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CITY OF HUNTINGTON BEACH Date
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Name �CQ> lci ' ET . fiv.. _
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home r T,ztt .tie Drive _
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15>33, rraYtm
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'Ct�rS`sttiictiiin. _.No. of Stbiies__:__ :-
pccupant 4oad lea _ ___So'rinki&ed
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No'fire:
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DEP�►Rl`A'iENT pF�C►CV��'Oif(1ACN1'�SE�tViCtS
7hls certificate d(becupancy
8E 13osti�d in a conspicuous place on
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the preriiises anti shall not be removed
by
by the 13uilding t)ificW.
SERVICES
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APOLICATiM OR CEi�`tl0iCATE OF ' CCUPA�ICY 0/
CITY OF NBNtI'1dtHEACH , ;
� D6PJiIT`1'MENT-'(5F DEVtLOOMtNT SERVICES. ��M
llUtlikXAON D M]i (PRINT Oil TYPE (ONLY? DATE
Districf��k.51 Q(AL
Address — - —
Buslness Nari e .1_ � —�—� Tel_
Business Type _ _ tCa ;F ��i __— _ _ �__� _ _J Occ. Group
t36WNG OWNER BUSINESS OWN11MMANAGER
lAN) 66Q -_ _ - _ Nnnze_ s . _ _C_ ix �e ------
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THIS USE 1 61MY`8E oESCAIDEVAS:
y 0 NEWIY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER LJ CHANGE OF OCCUPANT
I t. EXISTlNC3 BUILDINGt_ CNltiJt� - OF USE � ADD€TIONAL OCCUPANT
Wicate former use, if any_�� _-- _�' __ _Occut>�ncy Gr.___ --Div._._.
SQUARE FT. OF BUILDING TO`BE O(,CUPIED__ � 0-`�-►"�
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1. Occupancy of any building is prohibited and a business license will'ilot be issued until the boding has
been Inspected and a certificate of occupancy is issued.
2. No eleetild'al Servict' will be released for any existing buildinng until the service has been inspected and
ceffified safe. Aii applicants for occupancy` In Ian existing building are requi ed"to sctiedu{e an electrical
'fuse' up' inspection In the Department of ,Development Services at the lime this application is filed.
`s. CKange of ocdUoafty or Use'inspecttoi fee. Whenever it is necessary to make inspection of a biiiid'iiig
or prom ises in order to determine if a change may be'Made'in the character of occupancy or'use of 'the
building or pfemises luhich vaould pface the- building in a different divisionof the same groL1p of occupancy
or in a different group of occupancy, a change of occupancy inspection fee of
/�11 t st,ali�be paid. to the city.
�¢tb 8ea'd ' Fire Code Section 10.208 requires that building r un`ibers must be a minimum of four l � g g
(
d) inches in height with one half (112) inch stroke, and'of a contrasting color from the background. These
numbers must be posted on your building in a location that is visible from the street.
5. Hdhtiirtgt 'h' each Fire Code Section M301 reciuires fire extinguisher selection an ifistribtifion per
tlae Natioriaf I=ire Protection Associationlaarilphlet 10'(see teverse side),
(FOR OFFICE USE ONLY)
SUPPLEMENTAL tNFOhlY1 TION 70NINCY -._ _ ._-__
OCGtiFaAtdCY GfJOUt'.__ PLAN C Iil:t;K NO lJ PARKING f;PA{ f
OCCUPANT LOAD __ _mil:_...__.._.... __ .._____ ..____. PFr?Ehit' �€Cl __.__.._....__.- __ .---_-_-• ti€-ALTH DEPT. APPROVAL—_._____.______.—___
tftE'AJNO. OF STORIES `Cvli€f. h{i{?ii
.�.�- t'E NTIFIC;AT€" Oir OCC.t.1i=ANGY F LF •�' 7' _ __
APPROI't D CiY )fi,TE: C:FdAtJC't: OFUe,l. OR 0 :t UPANGY FEE ti
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