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HomeMy WebLinkAbout10030 Adams Ave - CofO (2)CERTIFICATE OF OCCUPANCY 7 CITY OF HUNTINGTON BEACH Address iuO30 ADAMS Business Name REFINISHING GENERAL COINTRACTUR (OFFICE) Business Type BUILDING OWNER DP , ID N1 L H E L., Name Address 1 C U` L A DA i-I S City HUNT BC11 9261!c Tel. 7 1 6 4 02 Construction — No. of Stories Occupant Load CONDITIONS OF APPROVAL Date District "4 Tel. 1 Occ. Group BUSINESS OWNER/MANAGER R L) t','P L Name Home RIJOK Address L, OT0 DE C A %ft Home 14 —53-_7 1 7 City TeL 10 Sprinklers DEPARTMENT OF COMMUNITY DEVELOPMENT COMMUNITY DEVELOPMENT .. E �f �1 APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH DEPARTMENT OF COM IJ%'4iTY DEVELOP v7ENT HUMWISTON PEACH (PRINT OR TYPE ONLY) Address Business Business k- b• DAT " ' ovoi _ a vrwcnnvvvvnvcn Name i �_'+'► Name - Home '�j Addr ss��L � .� Add r s' - 1 _ �jr City 14��i1C TeF1�� Cit 20 Home Tel.'s 1J / '. THIS UF.E WOULD BE DESCRIBED AS: ❑ NEWLY" CONSTRUCTED BLDG. ❑ CHANGE OF OWNER XCHANGE OF OCCUPANT EXISTING BUILDING� CHANGE OF USE El ADDITIONAL OCCUPANT Indicate former use, if any 'Cff w %�4 OccupancyGr. is Div: l SOUARE FT. OF BUILDING TO BE OCCUPIED_1y NOTICE: 1. Occupancy of any building is prohibited and a business license will not be issued until the building has been inspected and a certificate of occupancy is issued. 2. No electrical service will be released for any existing building until the service has been inspected and certified safe. AI, app' -;nts for occupancy in an existing building are required to schedule an electrical 'fuse up' inspertion in the Department of Community Development at the time this application is filed. 3. Change of occupancy or use inspection fee. Whenever it is necessary to make inspection of a building or premises in order to determine if a change may be made in the character of occupancy or use of the building I or premises which would place the building in a different division of the same group of occupancy or in a different group of occupancy, a change of occupancy inspection fee of $ shall be paid to the city. 4. Huntington Beach Fire Code Section 10.208 requires that building numbers musi be a minimum of four (4) inches i^ height with one half (1/2) inch stroke, a d of a contrasting color from the background. These numbers must be posted on your building in a location that is visible from the street. 5. Huntington Beach Fire Code Section 10.301 re,.;=..res fire extinguisher selection and distribution per the National Fire Protection Association pamphlet 10 (see reverse side). 0_,,0 36Ltqq k1r., 2 1-b 9 % TRAFFIC IMPACT FEE �JV DATE PAID AMOUNT RECEIVED NAME -__- (FOR OFFICE USE ONLY) GG E P Z SUPPLEMENTAL INFORMATION ZOO:; vG OCCUPANCY GROUP PLAN CHECK NO. Al NO. PARKING SPACES OCCUPANT LOAD Ib PERMIT NO. HEALTH DEPT APPROVAL NO. OP STORIES ADMIN. ACTION UTILITIES RELEASED CERTIFICA1 E OF OCCUPANCY FEE $ `� 1 APPRO D BY DATE T CHANGE OF u3E OR OCCUPANCY FEE $ TOTAL $ 75-039 Rev,1/97 COMMUNITY r)r •'_LOPMFI\rr 0 SUPPLEMENTAL INFORMATION '.. BUSINESS ADDRESS ��� rng ) v Person 2. to contact in case of emergencyAL����JAM- Telephone number: 58 '`? 1M _ 3. Does the building in question have electricity? �' Yes ❑ No (a) If No, are you requesting that the electricity be ❑ Yes turned on? ❑ No 4. The building is sprinklered? ❑ Yes 'Et No 5. Operations will produce dust/wood shavings or similar material? 11 Yes IE� N o d. Operations will involve the repair or replacement of ❑ Yes automobile parts? ONO It Yes: (a) Describe the components repaired or replaced. (b) Does the operation involve the use of an open flame? ❑ Yes JX No 7. The business is drinking, dining or assembly use that will result in an occupant load of more than 50 persons. ❑ Yes No 8. The following best describ my operation; Office Only` k Retail Sales l Warehouse Manufac`.uring / Distribution (describe process and end product) s i Restaurant / `fake Out Food Medical / Dental Other (describe) j, a, SUPPLEMENTAL INFORMATION SUPPLEMENTkL INFORMATION (Continued) Does the operation involve any of the following materials? If Yes, indicate quantities- �"ateriai ! Quantity 1. Flammable liquids Class I -A Class I-B Class I-C 2. Combustible liquids Class It Class II! -A 3. Combination flammable