HomeMy WebLinkAbout20052 Brookhurst St - CofO (60)+► HUNTINGTON BEACH FIRE DEPARTMENT
FIRE PREVENTION DIVISION Fire Only
2000 MAIN STREET • HUNTINGTON BEACH, CA 92648 File #:
(714) 536-5676 • FAX (714) 374-1551 FP:
FIRE PREVENTION - BUSINESS DATA SHEET
/+ For new Certificates of Occupancy
Business Name: Start Date: % �Q
Business Address: SUSS Opp-A/cA Avg
Number Street Unit Zip Code
Billing Address: Kame as business �+
Business Contact:
Emergency Contact: ZA�7 e.— '7
(24-hour) Name Phone Email
Description of Business:
Will there be any of the following uses on the premise?
❑ Storage >6 feet ❑ Welding ❑ Special amusements (escape room or similar) ❑ Motor vehicle repair
If yes, describe:
Will there be any of the following equipment (E =existing equipment, A = adding or new equipment)
Dry cleaning — list solvent _ Industrial oven — list fuel
Propane patio heaters — # of heaters, # of spares _ Cooking equipment (fryers, ovens, pizza conveyor, etc.)
Backup generators — list fuel _ Walk in refrigerators or coolers — list size, refrigerant
Spray booth or dipping tank _ Tents or air supported structure
_ Grinding/milling equipment that creates _ Fuel dispensing (including storage tanks)
combustible dust _ Carbonated beverage system — list total pounds of CO2
If yes, provide details (e.g., number, fuel, size, etc.)
Does the building have any of the following features (E =existing feature, A = adding feature)
Sprinkler system _ Other fire suppression system
Fire alarm system C Smoke detectors
Other detectors (e.g, methane) _ Other alarm system
Private fire hydrants _ Battery systems
_ Fire pump _ Methane barrier or other methane control installed
If yes, provide details filnA c►�L�
Does the business handle any of the following:
YES NO
55 gallons or more of a liquid hazardous material or hazardous waste. ❑
Compressed gas (or liquid/cryogenic equivalent) of 200 cubic feet or more ❑
Inert compressed gas (e.g., argon, nitrogen, helium) of 1,000 cubic feet or ❑
more.
500 pounds or more of a solid hazardous material or hazardous waste. ❑
Extremely hazardous material or radioactive material ❑
I certify, under the penalty of perjury, that the above information is true and correct to the best of my knowledge.
Signature: Title: mil_ Date:
HUNTINGTON BEACH FIRE DEPARTMENT
FIRE PREVENTION DIVISION Fire Only
2000 MAIN STREET • HUNTINGTON BEACH, CA 92648 File #:
(714) 536-5676 • FAX (714) 374-1551 FP:
IMPORTANT INFORMATION
ABOUT HAZARDOUS MATERIAL DISCLOSURE
If you are subject to hazardous material disclosure there are important steps you need to take.
We encourage you to reduce your hazardous material inventory below disclosure amounts to avoid
fees and inspections. However, if your business requires hazardous materials equal to or in excess of
disclosure amounts, you must comply.
A Fire Department representative will contact you to verify the information you submitted for your
Business License. If you are subject to this program, you will need to:
❑ Disclose online,
Businesses must disclose on-line either through either (but not both):
o Orange County ESubmit portal (https://www.esubmit.ocgov.com/home/)
o California Environmental Reporting System (CERS) (http://cers.calepa.ca.gov/)
Business must disclose information on the following forms:
o Business Activities
o Business Owner/Operator
o Chemical Description
o An Annotated Site Map
Identification o Emergency Plan.
You are encouraged to proceed directly to either online disclosure system and begin the
disclosure process. Failure to disclose is a violation and subject to significant fines and
penalties.
❑ Annually review and certify your online disclosure.
❑ Update your Business Emergency Plan every three years.
❑ Pay an annual HMDP fee. The fee is determined based on number and quantity of
hazardous materials handled at your facility.
❑ Inform your landlord if you operate in a leased or rental property that you are subject to
hazardous material disclosure. These are done in writing and sample forms are available on
our web site.
❑ Receive an inspection by the Fire Department's Hazardous Materials Program Specialist, at
a minimum of once every three years.
If you have question or are unsure whether you need to disclose please call (714) 536-5469 or (714)
536-5676. You can also obtain additional information on the City's website at www.surfcity-hb.org on
the Fire Department page under the section Fire Prevention.
Departrnent of Planning & Building
2000 Main Street
Huntington Beach, CA 42648
Phone: (714) 536-5241 Fax: (714) 374-1647
5075 IwarnerAve 101� JOSLYN RICHARD H
5075 APN 146-601-26
Occupancy Application
Certificate of Occupancy Application
Application Binder
Num Street Unit Bld _
Job Address 5075 Warner Ave 201 APN 146-601-26 RD 3210
Zoning CG Lot 4� Tract 86 Block
File Number Cofo?
B2008-005662 Yes
P2008-005664 No
M2008-005665 No
E2008-005666 No
02009-000038 Yes
B2009-002151 No
I
02010-002284 Yes
02010-002734 Yes
02010-006988 Yes
02011-00352T Yes
E2012-006377 No
02012-007144 Yes
Entered By Watson, Daniel Date Entered 11/28/2012
Default Inspector ]Dean, Mike Status Pending
Permit Type Certificate of Occupancy ` Issue Permit? Date
Origin Counter Issued By-��
Building Use - City Planner Arabe, Jill Ann
Building Use - County New Building? Plan Checker
Description
Internal Notes
CofO Number CO2012-007144 Choose PRntAll CofO Type Permanent Fees and Payments
_._ Sheets to Issue
Issued By Single C/O CofO Status Pending Inspections
Cofo Date Issued Temp. CofO Issued Date Printed
Utility Release Date_ Temp. COFO Expiration
License Number A285226
Business Name LUXURY SPA
Business Type Professional / Other
Business Phone ( ) -
Proposed Use
Former Use
Conditions
NAL SERVICE
SERVICE
Click the « button to copy the Business License
information into the Certificate of Occupancy.
Business Licenses Business Name
A154224 P R P HAIR STUDIO
A161728 SUBNICK BONNIE
A197962 CAMACHO ENTERPRISES
A163660 LINK & COMPANY INC
Approved Occupied Area (Scl Ft) : 980.00
# of Stories
DChange
of Owner?
D
Elec. Available?
Q Drinking I Dining > 50 Occupants?
Dj
Change of Use?
11
Want Electricity On?
n, Welding I Open Flame?
®� Change of Occupant?
al
Sprinklered?
�'i Automobile Repairs?
Additional Occupant?
Dust I Wood? Auto Parts Desc.
�loccupailcy
lGro-up/Load
Group Description Area
Construction Type Occupancy Load
B
SALON
10
B
SALON
10
Group Definitio Business Use - Building or structure, or a portion thereof, used for office, professional or service -type transactions,
WC Policy Number C� Exp. Date Carrier' �i