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APPLICATION FOR CERTIFICATE OF OCCUPANCY
yj y CJTY OF ttUNTiNGTON BEACH
"� OEPARTMENT OF DEVELOPMENT SERVICES j
HUNTINGrON W" �Pl,F%T 0H TYPV, ^^,, ri PATE
C�fZr
Address 51 R I-ro(1 L4A)e,r 5611-1 V j x- y HWJT1 k6r-'4,t,1 &---AC_ p �tr+it
��sinesstdame� 'HVS UML-1 MITEb �l1A ?Y2-d'3tr
Bu,,iness Type .C) h € E } � _ OcC Group
^� yy BLiiLDING OWNER 6tiStNi Sa CiirJNERMANAGER
Name
F^lc� i �t Uktf ! _.i%,.+, iVdlI14T J �lltrtl�} r!l�4/I� H0410
` Address ! 4-C i> t / t y 4V c f06P.. AAddtes ,!?
THIS USE WOULD BE DESCRIBED AS;
NEWLY CONSTRUCTED I31-UG CHANGE OF OWNER � CHANGE OF OCr,-W ANT
L__i EXiSTING € UILL ING � CHANGE. OF USE El A€ DtTK?t4ALOCCUPANT
�--s
SQUARE FT. OF BVII 01ING Tt, F E:
I�� T (� ? I1cc.f 7 srt :y r „S?Y I/u+ir�iR'� 1 (ytr,Pi::1tk.. e. i i . taL3 tit ,.a �i 4nso willnotbe iu5 L' t#nH t{?a (au0ding ha.s
been ins—o'Cieci Inf+ ,t CE'stitl C �'t, +7t 4i tSt Csr y < 4:•�at c'
L vJ
Na electrical service ,li art_ rya :£a : ;r r ar y ;tir+�l ta.; Virg -< tl` ti sear'�4o P?u5 beer. ?nstze tad and
'Ct?Ftitd(i{.i sale Ali hp 3(;'d81t T Inr i.Ii": itJcil"�rKy.;ri c..71 ktli:. f Rkr ;,}IJoa itj R'fi ip-„used jo ,ch,;rjule Fnelectrical
I 'kse an'. msj)rrt,tir*Il .9 thef)C-1pa'Mne,'A', of P''xJ"etoprnr ti t'jr',niit r,> at *he tinile thi,y; }JlplicalOn is filed. '.
s Changeofoccupancyoru--e Inspectiony t trpai e ra€ietitan of a building
C;t4 pferni ie; ' 4't orkj7'r to d,' = r t?me' if a C.nange may be rnvd(� in The Character of Qr Use Of the
fiah t� CC iiP£ iC ."+i4 YJ2b�Gt Yurd.alti t:Yia_ , c! +?t; C13 rhttia €.S a d vi!�iorp of jrie fi: +t;4a grotto of Occupw cy
itl` .r' �3 '°),I`E'ff:t'�t. {yrt�fl�'t i)' C), r,.'.paricy, s, r~I3F3"iCiC' rJi CSi.G,lt'.',3'it-;Y
shall be paid t.i Ine City
Huntington Beach Fire Code Section t p. 204 3 raquiic— t)%! bf tdip,q rttirriberg r us! boa rninimai n of lour
in hejg1jt ,rati, one hat' <' `a') mch , Itake, ai'aj of a contrasting Coinr from the backgru-u6d. These
nUmbets r%st bc. IZo ',el on your tat ildmg !r? i ;oration that is v rile I,= the Street
5. Huntington Beach Fire Cade Section 1013DI requaps tams extingjisher seler,tion and distritution per
the IVaticTri€?4 Firk, I�ro+r?cliOn .�._ C)c a�ltarfrt r,3 TTI^t'ir3t iI� (See reverse Side)
(FOR OFFICE USE ONLY)
SUPPLEMENTAL INFORMATION
CJGi iJ7APlC f FlfiUt'a ` PLANI HFt K W` r4O PARKING 30AGFS
i fGURAM! LOAD PEPMNT IK; F�E:t'�LTH DEP APPPOVAI,_....::.�-.�. - `
NO OF STC7F7tFS _._._._ ._ , ADMINIA� TkC7P$-� �:_. ... ,_ .. LiT#LITIES HELEASED .�
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+ E PTJFit A!F 0t)r C I'W," F"EE ;
APP136I ,ff 5 Y'" UA' E CtiALi(A OF USE, (IN O";C.L,t)`}A.NCr F r € s _ .
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