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Get CA CPDPSC-138 2010-2024

Business AddressPZUC No. City of Glendale Building Safety 633 E. Broadway Rm. 101 Glendale CA 91206 818 548-3200 PZUC No. APPLICATION FOR ZONING USE CERTIFICATE Instructions Please answer the following questions as completely and legibly as possible. Please provide a copy of the lease/rental agreement which shows the square footage being leased* Also provide a dimensioned drawing if lease does not show square footage. Please draw a seating plan on the back of the application if the use is for a restaurant delicatessen church classroom or theater. 2. Business Name 3. Describe in detail the business activities 4. Applicant s Title Owner President Officer or CEO Business Owner s Name Mailing Address Phone No* Fax No* / E-Mail 5. Property Owner s Name Address 6. Existing Building Use 7. Proposed Building Use Gen* Office Warehouse Retail Medical Office Eating Establishment Manufacturing Other Wholesale/Distribution Draw seating plan on back of application 8. Please fill in the following Floor Area for Occupancy Square Feet New Business No* of Workers on site First Time Business in Glendale No* of Seats For Patrons Outdoor Storage 9. Are You Sharing Space Subleasing Yes No Alcoholic Beverage Sales If Yes to Alcoholic Beverage Sales If Yes From Whom Existing Proposed Attach Copy of Current ABC State License Primary Lessee s UO / PZUC No* I DECLARE UNDER PENALTY FO PERJURY THAT THE INFORMATION PROVIDED HEREIN IS TRUE AND CORRECT. I FURTHER ACKNOWLEDGE THE ISSUANCE OF THIS CERTIFICATE DOES NOT RELIEVE ME FROM LEGAL OBLIGATION TO OBTAIN ANY AND ALL NECESSARY PERMITS AND/OR COMPLYING WITH OTHER APPLICABLE LOCAL STATE AND FEDERAL REGULATIONS AS MAY APPLY TO THE USE AND /OR BUSINESS Signature ID/Driver s Lic* Date Signature must be of the applicant listed on item no. 4. If a new Zoning Use Certificate has not been obtained within six months after the application fee is paid a new application and respective fees shall be collected* Upon written request from the applicant the Community Planing Director may extend the period of the certificate application* FOR STAFF USE ONLY DO NOT WRITE BELOW THIS LINE Accepted By Receipt No* Fee Zoning Designation SIC Proposed Staff Comments Conditions Restrictions Zoning Case Number s Specify Type of Eating Establishment OK to Submit By Inspection Requiered Verified Address with lease CPDPSC-138 03/10 Verified Square Footage with Lease Denial Letter OK to Issue By Section Sheet. Please provide a copy of the lease/rental agreement which shows the square footage being leased* Also provide a dimensioned drawing if lease does not show square footage. Please draw a seating plan on the back of the application if the use is for a restaurant delicatessen church classroom or theater. Please draw a seating plan on the back of the application if the use is for a restaurant delicatessen church classroom or theater. 2. Business Name 3. Describe in detail the business activities 4. Applicant s Title Owner President Officer or CEO Business Owner s Name Mailing Address Phone No* Fax No* / E-Mail 5. .

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