui:ldi:ng ih a different �divisiofi of the same group 'b
occupancy or in a -dzffererit group of occupancy, aharte cif. occupaicy
go inspection fee ''of $25,06 shall he paid to the. City.
(FOR OFFICE USE ONLY)
S' Pf UMtk* AL i' V6W+iATT0 3 V 1
Sq. ft. of h0ii-ding _ Plan Check No. _ r'
Occupanojr GroiTp , Permit NO.
-06e4arit Load -Admh. Anion _ 1
No . 6f Stor! 6s No . parking Spaces
Health Ddpt . Approvali
Utilities Released
APPROVE9 BY D
CERTIFICATE OFOGCUPAtCY'-FEE $ 5.00
(475-039) CHANGE OF OCCUPANCY OR USE rNSFECTTON FEE
TOTAL $