HomeMy WebLinkAbout15061 Springdale St - CofO (28)714/536-5271
CERTIFICATE OF OCCUPANCY 020- 0 - p
CITY OF HUNTINGTON BEACH
DEPT. OF PLANNING & BUILDING APPLICATION
(3id Floor -Must Apply In -Person)
Business License # 'Z .J Date /
Business Address %'"46/ /U"/ Zip Code 7?GY1
Business Owners Name �a - f ra 01 • "-d Vr,`, Telephone No. 7/ ,V- E 9 ?-.23�4_
Business Name Bus. Phone
Business Type
Property Owner Information (required) Tenant/Emergency Contact (required)
Name Name 5 '�-� z s V�� f fi-r_-9 07- 411- 4
Address I S CXA I S PIU NU b/4' L E Home Address 3 ybo
City State/Zip 9 LG (19 City 4 a+•,:5 &,t ck State/Zip e_!f
Telephone No. 902I Telephone No. %/ Y - YO-1— S2 oO
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or Existing Building
CHECK ALL THAT APPLY:
0 Change of Property Owner 0 thange of Occupant ❑ Change of Use ❑ Additional Occupant
■ Indicate former type of business / A- d f-�' c `p-
■ Are you requesting that the electricity turned on? Yes QNo
■ Is the building sprinklered? Yes QNo❑ /
■ Will operations produce dust/wood shavings or similar material? YesQNoo_
■ Will operations involve the repair or replacement of automobile parts Yes QNo 2_ If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes QNo
■ Will the busin e a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes QNo
■ The following best describes my operation: 3' Office Only ❑ Retail Sales ❑ Medical/Dental
❑ Restaurant/Take Out Food ❑ Warehouse /Manufacturing/Distribution
(describe process and end product)
0 Other (describe)
For Qf
ficial Use Onl
Occ Group:
Occ Groun:
Occ Group:
Total Sq Ft Occupied:
Bldg. Permit #
Area:
Area:
Area:
No. of Stories:
Entitlement #:
Plnr Initials: ate:�d�an Chkr Initials: Date:
Conditions of Approval or Other Notes:
Inspection Date:
Occ Load:
Occ _Load:
Occ Load:
TIF Review: Y/ N
Zoning:
Insp Initials: - Date:
(G:Building/Forms/document id goes here)