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CERTIFICATE OF OCCUPANCY
617Y OF'HUR'TINGTON BEACH
DrPAF MENT OF F IJILDiNC & rOMMUNITY DEVELOPMENT
ttt NTINGK)V Rt 401
Thi,, i.; to certify that the _._... _ Croce.�`__
I
under Building Permit No. —Existing _ _ a►xi is identified as
m4y_ It,tt 1976
---- :-, a(ltharized
126 Main Scree l-.
address
Hl%1Xtingt -n-aea Stobd�"1.t d____ 3.rke .____._.
in the building 0woe'd by l .sue_- r ..4ua-kmImh____ Pa ifIc H gh�_.___.______
r ne addrev,
complies •ti file wovisions of all pvttineht laws, codes, ordinances ,and any' imposed
conditions'`fCII the Ww described and classr'fie> s
MAMMUM OCCUPANT WAD PERMITTED -
No t ice
This Certificate of occupancy
SHALL BE posted it) a conspicunw, place on
tl;t: tltemisc% and s11,111 (lt t he temoved except
by t► e 13iliiding Oi ficiat.
y
IIi F . Behrens
Olfrctor of 8"ilt;1int) & f.onmilmity 0evelopmem
7� .PIP MIT
7777777777--=77777� —.11
poR MIANCY
A VP 1, T CA'I'T ON ()C(,,
C ity of flithtill(Itor. Beach qommllnl.0 (1 ve'. 10 MO-1)
-(Print or ty
R API"TiTCAN'll TO V"VIA., 'IN 1) A q i
1��)e only)
:tiJicnl-lon is hereby made for a Cei-tificAte of V
Occu anc for a:
Occupancy
Describe use
known it.-,
Name c) f Bu E, i. n es s
Located at
Business Address
V
Name: BUILDING
OWNER
Address
zip 111ono No.
I.Nilf; USE WOULD -
BE DESCRIBED AS:
Newly Constroct-ed Sup I'ding Chnficle of Owner.
L1_X_ J E _]Chancje of: occiwarit,
21j',Xisting Building Chanw-! of use A (10 i Ai-onal Occupant
Indicate former use if any
Name -
ICE: 1.
Reside City ty
BUSINESS OWNER Residence `Kddress Zip
Phone No. - Business: i' Residence:
Occupancy of any buiyd-T-n-9is prohibited and a business; I i'cense will. not be
issued until the building has been inspected and a Certifica-te of Occupancy
is issued.
2. No ele6trical service will be released for any existing building until 010
service has been inspected and certified safe. All applicants for oc(,.-ijpancy
existing building are required to schedule an electrical "fuse 111)"
tion in the Department of 3uil'ding and Community Development at- t_'he,
his application is filed.
OF OCCUPANCY OR USE INSP8CTTON FEE. Whenever it is necessary to make;
tion of a building or premises in order to determihe if a change may
e in the character of occupancy or use of the building or pre m is, (--2 s
would place the building in a di.fferent division of the same group of
ncy or in a different group of occupancy, a change of occupancy
tion fee of $25.00 shall be paid to the City.
C-D
SUPPLEMENTAL INFORMATION
(FOR OFFICE USH ONLY)
Sq. ft. of buildinci
Occupancy Group
occupant Load
No. SI-ories
A
V
'*-APM N D BY AT
Plan Check No.
Permit No.
Admin. Action
No. Parking Spaces
Health Dept. Approval
Utilities Released 7'_
CERTIFICATE OF OCCUPANCY FEE 5.00
CHANGE OF OCCUPANCY OR USE INSPECTION FEE
TOTAL