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CEATI CATE'OF OCCUPANCY
Fc►.2s txnry _� .9''4
CITY OF HUNTINGTON 6EACH
,
�4 DEPARTMENT-0F`OEVEt_OPMENT SERVICES
f
HUNttyGYOY UAIM
I
Address _ _ 15.131 `IritOn _LailC�_Qisfrict _ _ :___
f3uesiness`tVante. Y733S CH 511 .
£•. SM19-TAI %%iU5�------
Business Type CAR SATM Occ. Group
t
___tj—_�
!
9UILDIhG'bWNEii_
BUSINESS OWNERWANAGER
Name R_REEF _
Name P, It . Welggellhk
Address 3435 Wilshire B' Ivd .
_ y _
Home 3 ,4 2 Court�eldo Cir. .
Address. ----
City ins n cic1e5
-�
7�4;G0-9364
Tel. __ City ._ ilantinglon B iiC:i1 _Nome Tel Z �'•
Construction - No.'of Stogies—_. _
Occupant Loa(t _SprinkIered
i
Notrce:
E
This Certlficate'of Occupariey
DEP1`,RiMt 1 T OF DEVELOPMENT SERVICES
SHALL 13E'pasted in i conspicuous place'on
the premises and shall not be remdved except
the 3uildina Official:
by
y
_.._._ _-._.-___.__.___
A001LICATION FOR :C0*n*f1FIcATE OF OCCUPANCY
CITY OF OU NGTbN BEAm
T'
t)t0AAt'MENT OF UDEML0,PMENT SERVICES ___��/�
11UNT14CION 11ACH (PhiNt"16A TYPE ONLY) D�T ec,
ui District
tridt Address __j _L3_1 IT 0 lr_-
(_1�1_ , Tel. 86sinesi Name
Bijs I iness'(ype C4 Occ.Group—
BUILDING OWNER OWNERWANAGER
Name Name . . . . ......
7
I [hL_'( I
Address Address-!L
chy Tel.
fAlS USE W60LD BE'DESdhiBED AS:
NEWLY'CONSTRJUC TED BLDG. CHANGE OF OWNER CHANGE OF OCCUPANT
EXISTING BUILDING CHANGE OF USE At)6!TIO'NAL OCCUPANT
Indicate former use, if any Occupancy Gr. Div.'
NOTICE: 1. `Occtipancy,of any bUIIdIKq..Is'0rofiIbIted and a business license will niovbe' Issued until the bulli!160
,has` been Wpect6d and a certificate of 6ctd pa'Acy'Is issued.
2. No eleqtObl, service WhI be:released-for any existing bbildflin"g—until 'the service roas,bedn intioected
and, tortifled'safe... All applican- ts'for occupancy in an existid'o-btlildI66 are r0bit6d'to sched0le an
le' e _In n* the time this apollca-
C' trical 'fuse I ' the Depirtment of Develoorneht. Services at
t1oh" filed.
3. Change -df,occupianby-or Use Into'd6tio"Wfee. Whenever it-ishecessarylo, make Inspec* flioW6f ab6ifld-
In, or'0rP_,mI*,es* in'dirder to'de-..'errnine if a charige may be,made- IhAhe'6 hbraci'ter 61"occcipancy-br use
of the b ulldIAg or premises which would mace the" lJ61181h In a�dlfferent division of'the same I ro d
9 p
Of OCc(J0,a'h'_^y'ot in 4 different group of occupancy, a change of occupancy inspection fee of $ 660
shall be p6id to"thecity.
W A'h* .
4. i'fl9ft'0n-4) l3ijach Fire Code Section OA8 - re*0UIres that � b-6141ding -n Umb0'rs'm ust.be a minimum
n Im"
of four (4) inches in° heidht with one half (72) inch stroke, and of a contrastingColor from the back-
grouh .d. Theseniirhb8rs rw.lst t)a posted on'your bul It I IWO In 6 lociotio-n'th-at is visible from the street.
