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' APP'.° !,' ? I tiN FOR CERTiF[CATE OF OCCUPANCY
Y OP FIUNTtNGTON I3EpCli
05 DEVELOFIVIENT SERVICES
fATE
HuHTINCTON BEACH (PRiNT Oil TYPE ONLY) `
Address r & 11y7 N 1 2c_ ! �=_ District
} Business Nameifi� I-=-<.L#C .. Tel.
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Business Type - % 1# � ; c- r ra S r� C _ Occ, Groupf
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OWNER VNckAIMANAGEFI
BUILDING{3V
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Name JA � A A Name
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Acdress � _p Ct - / 3 � 7 'kddressi" i .14
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I city �ty c Tel. 6-7- �.
THIS USE WOULD BE DESCRIBED AS. .
NEWLY CONSTRUCTED BLDG, � -CHANGE OF O17NER � ;CHANGE OF OCCUPANT
EXISTING BUILDING - '+ CHANGE OF USE L] ,ADDITIONAL OCCUPANT �
I', ii ate former use, if any .-Occupancy Gr.
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NOTICE- 1. Occupancy of any building is ,prohibited and a business license will not be issued until the building
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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
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and certified safe. AII,. applicants for occupancy in an existing building are required to schedule an
electrical 'fuse up' inspection in the Department of Development r .rvices at the time this applica-
tion is filed.,
3. Change of occupancy or use :inspection fee. Whenever it is necessary to maize inspection of a build-
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ing or premises in order to determine if a change may be made in the character of occupancy Or use
of the building or premises which would place the building in a different division of the same group
if of occupancy or in a different group of occupancy, a change of occupancy inspection fee of $30.00
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 ('yz) inch stroke, and of a contrasting color from the back
ground. These numbers must be posted on your building in a location "ghat is visible from the street.
5. Huntington Beach Fire Cade Section 10.301 'requires fire extinguisher selection and distribution
per the National Fire Protection Association pamphlet 10 (see reverse side).
(FOR OFFICE USE ONLY) '
SUPPLEMENTAL INFORMATION
SQUARE FT. OF BUILDING w � PLAN CHECK NO. _— _. _ _ _.. NO. P4RKiNG SPACES
OCCUPANCY GROUP PERMIT NC. _ W, _ HEALT14 DEPT, APPROVAL
OCCUPANT LOAD _ _ - ADMIN. ACTION � �� w_ UT141TIES RELEASED
NO. OF STORIES
�'' ' ✓ CERTIFICATE OF OCCUPANCY FEE $
APPROVED BY DATE CHANGE OF OCCUPANCY FEE $ _ 1
TOTAL 5
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