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Alt APPLICATION FOR GlRTIFiCATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
DEPARTMENT OF DEVELOPMENT SERVICES
fiuNLNw"TON KACH ? 4,Rifil Ln DATE
TYPE ONLY) �
Address »_'�i f District. -
t Telm'�5sls _ 3
Burnes
(�� Occ. Group
Business Typ'j
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I3UiLElitQG OVdN=H BUSINESS OVONEITIMANAGER
� Name
Home'1 ,
Address - - - Address
city _:.,.Tel. Cityl C3L. Home Te���'
THIS USE WOULD BE DESCRIBED A$
^ n NEWLY C'J" NSTRUCTED BLDG. n ;HANGS OF OWNER � CHAf ICE OF OCCUPANT
' tt��ti
. EXISTING BUILDING L � CHANGE OF USE D ADD:TIGNA_ OCCt}PANT
Indicate former use, it any ___ ._,_ wc- ""Occuoaricv Gr. �Di� .
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SQUARE FT. OF BUILDI, TO BE OOCUPEt s"'._ _ •+ s--
` NOTICE: 1. Occupancy of am building is prohibited and a business lice"n e will not be issued until the buifdimg c+as
been inspected an6 a ce.tificate r?f occupancy is ;:.sued.
2. No electrical servicewill be released for anv existing building until the service has been inspected and
rertified safe AII'applicants for occupancy lrr, an existing building are required to schedule an electrical
Muse urj* inspect or in the Department of Development Services at the time this application i8 filled.
5. Change of occupancy or use inspection fee. Whenever it is necessary to muke inspection of a building
or premises in order to determine if a change maybe made in the character of occupancy or use of :he
building or premises .which would place the bui ding in a differ-nt division of Ilte :same group of occupancy
or in a different group of occupancy, a change of occupancy inspection fee of $
i shall be paid to the city.
n. Huntington Beach Fire Code Section 1 it 208 requires that building numbers must be a minimum of four
(4) iri=Nfae"a in height vr.Yh one half ('.'z7 ir& stroke, and of a contrasting color from the background. These
numbers must be posted on your building in a location that is visible trotr. the street
5. 14untington Beach Fire Code Section 10.301 requires fire extinguisher selection and distribution per
the National Fire Protection Association pamphlet 10 Isee reverse side}.
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(FOR OFFICE USE ONLY) ZOINo
SUPPLEMENTAL INFORMATION
OCCUPANCY GROUP—:�I'- PLAN CHECK NO. NO PARK114G SPACES --
OCCUPANT LOAD- — PEI;Iv1aT NO w-------�--- HEALi H D,,:PT; APPROVAL
NO) OF STORIES _ Al` MIN_ ACTION
CITIL13IES RELEASED ��p{
CERTIPIGATE OF OCCUPANCY FEE $ ` S
APPROVED BY "
. ATE CHANGE CAI: USE OR 0GCJPANCY FEE $
tOiAL S(
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