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APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
xUNTINGTON. 9EA11i DEPARTMENT OF DEVELOPMENT SERVICES /
(PRINT OR TYPE ONLY) DA .
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Address YZZ
Business Name
BuamessTypc
—, Occ. Group ?
BUILDING OWNER11�OWNER MANAGE f
Name _L�' f��$`!'�S!1/%�rBr? �tr._ _ Name --� t
Address--,/�2—_"5- _ . � t� Address L..... a
i` City 1_ lv� City 1 �J
THIS USE WOULD BE ESCRIBED AS:
i
k NEWLY CONSTRUCTED BLDG. CHANGE OF OWNER CHANGE OF OCCUPANT
i EXISTING BUILDING CHANGE OF USE
(� ADDITIONAL OCCUPANT
Indicate former use, if any 77 Q22 E /
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NOTICE: 1, Occupancy of any building is prohibited and a business license: will not be issued until the building
has been inspected and a certificate of occupancy is issued.
2. No electrical service will he released for any existing building until the service has been inspected
and certified safe. All applicants for occupancy in an existing building are required to schedule an
electrical 'fuse up' inspection in tha_Department of Development Services at the time this applica-
tion is filed.
3. Change Ot occupancy or use inspection fee. Whenever it is necessary to make inspection of a build-
ir.g or promises in order to determine if a change maybe made in the character of occupancy or use
' of the building or premises which would place the building in a different division of the same group
Of occupancy or in a different group of occupancy, a change of occupancy inspection fee of $0'
4, shall be paid to the city, a
Huntington Beach Fire Code Section 10.208 requires that building numbers must be a minimum
of four (4) inches in height with one half ('/?) inch stroke, and of a contrasting color from the -back-
ground. These numbers must be posted on your building in 2 location that is visible from the street.
5.. Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection and distribution
per the National Fire Protection Association pamphlet10 (see reverse side).
7 Tf-Tr,r J T,,.
SUPPLEMENTAL INFORMATION (FOR OFFICE USE ONLY)
SQUARE FT. OF BUILDING PLAN CHECK NO. _�W. _ rJO PARKING SPACES >C
OCCUPANCY GROUP PERMIT NO, HEALTH DEPT. APPROVAL
OCCUPANT LOAD- �._,. Ail ,11N. ACTIONNO, OF STAR) S _ _ �,YTiLiTIES RELEASED
-. �w f �, , ,,"✓€; ,�;,,.
CERTIFICATE OF OCCUPANCY FI.
APPROVED BY DATE CHANGE OF OCCUPANCY FEE $
TOTAL $
75-039 REV;
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