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j I CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON RFACtt
OtPARTMENT OF DEVI LOPMENT SERVICES �Date
HVIINGION tlrJ1CN 4�
Address
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Business Nae m
Business Type ._,� :_ __.. ___ _.. i _� -_:-.. -- Oce. Group
BUILDING OWNER -_'—_
04YM11Cf�/A4lltVllG�fi
Nama
Name . _ ____. -_ _ . • ' ,
Md(ess ._____.__.:___---'- _--;.__, _.._.__.____.._._—_ --------
Ci4y� Tel. __ ___._.__. _ City .__ ._. _�'_�. _.-.--- '..__� __.�': ��� Tel.
Construction__Occupant Load
Nofire:
This Certificate of Occupancy DEPARTMENT Oi f)EVCLOPK9EfdT SEAVICI±S
SHALL BE hosted in a conspicuous Place on
'ttte premises and shall riot be removed except
fiytitE~`BuitdingOfficiai. t,y_....___._-.___._. _.__..
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PLICATIO FOR CERTIFICATE: OF OCCUPANCY
Cit liunting't`on Beach Department of Develapine"nt Services
*OR APPt:iGANT 'IO'i ILL IN (Print or type only) `DATE _l�� ' y t1�,, _198l2.
App1icafl:6h is hereby made for a Certificate of 1OccUP6ncY fora: �• �
CLTNTCAL LABORATORY (IVCLbb'ING 6PPICES) OcC l L6h Gr•..-
Descri be - BUsibess Use -
1'�tYSICIAIvS & 8l3md# s 1,00.MT16AtT S, INC.
To be k'n6*' n as ur,a phy3;.p1ans It fer6q-&e 'i,tg rafor
Name of us Mess
151.62 TrIt6h T:ane, itilwtittzton 'gea6h, CA. 9261+9 (90LSA"90SINL'SS VA
RK)
B 0 s 11Es`—s 7wress
3 ?"1346 Vie StrFiits' ).n. Hui tin` -tor, 'Beach, CA. 0646
C6r'obrate Pres' lil6ht: Stanley 1..Ordway, , P
Name: BUS E S OWNER Res de_nCe�ci^6ss---may-�i-p---
Rhone No. - E friers: (714) 842--7486 Resid6h%;o: (114) 964-6428
96L84' BUS INE`SS PARK _
&-`A 'MANAGEMENT 'C0. 5122 Bolsa HifltI,lip'tgn I3e ch, A. 9?.6_ :. 14 it 3
Address Z` ty zip
THIS USE. ''NMLb`; E3E: I)MkIBIO AS:
xxx Ne�,il Constrlicted 8ui ld`i ig [ Change of Owner]
Charge of Ocet pant
Cry y
(� [:xisti'ng tluilding 1 Change of 9se Additional t)ccupalit
Occu` ante Gr. Div.
Indicate '6o 0_-r use if any _ __�� __ _ __ �_�
�lccuparicy of any u ng s prb 1 to anci� a bu messcenS"i r►t issued
uhtil the buildin0 `has been inspected and a Certificate of OccUliarcy is issued.
2. No electrical service will be released for any existing. bbil'ding until the
_ seM ce has been i r►spacted arid'' certified safe, A) `1 appl i cants for occupancy
In an,existing building ,are required to schedule an electrical "fuse 'up"
iitspei t;ion 'in the, Dapai^tment of Building and Community �DE:velo`pment at the time
this application is filed.
s
� . CHANGE OF '`GCC0MCY'OR `05E: INSPECTION FE r Whenever i t i s `necessa ^y •L'o make
%1 i n�pection of a bui l ding or. `premises in order to detef ibe if a change` may
be made in the character of occupancy or use of the building -or premises which
would 'pl ate the bui l ding in a di ffert t di vi sion ' of the same group of ocedParicy .
or in a different group of ocdpancy, a change of occupancy` nspection fee of
$30:00 shall be paid to tiie City. -' i
(FOR OFFICE use ONLY)
SbPPLFMWAi- INFORMATION
Sq. ft. of building_ __ 1 a Plan Check tin: ___._-_._.._.__.._..
.1--r.,, ,. too .
Occupancy GroUp._._� Perrin
Occupant Load Admin. Rrt i err?
No. cf Stories�V_ No. Par -kind Spaces
Health t)ept, Approval
1tz17 tIes Released
�API 'R VET M t�E`EK- -
CrRTIF!CATE OF OCCUPANCY FEE _...._6-.00_.
CHANGEr 'OF OCCUPANCY OR USE INSr'EC1"I0N f"I
TOTAL.; ...�
(#75-039 )
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