5. Hitnti6gton Beach Fire Code Section 10.301'requires fire extin'OURlier selection and distiNufloin
I
per the Natfnal Fi 1-c Protection Association OaMphlet 10 (see revers SIOA).-
I0:A- k
(FOR oFFicE,usE ONLY)
SUPPOEWENTAL INFORMATION
O. NO, PARKING SPACES
SQUARE FT. OF BUILDING PLAN MirCK N
OCCUPANCY GROUP PER
MIT NO. HEALTH DEPT. APPROVAL
OCCIPANT * LOAD A' DMIN. ACTION UTILITIES AELEMED
No. OF STORIES
CERTIFICATE OF OCCUPANCY FEE
APPROVED BY DATE CHANGE OF OCCUPANCY FEE
TOTAL. $
U ors - f4111C_IkUI- /I J 1
11-OrM i-41111141-1q, �; . __ _ p .1
[V!�
III .�:iccikjl. lz�
75 039 9EV.
f� V
r
-a4 C R TICICATE OO'OCcl1PANCY
j CITY OF HUNTiNGTON BENCH
DEP ifi lUlf NT OF DEVELOPMENT ViCE5 Cate
IiUWTititlh�t BfACF!
Address
Business Name Ois"trict-.-�___
8usiliess'Type - _ _ -- --- _., __---.___ _ Tel.._
,t� Q Occ. Group- [
(il/, ANArER
Name -- -_ _.
Name
Address
Address__��
Tel. City
Tel. Construktion— _No: 0! Stbriei_ _____Occujont Loaf(___ _______Sprinkferett
No tire: -
-ThisC"Micate 4_6rcupancv GCPARTIMENT OF dEVELC'Pf11Ei IT SERVICES
SHALL 13E posted in a cwSpicrovs place on
tile, 'ptetolses and shall not be removed except
by the f3Uilding Official.
by
11
'
Business Name
1360nnoTvpu
'
'
APPLICATION E F1 CA E OF OCCUPANCY
�IK0 0EP&��E0TOPZjGM6PIVIENT sErivICES
Name
. `
Addrma________-_-
City
THIS USE BE DESCRIBED :
F7 NEWLY COmSfHUCTF0BLDG.
�|ST} | BUILDING
Indicate former useif any _
�1_^���~����~/
��� �7
DATE
Ab:�:Rry — ) -
--- —'- -----'--'—
Address
����
_ CityTei
F—1 CifANGEOF��^*/E' H�NGE/`F[���UPAN.
L-J `~``'^ ^ ~ ~ '
CHANGC OF USE (—1 ADDITIONAL ^'~~T
~~'~'`
~^ICE: 1 Occupancy of any bJ01I(dIhg is, (Jr6lilblted and a business license will not'be issued tintil the bull . dih'*
has been inspected abd a ceetifidate 'Of occupancy is issued.
2. No electrical service will be releasedJor any' ekkil h!ybbilding until the service has bee'n inspected
andcortifled safe. All applicants for occupancy in'an existing bbildin'g -are. re.4uIr6d to sc.hedu'16 an
electrical 'fuFe up' li.sp6ctllon i0ho Department of Development Services at the tione'this applica-
3. 'Cl4rige ot occupancy b r use inspect1drilee. Whenever it Is necessary td,'Make inspection of abtJild-
ingtor premises in order to detetmine'lf a 'change may be rnade in he character Of Ord0pancy or use
of occupancy or in b'd if Went grob of occubaficy, a'dharf(
shall -be paid to the city.
rif four (4) inches in'height with one half (Yz) inch stroke, and of a,contrasting color from tho'back-
ground. These numbers hiust 1,eposted on your building in a location'that is visible from the street.
0 sec'tl v, 10.301 requires fire exti n4U!§her selection and 'distribution
per the National Fire Protection Association parnphlet 10 (sce reverse side),.