liquids 4. Flammable gases 5. Liquefied flammable gases 6. Flammable fibers - loose 7. Flamm-bie fibers - baled 8. Flammable solids 9. Unstable materials 10. Corro-ive liquids 11. Oxidizing material - gases 12. Oxidizing material - liquids 13. Oxidizing Material - solids 14. Organic peroxides 15. Nitromethane (unstable materials) 16. Ammonium nitrate 17. Ammoniur,i nitrate con,pound mixtures ^,-.ntatring more than 60% nitrate by weight 18. Highly toxic material and poisonous gas 19. Smokeless powder 20. Black sporting powder ❑ Yes )E*N o I hereby certify t the above information is true and correct to s the bes�o owledge. —___ �— Signature Date South Coast AIR QUALITY MANAGEMENT DISTRICT 21865 E. Copley Dive, Diamond Bpr, CA 91765-4182 (909) 396-2000 Company Name: Location of Property: City: AIR QUALITY FLIZMIT CHECKLIST _ for n esiden\tial baildi- s only ` �C� iC2 - Wv\� s\ k v\c1 ` OcC, v Zip Codo:2�� Contact Person. Title: Telephone Number: C1�,Lk' �L(��.Q !!__t Fax Number: Type of Industly/Business: Cs.�tTc\ To apply for a nonresidential building pernit, you n.ust complete this checklist. If you have any questions about completing this checklist, please call (800) 388-2_121. YES NO 1. Will the facility have a charbroiler? [ ]' 2. Will any intrmal combustion er>gine with greater than �J horsepower operate at the facility (excluding motor vehicles)? j ]' 3. Will operations at the facility involve mixing, blending, cc processing of solvents, adhesive, paints or coating`? [ ] 11;4 4. Will dust or smoke be generated at the facility? [ ] §4 5. Will refining of any liquids or solids be done at the facility? [ ] 114 6. Will any pla:.mg or coating of materials be done at the facility? [ ] jXJ' 7. Will any combustion equipment rated grr-ter than 2,000,000 BTU/hr be operated at the facility? 8. Will any acids, solvents, or motor fuel be used or stored at the facility? [ ] [KI 9. Will any organic liquids or gases be reacted or produced? [ ] [ 10. Will any ovens be used to dry or cure products at the facility? 11. Will any CFC (Freon) recycling machines operate at the facility? �i -kpplicant` \\Vv, V jk"GCD\01k1a Signature: �L_ (Print name clearly) If you have marked "NO" in all the boxes, an air quality permit is not needed at this time, and this checkUst is your written release. If you marked "YES" in airy of the boxes, you must contact the South Coast Air Quality Management District (AQMD). Please read the requirements on the back of the checklist. (800) 388-2121 AIMMONAL SUPPLEMEN-AL INFO"MATION A I -PPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH - DEPARTMENT T OF BUILDING & S 1 4'E Y q-e- (3"' Floor- A usf Apply Di -Person) Business License # t-t30 Date ©q- Address 10050 /kDA--' S \fc- H 6 9 2 &q c- Business Name ZO i,�N M/} 21Cw tTt) snm rc- F<A rL/v\ Telephone 71 0101 G v 3 !z- s-s- Business Type 01=4--I61-= CNL--�-r Pronerty Owner Information Business Owner 'Name 17 htv1 0 wr L, -� C " Name J-o H N M fiCicco,"r ( Address t o o zc> /'\ 0 &-�, S A v E Horne Address S a l pi t-r A N C "- Ttv & City 14- 15 at 2 C. 4 C.- Tel. City I Tel. (0)19 2,�sf2 7 THIS USE WOULD BE DESCRIBED AS: ❑Newly Constructed Bailding or Existing'Building, 1, CR:>i;CY ALL THAT APPLY: ❑Change of Owner Wharae of Occupant ❑Change of Use O Additional Occupant Indicate former use, if any dp�p1 wa Does the building have electricity? Yes NOQ If No, are you requesting that the electricity be turned on? Yes No The building is sprinklered? Yes ❑ T4o� Operations will product dust/wood shavings or similar material? Yes ❑ NA Operations will involve the repair or replacement of automobile parts Yes Ej No If yes: Describe the components repaired or replaced, Does the operation involve the use of welding or open flame? Yes O No The business is drinking, dining or assembly that will result in an occupant load of more than 30 persons. Yes ��. ' TO T The followh-,a best describes my operation: Office Only ❑Retail Sales ❑Ivledical/Dental ❑Restaurant/Take Out. Food ZSWarehouse ❑iVIanufacturing/Distribution (describe procc--ss and end product) a Other (describe) Office Use 0711Y: zoning: Sq Ft Occupied: Occ Group:_ Occ Load: r Stories: r Parking Spaces: _ _ TIF Review: Y/ N Anit PaidS: Paid BEFORE Final inspection Building, Permit A Entitlement m: Cornme>s ts: