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CERTILI�AY� ('1F OCCClPAi�`G�Y
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CITY 01 tlUNTl GT6N bEACti ;:"t'tYn "}•..*.r 'i 3 ?
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Date
DEPAOMt-'N F OF DEVELopmM NT`SERVICBS
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I fIN WN BtACti
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'IlcidreSs . I fy.t:::��-.fiC, 'e a �=..�s� 4at•.tp.s: :I as•� _�___._._..___.—____— 't�i3�'t`iet_ _._
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.... I t: t z t' i i" `-tt�l t !rt t or t �'.t3 dt4 ;'�•:
Business Name Tel.—
BusinessTOe f°!' =>aF'? r ''Ex :tt `•` .�"'�' `` ��____--___ _— _. Occ. Group
BUILDING OWNER OWNEWMANAGER
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Name
1
Ati d ifess ' ��- b';; � t;Gt; ___ -_� Adiess
1
_
`
City_ l•''-`vitlo Cris 9 :� 1 '? _ Tei. r'`; t" .8.' City
Constr"t ctibn _ No: of Sf�if teS_, _. _ Ocr ffl) t Loan!__ F' ._ Sprinkfe4ed
Notice:
Tel `Certificate'of Occupancy bLPkkTMENT`OF DEVEL{SpMf~(�iT SERVICES
SFfALCbE po'ft�d in a conspicuous place on
the Oi&f ses anti Ohai! iiot be removed except
b `;
by ttte Bull, ihtOffic' W. y ___ .._ _ —'
APPL:ICATIQNTO.R �CERTiFICATE OF QCC'UPANCY
GI tY of tiDt4 If4dTOiV BEACH
ncol6i 'MEiVT OF_DEVE(.OpMENT SERViCES nAVE
It t IFWGIONUkM iPAjf Ton 7YPE'ONLYi
f r /c��� bistrict __
Address--- `;
�rei.
ousinass Name .%
Occ. Group ~-------
Boslness toe
BUiLDINi3 owNt p Uwr1Ef!1MANA`c3t
f :7 - > 'tl�C.. ,,y Name
Name --
h%Address-__LAdress _f
Tel.
Tel.`
City./1�--.---�
DESIaFiIaED AS:
1"N15'USE WbU 3�� _tk G'N
!i NEWLYCONSTFiIJCTED 1LDG. CHANGE OF`(MNER
1 v r T �- OCCUPANT
E?�ISTIIVG sUii:DING
CHANGE OF'USE a
Occupancy Gr.
Indicate former Usc, if any
NO
'1'i E: 1. Occupancy of any building is nroh{bitPd and a business license will n6� be issued Until the Wilding
has been inspected and a certiflc:,te of occupancy is issued
2. No electFical -service Wlll''be'released for any existlrlg`ti ilding untll the service #ias'.been`inspected
and certified safe. All anplica'nts:`for, occupancy ir1 an ex{stiriq 6�uiiding are regUiredti� schedule an
electrical 'if Use up' inspection -in the Departrnerit'of'De'vei60ment`Selvices at the tiirte tills applica
lion Is1l d.
3. Change of`occupa1cy or'use irlgpectidnfea.' Whenever it is`neessarye cnara er of occupancy or iu"se
ing"or premises in oi`der to deterrniiie if a`change tray be made in. #h ,
of the Wilding or prerliises which would`place the tSiiiidin`�'in a dit`ferent iilvtsion of"�� e`san�e group
of occuP3 1ncy or in a different group' of occttpaltcy, a change`of occupancy'Inspeciibrt fee if $30:�0
shall bG paid`to tits °city.
tj 10 208 re4dlres that b IIdih`g nuifi�bers rYlust be a minimum
v - 4. F�tli�tiigfh;� Beach Fira Code Section a
�-' of four (4j'"I ches in heighf �vithaone`ha{f '/z) inch stroke, aad� lid that is visible th street.
1 around. These rilrrbers must tie `posted on yofi�r bt111dir� In
5. 1liiiitirl' tdri Beach Fite Code Section 10'.501 requires fir- extI'6g' bl;iier selectiori`an pdisfi`it3tltlijrl
7�4per the National Fire Pro* tectidn"AssoclAlo'n patnfih{et 1(i`(sEe revers s`
V..r_ x t CGc't.� c (FOIR`(?FFICE`USE ONLY)
G (, t
SUfyf't.EM " NTAL iN176 M TION
PLAN ctIE:CK I40. -.--_— ___ NO. PARKING SPACES
SCILIAftE FT: OF BUll.oiN—-,t—_—
HEALTH DEPT. APPROVAL --.
OG('UP%ANCY Gat7UF _�'.- -.- _ _ _. PERMIT NO.
G;{'"� _ _.. ADMIN. ACTION ___. _ ____._ ._,U ILITIES'R Li=.<.SEd �
CUPANT LOAD --- c c�, _1 . ��01 y"
CERTti'iCAi I-,OFOCCUPANCY f' E S