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APPLIC '-ION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
Dt:, :RTMENT OF DEVELOPMENT SERVICES / A�s
HUriMToNAV.0i (i"asNi C}nTYPE OWY! DATE
Address Y /t"'-0h� Gd '4-110 /la�fr/ii � District
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Business Name. __ , 1� ' 1/V' ;4 Ljy41,1� Tel, (,3 j / jC,f9
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G: h17� T }I tn-jt-"A/lr `Business. Type � .� Occ. Croup
BUILDING OWNER BU,91NESS CV, NER.VARACER
Name— e t
NName CG t Fi` t ixr i L L t 6�lkf
Hone
Address Address-119
city—,_ . _ _ Tet t t-..,r
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THIS USE WOULD BE DESCRIBED AS;
F] NEWLY CONSTRUCTED BLDG [J C>IAN E OF E3i^JNER CHANGE OF OCCUPANT
i1 EXISTING BUILDING � CHANGE OF JSE L ADDITIONAL 01-CUPANT
Indicate former .:use, if a.iy U� Cupanc°y ae D.v.
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SQUARE FT, OF BUILDING TO BE CCGUPiLJ
(FOR OFFICE USE ONLY) �L--1y f�i7-S
SUPPLEMENTAL INFORMATION 2ONIN(,
OCCUPANCY C:ROUR PLAN CHF,,K NO,,_ , . _ _ 11401. PARKING SPACES
OCCUr,\NT LOAD G'ERM17 NO� HEALTH DEPT APPROVAL
40 OF STORIES A[AMIN ACT!0N- _ . _ UTILITIES RELEASED
CFR JFICATf OF 0 t UI'ANGv FEEL
APPROVED BY )ATE CHANGE OF USE OR OCCUPANCY FEt~-
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