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APPLICATION FOR CERTIFICATE OF OCCUPANCY
' CiTY OF HUNTINGZTON BEACH ,
DEPARTMENT OF DEVELOPMENT SERVICES
HUNW GION trtn[rr ,P'aI aT nq TYPE ONi.r1 DATE
Address �• ��� � ,<i ri'�z'�_.-.f.�`���_..�r _ District
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Business Name
Business TypeT'! kCcc Gi our
BUILDih1G OWNER BUSINESS-OWNcR-MAFaT,GSR
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Name Blame
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City C,iy L rule �+ C e4 Home Te /
THIS USE WOULD BE DESCRIBED AS
NEWLYCONSTRUCTED BLDG El CHANGE CF 'NNER r�--�CHANGE OF OCCUPANT
CAiSTING BUILDING CHA;-X;E OF
U$ L t ADDITIONAL~ OCCUPANT
Indicate tormnr'use, if anu „� � � _ � �.f f,+ w� ar�cy Or —Div.
SQUARE. FT. O, : BUILDUNQ TO BE OC'CUMECr—0- )
p' NOTICE: 3 Occupancy of any building is prohibited and a business license will not be issued until the building has
been inspected and a certificate of occupancy i5 ssued.
i 2 No electrical service will be released for any er isting butlding until the service has been inspected and
t cer"ifi d safe.AP applicants for ficcuparJ y in a` ` istiric ouildiog, are required to SCIi$%{Lfle an el ctrical
{ 'fuse tip' iiispecta n in the Departrr ert oa Devoicipariie nt services at the time this application is filed. <.
3 Change of occupancy or up,9:nspection fee. Wher,ew3, J is necessary to mare inspection of a building
or premises in order to det:o mine if a change may do made ir. tre character of :occupancy or use of the
buitdin;q or prerii ises which �vouLd place the building in a differenf division of the sarw- group of occupancy
Or in a different group of o=iP ricy. a cnarige of occupancy inspection fee of S
shall be paid to the city.
a Huntington Beach Fire Code Section 4 OJ 208 reGLAr0r, that building numbers mustbe e a minimum of four
l (4) inches in height with One half r'.: a i inert Strout~, acid of a conirasling color from the background. These
numbers must be posted on your building -m a location ,r;at is visitlle from the street.
5. Huntington Reach Fire Code Section 10.301, requires fig extinguisher selection and distribution per
the National Fire Protection t' ssociatloo pamphlet 10 (8t?ey reverse side),
SUPPLEMENTAL INFORMATION (FOR OFFICE USE ONLY) ZONINGr
r � _.:. PLAN Ci 1E ? N � i O PAR KtN#a SP PkES
CC CU€'AruCY Gi Up _ _ _ W
OCCUPANT LOAD w — __..a _ PE:Rf iiT NO _ IEALTH DEPT. APPROVAL
NO OF STORIES -- ADMIN A: TIr?N aTILITtES RELEASED
r -
i, ERTtFICATEL C-F OCCUPANCY PEE
APPROVAL} BY DATE CHA.N`-F OF USE OR OCCUPANCY FEE
TOTAL,