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Applicac on For
Certificate of Occupancy of HUNTINOT ON BE
City of Huntington Beach, California
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Application is hereby made for a Certificate of Occupancy for a:
1 Describe Use � s ,
n. To be knowas t! l �T�� _ �� CA '-' -) 64-4\��Cie,� �>
Name of Bu s ass
Located at _ t 46-
1 -- Address
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By-�=►—
E er,,o �$uildin _ dr' s CityPhone No, Date
�L k; ;� c�sc~�Af ` f t 73 . Jib,
his us would be described asCfL 7 S
New Building[]Existing BuildingXChange of Use�Change of Ownero Change of Occupant ]
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Indicate former use if any
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Name SS OWNER Address
,'if���� Cit
r� Phone No, - Business% Ali _ Residence;
( , NOTE: A business license will not be issued until the building has been inspected
�J and a Certificate of Occupancy it issued.
OFFICE USE 014LY
DEPARTMENTAL APPROVALS:
1. Planning Department Remarks:
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Name Date
Z Fite Department Remarks;.
Name Date
3. B ildin; Department Remarks: i J : °lam{ P r"'
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Dates
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4. Public Works Department Remarks: c�✓ «
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%SUPPLLMiNTAZ INFORMATION fi{� I p ti- �j
�L Sq, ft. of bui idin �20006 (yr" ;'S -b PPllan�Check No,
Occupancy Group No. Parking spaces q
Occupant Load a C.E. o': U.P. No.
No. of Stories ice) Utility Release
Permit No.
Application For
Certificate of Occupancy
City of Huntington Beach, California
Application is hereby made for a Certificate of Occupancy for a:
i
Describe Use
To be known as
Name of lousiness
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Located at
Address
By
Owner ,of Building Address City Phone No. Date
This use would be described as
New Building[]Existing Buildingf2jrhange of UseF Jkhan,-,e of Owner[] Change of Occupanti—j
Indicate former use if any
2,
Name BUSINESS OWNER Address City
Phone No. Business :: Residence
NOTE: A business license will not be issued until the building has been inspected
and a 4ertificate of Occupancy is issued,
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OFFICE USE ONLY
DEPARTMENTAL APPROVALS; T
1. Planning Department Remarks:
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Name Date
2. Fire Department Remarks:
Name Date
3. Building Department Remarks:
Name Date
4. Pablc Works Department Remarks:
Name Date
SUPPLEMENTAL INFORMATION
Sq. ft. of building .'„ Plan Check No.
Occupancy Group No. Parking spaces
Occupant Load C.E. or U.P. No.
10. of Stories Utiiity Release
Permit No.
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