HomeMy WebLinkAbout15323 Pipeline Ln - CofO (6)ICERTIFICATE
OF OCCUPANCY 0200_2� . �5 INS-,
CITY OF HUNTINGTON BEACH -
ca
DEPT. OF BUILDING & SAFETY APPLICATION
HUNTINGTON BEACH 714/536-5241 (3'd Floor — Must Apply In -Person)
Business License #
Business Address
Business Owners Name
Business Name
Business Type
Date l'/v*
Zip Code 9 2 q 8
Telephone No.
a'/Jkgus. Phone
Property Owner Information (required) Tenant/Emergency Contact (required)
Name rYU of ty&_ L=o-r"u ` \(, u/it- Name a-C) N N
Address 1 53 0 Pi If 0_ Home Address fa-1 rlc'S /ham .
City M awl22j tti 6e"tate/Zip CA, &6 ` 9- City L(_ t, State/Zip c4e,- z G,l8
Telephone No. Telephone No. G%Yq- Zgi z5 - SSs 2-t/
THIS USE WOULD BE DESCRIBED AS: �
❑ Newly Constructed Building or [existing Building
CHECK ALL THAT APPLY: �
❑ Change of Property Owner 2 hange of Occupant ❑Change of Use ❑Additional Occupant
■ Indicate former type of business S ►�- �wav� ti ow�c ,/ d; f , h 'v v
■ Are you requesting that the electricity be turned on? Yes NOT'
■ Is the building sprinklered? Yes2l No ,�/
■ Will operations produce dust/wood shavings or similar material? Yes❑ , NoC
■ Will operations involve the repair or replacement of automobile parts Yes 0 No H"' ff�yes: Describe the
components repaired or replaced. Q r «a oe��fis 4 .sed "te�,-te / 0"S.1-c- cAres .
■ Does the operation involve the use of welding or open flame? YesQ NoD'
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes QNo
■ The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑ Medical/Dental
24arehouse Manufacturing/Distribution 11 Restaurant/Take Out Food
(describe process and end product)
❑ Other (describe)
For Official Use Only
Occ Group: 5 C D Area: S Occ Load: 2-
Occ Group: 5 1 o uIF_) Area: t 2 S v Occ Load:
Occ Group: Area: Occ Load:
Total Sq Ft Occupied: J `f o o No. of Stories: TIF Review: Y/
Bldg. Permit Entitlement #: _. _ _ .....Zoning: _ .. _... _._ ..._ __.._.......
Plnr Initials: Date: �� Plan Chkr Initials- T- Date: ! r Insp Initials: Date:
(G:BuildingAdmin/WebDocuments/CertificateofOccupancy)