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� ► CIvh I~iCA I E OF OCCUPA
CITY OF HUNTINGTON BEACH
DEi'A' tMENT 0F't)EVFL0PMtNT SEAViCCS
tiUNIiNC1()N BEAffI
,Ytax
Date
Adde6ss
E3usiitess Nki1et. ' ``t"L��' _._ _-._--_ _.__ �____ . __ _._� .._._ _-__ ______._ __. Tel.
BUsikiessfiype ___ ii`a , ;I:L1 _U3:iz <: t _ _ __�. ___ __ _____ _.� _ -. __�_.___ �_..___:_.__._,..__ ___. _ Occ. Group
i36iLt)fN(j OMER OWNFIA/MANAG01
Name
/�dtii ess i ' r'a " c C`< � d> ; '' : _ _ � __. _ Ad i f fess
City __�_LL�#'.1.1�#,�?t�_`t itb7__
Cbiirtlti _. __ .No. of Sti�rcS___-:--_......_ ___Occtipiit
/Votfce.
T_his`G�ttil16 Me oCOCCup"ncy
DI~P/1RT114ENT nl='[)t-V�Lopk4CNT SERVICES
511ALL EiE dsictl iW�a c0, SpicLious ptaee'oll
the Oremises and shall not be removed except by
,-
y'tt�e Building Official.
APPLICATION FOR-CERT l FICATC OF OCCUPANCY
CITY OF HUNTINGTON BEACH •�
pGPARTMENT OF DEVELOPMENTSERVICES �`
(PRINT OR TYPE Otit_Y) DATE
AddressOt
iBusiness Name
Business type
District
Oct. Group
BUlLt5* NC(6 N" ER 6WNFn1K1ANAGFR
Name
Ad rets ,f/a t '1�1 %� (ACC . / f ';fit/ Aiidr ess
city
_ City
1'J4USE ti►61 � a�sc "i�I+p`U:
Tel,--
NtWLY ddNilS UUCTEi� 60G. CNANGE: OF OWNER CHA C E OF OCCUMNT
f=FISTING° Uill)`i'NG CHANOF OF USir � ADDITIONAL. OCCUPANI*
#ndieatd former Use, if any _ Occupaiicy'Gr.
Qc+ i p ncyyof any btilldiftg �s prohii ifetl'rai d a business*iiceMe` ill tcit't�e tssued ur t�l the bCiiitiir*g
has'iieon In�0pe8ted"and: a"certificate of 6ccti06hey is isstietl,
2,
No eti E:tticai si3t ire ^Vviii be released for airy'existirig�i�t�ii ling--d "tl�l °the service as been ih.sp ted
and ceYtlfied safe. All applI' tslor occUlSat cy in an E3xistii l t3i11iriiirtt are rec lireci to sciy Buie aii
�w
electrical 'fuse -ifp' inspection-iri` the Dep'ertrment of ``nevolopm6ht Sot rleas et ,the tine this appiica-
tiori is"e 0M.
..at°,oci;t i arcy or'usa inspatttitirt'fee. Wh6io er it is tiecessary'to makiti`ihspeotion°cif a'15611 i-
ilig ur''prei is6s in order to rieterifilhe if a change rtiay be made,iilxtifie character of Occupancy (it Use
i f `the bi:iiidirlq'or pre�iises which �tirotylci{�SIaCe tine iiClli�itygrin a iftffE3rrn tiii�i�idn`of the sanin igrot` p
of nGt ty'tr of in EI` 'different roll l of'occu occupancy, a chilli e of occ'U one ins "ect1011 too of $80,;60
Y t' p Y, ?l t Y p
q.
snail ire paid t�a`�1;�'city.
Ntiiiii'i`ti'Beilh lAire Coiltt'Sectiott 10.68 retltires that ijiiiiclgfltit9ribors mitst'be a niir�iiii'iti'�
1
of four (4) inches iti'°heigitt with one half l'l21`inch stake; and of a coritrastlrig'cdlor from the b#ck-
grotfhd. Tifese i afters most be posted On your b iilrlifva In a1ociitloii that is'Visibie'frolii the Orem,
5•
MuFire Colo Sedtioh 10.301 requires fire e Wh'g islier solectitfn and cii,tribiffian
povthe National Fire ProtectionAssociation pamphlet 10 Isee, rove rse
(FOR OFFICE USE ONLY)
SOPPLFMIw'NTAL `iNFOHMATipN ' ;i_ O -'
�
- PLAN CHECK NO. __�:.__.�___._ .._._:__ _.._ NO.' PARKING SPACES
SOUARF; FT OF i�UIGi�IN�, � .__.._.__�._.._____..
OCCUPANCY GROUP _�� �": �= '_: _.T__..___._.._.�_.. PERMIT NO. {EAt_TN UE#'1'. APPROVAL � ...
OCCUPANT'LOAD _...____: _�r '� _ _....:._.___-_-__ ___._ EiMIN, ACTION __.____._ ....__ _,.__._ __ tlTILITIES A[--LEASE.E� .. ,,.:.s. �.�_. L t
NO. (?F TORTES , ` ;.'
/f
1.:.rc.�:.-.._.._......._.. __. t --
CERTIFICATEOr-OCCUPANCY FEE
APPF`it�4� i�`E3ti` DATE 64AANOE OF C)CCL`�gAC�SCY FEE S :� _
T TOTAL
� � '. � `�' "t ' 't,.�`. «"-,•� t'�i.;.. ,� Via_ �,� ,., f � { {!�: ,;,_ � �,�y:� _
7&�039`i3lEV.
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