Ot-Fl I;E-= 0 t c am. ON L- ° - Co-t=0 p4adrtA i t a9 Planner Initials: - 6 BIOW Bldg!Plan Chec :er Initials: COLo it HAZARDOUS MATERIALS DISCLOSURE INEORIMATION Huntington Beach Fire Department California Health and Safety Code r-.quires the Fire Department to regulate busiri-sses that handle hazardous materials. Moror oil, hydraulic fluids, gasoline, dry cleaning fluid, etc., are consio !red hazardous materials and must be disclosed. If you use, handle or store hazardous materials or waste materials equal to or in excess of the following basic quantities, your are required to disclose: ® 55 gallons of liquid • 500pounds of solid • 200 cubic feet of cGrnpressed gas • Any amount of radioactive materials. • Any amount of Class A explosive • Any amount of chemicals known to cause cancer • Arty amount of commercial pesticides v Reportable quantity of any chemical on EPA Extremely Ha; -ardous Materials Substance List Disclosure is not required for the followi.., I .. Hazardous substances contained in food, drug, cosmetic or tobacco products. 2. Upon approval of the Fire Chief. hazardous materials contained sol :ly in consumer products packaged for use by and distributed to the general public. However, pesticides, herbicides, and ammonium nitrate fertit'ers over the required disclosure amounts are not exempt from disclosure. 3. The transportation of hazardous materials accompanied by shipping papers prepared in accordance with the provisions of a> Lode ofFederal Regulations. 4. lnfectiot s waste generated by health care Facilities that are regulated under Title 22 of the California Administrative Code. Check one of the following: No chemicals are used, handled or stored at this business. Chemicals are used, handled or stored at this business, but do not meet the requirements for disclosure Chemicals are used, handled or stored at this business. .Disclosure forms will be sent to you. Amounts will be verified by the Fire Department during annual inspections. It is unlawful for any person to knowingly violate any provision of this ordinance. I certify, under the penalty of perjury, that the above information is true and correct to the best of my knowledge. Si`nature Ak. —5_ Ho&Mn (77 t G ) 5 19 - 5 12 Date 3 IC4 / 0 4 Please call714-336-5675 fvith questions regardin the Hazardous Materials Program. South Coast Air Quality Management District 21865 E. Copley Drive Diamond. Bar, CA 91765-4182 (909) 396-3529 htpp:/iwww.agmd..gov Air Quality ]Permit Checklist California Government Code 65850.2 prohibits cities from issuing a Certificate of Occupancy to a business without clearance from the local air quality agency. This checklist will determine if you need to obtain clearance from the South Cc,ast Air Quality Management District (AQMD). Company.oTame: OI(- r"\AyQ-IC ,ITk-1 S�'��ti: � t'f V- A�,\ Property Address: ? U U C' ^- D"i /Xk S A �► & _ f City: t rr 6 C(--� C 12 - Zip Code: 13 2 6 y � Contact Person: �-ro N ti Y'—\ ^ V- /c 4, f < <—\ Title: /a-C (' 1 i Type of Business: 1 vzf N-N c Telephone: (11, 7, ' 1 G F, 3 6 SS Applicant (print name)_ J o 1+ s'i'gna Will the facility have any of the following equipment? < Yes Q No Charbroiler Ivry cleaning machine Spray Booth Printing Press (screen/lithographic/flexographic) Internal combustion. engine (greater than SOH?) (excluding motor vehicles) Moiler/combustion equipment (greater than 2 million BTU/hr. ma;�mum input) Abrasive blasting cabinet/room Baghouse/cartridge type dust filter/scrubber Motor fuel storage and dispensing equipment • Will any of the following operations be performed? Yes U No Application of paints or adhesives Etching, plating,,casting, or melting rifinetals Molding and blending of liquids and/or powders Storage of _yids, solvents, organic liquids or fuels Production of acids, solvents, organic liquids, or fuels Production of fumes, dust, smoke or strong odors e If you answered "No" to both 4uestions, this checklist is your, clearance from AQMD. • If you answered "Yes" to either question, you mast contact AQIVID to determine if air quality permits are required. If permits are needed, AQMD will assist you in submitting permit application(s) and then provide you with a clearance letter. You can call ACT at their Small Business, Assistance Office at (800) 388-2121.