HomeMy WebLinkAbout111 1/2 Main St - CofO (4)APPLICATION FOR CERTIFICATE OF OCCUPANCY
S e CITY OF HUNTINGTON BEACH 7
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DEPARTMENT OF REVELO?i`.:ENT SERVICES
HUNTINGTONBEMIt (PRINT OH TrPF. ONLY) DATE
4
Address _ r __..' .__._T .� _ _District
Business Name _ _ .__: Tel.
BusinessT Tn _. `._ 'a_.___ ._ -Oro. Group
BUiLt)IfSf, Ci'nNER OWNERW NAGER
Name ..---- --- ._ __ , M W_.. .... _. _ : Name �
Address Addre�5 e
City _ �_ _ Tel.._ Tel.
THIS USE WOULD BE DESCRIBED AS: j
NEWLY CONSTRUCTED BLDG. (^ CHANGE OF OWNER CHANGr- '3F OCCUPANT
EXISTING BUILDING CHANGES OF USE ADDITIONAL OCL,%jP.ANT
` Indicate former use, if any _ _ .__... _ _ __. Occupancy Gr. ._ ._..: _ .__ Div. _
(FOR 01-FICE USE ONLY)
1 SUPPLEMENTAL, IN FOAMATTON
SQUARE FT. OF BUILDING %IZ f PLAN CHECK NO. NO. PARKING SPACES
OCCUPANCY GROUP 29-2,_._ PERMIT NO. T . _ HEALTH DEPT. APPROVAL _
OCCUPANTLOAD ADMIN. ACTION �� __.� UTILITIES RELEASED _r_'%' Ff✓
No. OF STORIES
— � CERTIFICATE Ot OCCUPANCY FEE
APPROVED„ja' _.. DATE CHANGE OF OCCUPANCY FEE $ _
TOTAL $