HomeMy WebLinkAbout119 1/2 Main St - CofO (6)APPLICATION FOR CERTIFICATE OF OCCUPANCY
FOE
CITY OF
_
DEVELOP ENTDEAC
DEPARTMENT OF DEVELOPMENT wFRVICES
HUNTINGTON LEACH
!PRINT OR TYPE ONLY)
DATE
�r Y1
Address �1\i �it`i l��t j�t�ijii be
t F— i t .A _
District
t�-�i1�
Business Name rilii Il\ Tt'a:N' (i ( l j 1IL VriA L
Tel. I��{i
Business Type t3 tCt� lI i-' , - t �f-. k 4
Occ. Group
BUILDING "'NER r BUSINESS OWNER/MANAGER
MANAGER
-Name �f �' s� �.-�-x.-�:,. ��• Name
Address c .' T`/.'� ° `� Address - n
City f, .: Tel,_ J'r;_' Tity
_H eTel.
THIS USE WOULD BE DESCRIBED AS:
NEWLY CONS-i'RUCTED SLOG, CHANGE OF OWNER (
CHANGE OF OCCUPANT
EXISTING BUILDING Q CHANGE OF USE
ADDITIONAL OCCUPANT
' ndicate former use, if any , �R _ _ Occupancy Cr„
SQUARE FT. OF BUILDING TO BE OCCUPIED
{FOR OFFICE USE ONLY}
SUPPLEMENTAL INFORMATION ZONING C'
}
OCCUPANCY GROUP' « PLAN CHECK NO. NO. PARKING SPACES
OCCUPANT LOAD __ ._n PERMIT NO. HEALTH DEPT. APPROVAL .
NO. OF STORIES _ ADMIN. ACTION UTILITIES RELEASED
-4'� CERTIFICATE OF OCCUPANCY FEE $I
APPROVED BY DATE CHANGE OF USE OR OCCUPANCY FEE $ _
TOTAL $ _---
7"39REV.