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APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
DEPARTMENTOF DEVELOPMENT SERVICES
auNnNcroN SEAM (PRMT OR TYPE ONl,v) DATE
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Addressk mDistrict
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Business Name a"-r w Tel. /-..`t .�, t
Business Type `,x i �_ .....M.. ,iiCr1i7D Occ.Group. yM
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Name-_.-,_� 'Zi r�«t' .r °"�P Nan
.Address �n L �-�`ri�.�r � �'� _ Address � M
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City _ V -,� y Tel. .P_ , ! 4 city
THIS USE WOULD BE DESCRIBED AS:
I E] NEWLYCONSTRUCTED BLDG. ' i,kiAkIGE R F (7t'�KJtfi f,. x, t >Y� irCQKIGE OploCGUPANT
` EXISTING BUILDING 'CHANGE OF USC ADDITIONAL OCCUPANT
Indicate former use, it any
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NO :ICE: 1, OccupGncy of any build n_ i� prohibited and a business licensa will not be issued until the building i
has been inspected and a rartificate of occupancy is issued.
2. No electrical service .vill be released for any existing building until the service has been inspected
and certified safe. Aft of plicants for occupancy in an existing building are required to schedule an
electrical 'f rse up' inspection in the, Departrnert of Development Services at the time this applica-
tion is filed. a
3. Chango of occupancy or use inspection fee. Whenever it is neeessac y to make inspection o'c a build-
ing or premises in order to determine if a change may ba 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 $30.00
shall ba paid, to the city.
4. Huntington Beach Fire Code ection 10,208 requires that building ,numbers must be a minimum
of four (4, inches in height with one half (Ax) inch stroke, and of a contrasting color from the back-
ground. These numbers roust be posted on your building in a location that is visible from the street.
5. Huntington Beach Fire Cede Section 10.301 requires fire extinguisher selection and dist4b144
per the National Fire Protection: Association pamphlet 10 (see revArs
(FOR OFFICE USE ONLY)
SUPPLEMENTAL iNFORMATION
SQUARE FT. OF BUiLDING �'� _ PLAN CHECK. NO... ._ ___. _ NO, PARKING SPACE
OCCUPANT" I .0 JP ___ �__ . c r ° W A ` m UTILITIES RELEASED ._
OCCUPANT LC' .!� _ _..�� � ��.._�... At'�.JlIN. ACTION
NO. OFSTJR!ES F'�RtL,kTNO, IiEALTi-kDEPT.APPRO4'/kL _.
CERTIFICATE OF OCCUPANTGY FEE $
APPROVED BY DATF :.. N .._
CHANGE OF OCCUPANCY FEE.. $."�.:,,s._..�..„..._.W......_,._.,.�,w...
TOTAL $
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75-039 RSV
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UTILITY RELEASE AUTHORIZED,,
BY LAND USE
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