(FOR'0FF|CEUSEONLV)
SmPpLEMETAL|NFORK4ATION
SOUARE FT. OF BUILDING
-64��7:�.---_,
PLAN CHUCK NO
NO.PARKIN(}SPACES.-
OCCUPANCY GROUP
_p[RM|TN0.
_ --- _
HE/\iTf4DEPT.APPR8VAL
OCCUPANTLOAV_- - -_---_-'^_._-_�__-/\DM!�.ACT(ON
���
UTILITIES RELEASED -------- ^
NO. OFSTOR|FS
CERT|F|CATEOFOCCUPANCY FEE
APPR0VEUDY
D/J[
CHANGE OF OCCi)PANCY F[F
TOTAi
7sn39nsv
�1 CERl`IFIC•ATE OF 66WU NNCy
CIT Y OF fJUNTiNGfON HEACtf
DEPARTMENT OF DEVELOPMENT SERVICES ,` � Date
MINTWGitNJ NAM r,
Address
... _._ District____-
V
Business
Business Type ._-- - --
__...._- __ .._. __`d'►__. _. _____ ___._,__ _.__._- Occ. Group
E?ttit:DING OtVNEI? OWNERlA7APv't1GFR
Name dame
Address _ _Addw-Ss
Tel. _ :M.._ _ . ` city--
Canstruction.__ of Stories_, _ �Occujx:int Load.__...._.
Notke:
This Ce►tificare of Orrupancy DEPARTMENT Of UEVE{-C7P[i4ENT SERVICES
SHAD [, BE posted in a conspicuous Place of)
the (;remises and shill not be removed except
by the Building Otflcie„ ify .._....__ ._ ...._...... _
I
Cifx of Nunt`ii §t6n Beach
iFOR APPLICANT TO i'�ILL IN
APPLICATION FOR CERTIFICATE OF OCCt1F MCY
Uepa+,tment of Development SI-rvices .
(Print or type only'
DATE
AW1 ficAtion "is hereby made for a C 'rti f i Cate of Occupancy for a:
scribe Uirs ine5';' Use
To be Inown a41 - Z-) <`' h
;of Busines
)/VorfIoAll Ijt (`
Located at /,S-/`3 : , IL6_ i 1_
ur i n es —Add—res s
Name: BUSI JRSS OW R Residence-Addrqss i
Phone No. - Business:/"L Residence:
r/03,
ame:OWNER ---Adfte s s pity dip pho5e o.
TNYS USF WOULO'BE DF.SCRIOED AS:
fp Newly Constructed Building
[~] Existing Building
Indicate former use if any
z
i
3
Change of Owner
(� Change of'Use
Change of OcOu(aar�t
� jAdditional Occupant
_ Occu an� Gr. Div.���w
Occupancy of any building is prohibited -and a business license will not be issu
until the building has been inspected and a Certificate of Occupancy is fistbed.
No electrical service will be released for any ekisting building until the
service has been inspected and certified safe. All applicants for occupanc+,
in an existing building are required to schedule an`electrical '`fuse up"
ib§oectior► in the Department of Bui';dihq and Community Development at the time
this application is filed.
CHANGE OF OCCUPANCY CR USE INSPECTION FEE. Whenever it is necessary to make
inspection of a building or premises in order.to determine if a change may
be aide in the character of occupane,., 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
$30.00 shall be paid to the City.
(FOR OFF r (:c' USF ONLY )
SUPPLEM.i=NTAL INFOR}fit TioN
' ,St}. ft. of building_._. Plat) Check No.�� �..�_.-.._�._._.__.__._..___......_
Occupancy Group ...' . C'_.__. Per,mi t: No. ._.-.__ _ ._.___-..___—
Occtipar,t Load Ad►irin. Action
No. of Stories No. Parking SpaeesP___._ Heth Dept. Approval- .
u l
Utilities Relcased
- f-PPRMF 17` _ _-- G'itT E:
CCRTIf ICATt, Of OCG�lPA3tf,Y F Ef: �6.t?Q
CHANU OF OCCUPANCY OR USE I NSOECTION FCE -_-
({75-039) TOTAL
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