1996, 07-17 Permit: 96005288 Certificate of Occupancy7/17/96
Permit No.
Certificate, of Occupancy
Building Address: 5524 Mirth Best Road a
Legal Description- pazo� Naber 46353'0104}
Owner: Elaine Charon 1 � \ Address 1500 w 40th Ave 0505 99204
LC UR
Occupancy Group: Land Usc 3.5
VNt'J 6 LC Clients
Construction Type* r^Tl\ Occupant Load:
'rI P p
.Occupied As• Adult Family Group Home I y I t 1 it
I 1 ' 41 L ,a, .A_
Additional Information* wed.. fvr three (. ggcound, level`sle 01.19.roas ,for sis (6) t�ants2
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t'- I I ' °'. , 4v.f ` )
with (`]ens I. II, or III evacaaatiaat Yli
. . . . . ......... i;tt-1Yi"F .. ...
This Certificate is issuedhpursdant to Section 307,.of the Unifonn Building.iCode>and.is to indicate the
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-,t>.f•V:17t c �^� el: NI t r 1 ele
above described structure is_approvcd .for occupancys�
atiati401 ka.64°- OCAir
Building Official's Signature
Tf1IS CERTIFICA'T'E MUST BE PERMANENTLY MAINTAINED IN THE BUILDING OR STRUCTURE REFERRED'I'O ABOVE
--If the building or structure is used for any occupancy other than that listed, an application for change of use shall first be made.-.
[o the Division of Buildings.