HomeMy WebLinkAbout10034 Adams Ave - CofOF R
APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY C'. .-IUNTINGTON BEACH
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DEPARTMENT OF COMMUNITY DEVELOPMENTt—
HUNTIM.TON KAQj C,T f-
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THIS USE WOULD BE DESCRIBED AS:
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NOTICE: ^— � -
1 Occupancy of any building is prohib-ted and a business license will not be issued until the building has been
inspected and a certificate of occupancy Issued.
2 No electric:,: >ervice will be releasad for any existing building until the service has been inspected and
certified safe. All applicants for ^ccupai v in an existing building are required to schedule a^ electrical
'use up' inspection n the Department of Community Development at ,ne 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
or premises which would place the building ii, a different division of the same group of occupancy or in a
different group of occupancy, a change of occupancy inspection fee of S -- --__ shall
be paid to the city.
4. Huntington Beach Fire Code Section 10.208 requires that building numbers must be a minim,im of four (4)
i inches in height with one half (12) Inch stroke. and of a contrasting color from the background. These
numbers m ist be posted on your building In a location that is visible from the street.
5. Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection and distribution per the
National Fire Protection Association pamphlet 10 (see reverse side).
(FOR OFFICE USE ONLY)
SUPPLEMENTAL INFORMATION
OCCIJPAN( Y
nCCLJPArqT )A[
NO OF STORIES
A P
T
75-039 Reo• 11190
fiUa1 EMEfd'1:AL iNFGRM/,T`ON
1. BUSINESS ADDRESS
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i�,?F'rnc5 i
Nt'rrIN 7c.
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2. Person to contact in
case of
emergency —
Telephone number:
__ 4-7
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
_ 4 No
5. Operations will produce deist / wood shavings or similar
material? ❑ Ye-
D�- No
6. Operations will involve the repair or replacement of ❑ Yes
automobile par'cs? ham' No
if Yes:
(a) Descriue the components repaired or replaced.
(b) Doec the operation involve the use of a:-i open flame? ❑ Yes
❑ No
7. The business is drinking, dinin., or assembly use that will
result in an occupant load of more than 50 pervons. ❑ Yes
)R`No
8. The following best describes my operation;
Office Only
Retail Sales
Warehouse
Mai-,ufacturing / Distribution (describe process and end product)
Restaurant / Take Out Food
Medical / Dental
Other t'describe) �� C 24r ti _
9UPPLIt�0,1TAL''WORIVATION
i
d
poisuncuz3 gas
---- ------
I hereby certify that the above information, Is true and (,,(�rrect to
the best of my knowledge.
Signattire Date
I
SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT
(Nonresidential Buildings Only)
Location of Subject Property: x,) /��%v4s 1wr
Property Owner name: DL--V,y �� tt idu t 17i�`� P'zone
Nane of the Person Preparing this form in print and signature
Name � IITLA Signature rI C;
The person preparing this form must be the sae p rson applying for
building permits. Please answer the followir_�j questions regarding your
proposed occu�-ancy of the subject building. IF YOU DO NOT KNOW THE ANSWER
TO A QUESTION MARK IN THE "YES" COLUMN:
SCAQMD PERMITTING CHECKLIST
YES NO
1. Does your facility use any internal combustion
engines greater than 50-HP?
2. P^es your facility involve mixing, blending, or C� I ��"JI
processing any solvents, adhesives, paints t
or coatings?
3. Does your facility create any dusts or smoke?
4. Does your facility refine any liquids or solids? Eg
Reclaim any metals? L
3. Doe, your facility plate or coat anything?
6. Does your facility have any combustion equipment
i.e. boiler, furnaces, broiler, baking ovens, etc.)
rated greater than 2,000,000 BTU/HR?
7. Does your facility handle or store solvents or motorP El:j
fuel?
8. Do you use or store any acids?
9. Do you use any chemical process? '
10. Do yoc, use any solvents for clean-up? I c
11. Are you a dry cleaner, restaurant with a charbroiler,
body shop, gasoline station, printer, or part. coater? 11--11
12. Is the subject building located within one thousand"
(1,000) feet of any school"?
PROPERTY LINE TO PROPERTY LINE. GRADES K-12.
If you have marked "NO" in all columns, you do not need an Air Quality
permit at this time. If you have marked any questions in the "YES" Column
you mu- contact the South Coast Air Quality Management District located
at.
9150 FLAIR DRIV,, EL MONTE, CA 91731
Please call these offines: Plan Check (818) 572-6406
(816) 572-6111, (818) 572-6261
D:AL00603
0
CERTIFICATE OF OCCUPANCY
CITY OF HUMTINGTON BE) -.CH 12/12/91
Date jl
Address 100 R ADAMS District
Business Name LE J U E . MADA , G.D. Tel. 1 F�
�T'rX B--2
Business Type Occ. Group
BUILDING OWNER BUSINESS OnWNE�gRIMANAGER
,DAVIL
T 7y t y�1 y t T Yg� E.
f�
Name Name —
Home
'F Addressl a�i2�i A iA'A', AVE _ Address73L 1 KILL Ctfo _
me
City �i , C:A Tel. 714—tI62-2�i02 City �i 3, Cif let. 1 14-847-3 59
Construction No. of Stories 1 _ Occupant Load 1 t°_ Sprinklers
CONDITIONS OF APPROVAL
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DEPARTMENT OF C;GNIMUNITY DEVELOPMENT
This Certificate of Occupancy
SHALL BE posted in a conspicuous place on the
premises and shall not be removed except by the
Building Official.
COMMUNITY DEVELOPIiI:ENT
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