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APPLICATION FOR CER1 WICATE OF OCCUPANCY
ctAa, CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT
HUNTINGTON BEACH (PRINT OR TYPE ONLY) DATE
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Address ! y! 9 '� District
94@i� Name Tel.
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B�silaass Type ^rtit,! Ai tea.�.S r C% Gt:�f'� _ Ocr, Group_
BUILDING OWNER % BUSIN .'S OWNERIMANAGERf
Name �1i✓' V
l i��T Name 1C e
Address �, { Home Address
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City4 �' 1.-- City L�1' 4 Home Tei
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THISAISE WOULD BE. DESCRIBED AS:
L� NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER ❑ CHANGE OF OCCUPANT
❑ EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPt',NT
Indicate former use, if any Occupancy Gr. Div._
SOUARE FT. OF BUILDING TO BE OCCUPIED (� �' f `� h ` r
NOTICE: 1. Occupancy of any building is prohibited and abusiness license will not be issued until the building; has been
inspected and a certificate of occupancy is issued.
2. No electrical service will be released for any existing building until the service has been inspected and
certified safe. All applicants for occupancy in an existing building are requiredto schedule an electrical
'fuse up' inspection in the Department of Community Development at the time this application is filed.
3. Change of occupancy or use inspection fee. Whenever it is necessary to make inspection of a building or
premises in order to determine if a change maybe made in the characterof 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 $ shall
be paid to the city.
4. Huntington Beach Fire Code Section 10.208 requires that building numbers must be a minimum of four (4)
inches in height with one half (1/2) inch stroke, and of E contrasting color from the background. These
numbers must be posted on your building in a location that is visible from the street.
5, Huntington Beach Fire Code, Section'10.301 requires fire extinguisher selection and distribution per the
National Fire Protection Association pamphlet 10 (see reverse side).
®� _ t�., (FOR OFFICE USE ONLY) e
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SUPPLEMENTAL INF(�MATIONJ ZONIN,�r
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/ S OCCUPANCY GROUP PLAN CHECK NO. NO PARKING SPACE �7
113
f OCCUPANT LOADT-r4� PERMIT NO HEALTH DEPT P.'PROVAL
NO. OF STORI_S ADM,N. ACTION' 1' UTILITIES RELEASED
!dQ CERTIFICATE OF OCCUPANCY FEE $
APPROVE �BY DA E CHANGE OF USE OR OCCUPANCY FEE
TOTAL $
Y DEUEL O
7&039 Rev. 6/e8
COMMUNITY P.
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