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APPLICATION FOR CE1RTIFli,.AT F OF OCCUPANCY
'4r 1 CITY OF HUNTiNG7'0N BEACH
Df
Hcwnrrcroxaeaci+ PARTMENT OF DEVElrf_1P19 01T SERVICES rv�'
IPRINT OR TYPE ONLY) DATE
Address' s ems.: �':�w: , c_ �r; P ,+ '.. �ti k �r3
District
Business Name F M !' I Jl ' ' +_. r't c c `` �; + ' f f i4 S 3
Td. 7 �' �
Business Type am `
Oce. Group
BUILDING OWNER OVINERIMANAGER
Nerrrie �. XT r N< r'+« t 1f c f
N me
Address.;.. _ Acldress.
City _" " _ Tel. _ m Gate! ._ _ ° ^- Tel,
,I
TMS I ISE WOULD BE DESCRIBED AS:
NEi,LY CONSTRUCTC0 BLDG. CHAI!GE OF OWNER
CHANGE01=CxCCUPANT
EXISTING BUILDING CHANGE OF USE � i ADDITION -AL OCCUPANT
I._.z
Indicate former use, if any � _ iiccupancy Gr,
NOTICE: I. Occupancy of any building, is prohibited and a business license will not be issued until the building
has been inspected and a certificate e of occupancy is issued.
2. No electrical service will be released for any existing building until the service has been inspected
and certified safe. All applicants for occupancy in an existing building are required to schedule an
electrical 'fuse up` inspection in the Department of Development Services at the time this applica-
tion is filed.
' 3. Change of OCcupancy or use inspection fee, VVhenever it is necessary to make inspection of a build
'i ing or premises in order to eatermine if a change may be made in #,re character of occupancy or use
/ of the building or premises which would place the building in a different division of the same group
of occupancy or in a different group of occupancy, a change of occupancy inspection fee of 430.00
ll( shah be paid is 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 (lia') inch stroke, and of a contrasting colorfrom the knack-!
ground. These numbers must be pasted an your building in a location that is, visible from the street,
5. Huntington Beach Tire Coll: Section 10,301 requires 'lire extinguisher selection and distribution
per the National Fire Proteot on .Association pamphlet 10 (see revwte ' Pj_,
SUPPLCME4'TAi INFORMATION (FOR OFFICE USE ONLY)
SC2UAR F7 Or BUILDING ,Z:& PLAN CHECK NO. _ r . NO. PARKING SPACES
OCCUPANCY GROUP ,`:Z PERMIT NO. _: HEALTH DEPT '1PPROVAL
OCCUPANT LOAD _ ._ ADMIN. A :TION} UTILITiES RE, 3EDNO. OP STORIES—
tP)CATE OP OCCUPANCY$EE a _
APPROVED BY DATE CHANGE OF OCCUPANCY FEE
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75,Me REV.