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APPLICATION FOR CFRT►FrCATE OF OCCUPANCY
CITY of HJNTiNGYrON BEACH
DEPARTMENT QC ;)EVELOPMENT SERVICES
HUNTMTQN BEACH (P'?1NT OR TYPE ONLY,
DATE ,
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Address� District
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Business Name-
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Business TYP —1Z: "J&_ _ . 5 _ E %t �' F Occ, Group
BUILDING OWNER BUSINESSONINFRtMANAGER
i Name_._,. Na � UJci.- r` fYrr- C%r^
Address Adh.� --
Cit� _ h_Tial _ _ C+ _� `1zcu+1?t` c'-- 1`.cse{ 1ItlrYneTr71: o
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THIS UsE WOULD BE DESCRIBED AS:
NEWLY CONSTRUCTED BLDG, � CHANGE OF OWNER � C'HP14GE OF OCCUPANT
EXISTING SU►LDING CHANGE OF USE ADDITIONAL OCCUPANT
Indicate former u:>e, et a"Y,_ __- Th LS C c = psncY tar L)iV .
SQUARE FT. OF BUILDING TO BE CCUFiFiER r ; ar�rX
(FOR OFFICE USE ONLY)
SUPPLEMENTAL INFORMATIt N---
QcCuPANC:'r` faHOUP—.. -. PLAN f�o.. _ _, _ -. w). PACIMINU SPAS. ES
OCCUPANT LOAD PLRAIIT NO HL-ALTH DEFT. APPHOV ►
I tJri F: STORIES _ A9 a N ACTION--- UTILITIES F?ELEASED
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APPr'?WEC) By t A7t ; N l4 ` NGE i. t,$E OR, C01UFAPNt. Y FEE S
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