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Home My WebLink About10034 Adams Ave - CofO (3)1 f ii APPLICATION FOR CERTIFICATE OF OCICUPANCY - CITY OF HUNTINGTON BEACH ® DEPARTMENT OF COMMUNITY DEVELOPMENT Hu ON aAol (PRINT OR TYPE ONLY) f Il (E 26(A Address C(Distrct Business Nam:' C e Q- Tel L it—" Business Type E . kAQ_1z Occ. Group BUILIALIG OWNER BUSINESS O NERIMANAGER { Name Name - Home �' S•D--- )4 Home ✓ ;�, r Address d il�S �1 "F�f-��= Address-91-r ?r� City_— Tel /' .. Home Tel. THIS USE WOULD BE DESCRIBED AS: ❑ NLWLY CONS'fRUCTED BLDG. ❑ CHANGE OF OWNER CHANGE OF OCCUPANT P EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT j Indicate former use, if any o o 11^ D y Occupancy Gr.—Div. SQUARE FT. OF BUILDINU TO BE OCCUPIED b NOTICE: y, OcAeld nc.1 of any building is prordbited and a business license will not be issued until the building has been ind .and a certificate of occupancy is issued. 2. otrical service will be released for any existing building until the service has been inspected and :f er Pied safe. All applicants for occupancy in an existing building are required to schedule an electrical Ittif e up' inspection in the Department of Gommunfty Development at the time this application is filed. 3.• Change of occupancy or use inspection fee. Whenever 'sf is necessary to make inspection of a buildir i or JJ premises in order to determine if a change may be made in the character of occupancy or use of the builumg or premises which would place the building in a different division of the --,ame group of occupancy or in a F d!fferent group of occupancy, a change of occupancy ins, Ion fee of 5 shall be paid to the city. 4. Huntington Beach Fire Code Section 10.208 requires that bu,.ding numbers must be a minimum offour (4) ��Q inches in height with one half (1/2) inch stroke, and of a contrasting color from the background. T h5c;e r numbers mu,.it be posted on your building in a !ocation that is visible from the street. F. Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection and distribution per the National Fire Protection Association pamphlet 10 (see reverse side). - f . '1 c vw I { \\ TRAFFIC PIMPACT FEE DATE � DATE PAID AMOUNT ECEIVED NAME 1jpQ SUPPLEMENTAL INFORMATION �� • (FOR OFFICE USE ONLY') � �? ZONING f - OCCUPANCY GROUP P PLAN CHECK NO, NO. PARKING SPACES OCCUPANT LOAD — ra PERMIT NO. HEALTH DEPT. APPROVAL NO. OF STORIES ADMIN. ACTION UTILITIES RELEASED CERTIFICATE OF OCCUPANCY FEE g APPROVED BY DATE CHANGE OF USE OR OCCUPANCY FEE g TOTAL g 7 -038 Rev. 11/90 COMMUNITY DEVELOPMENT ' J �\ J` APPLICATION FOR CERTIFICATE OF OCCUP('*NCY CITE' OF HUNTINGTON BEACH �1 DEPARTMENT OF COMMUNITY DEVELOPMENT O 1` HUNr^;.TON BEACH (PRINT OR TYPE ONLY) I A I E F 1 i< }it !i Ad r Irin Sk o a 974 District Business Name J u _ Tel h'. — I Business Type u Occ. Group ' BUILDING OW ER BUSINESS O\k .ER/MANAGER Name °'hr. H r� vi V t ;- Name Malmdecl.bHome Address. Address _Z 0 City_ _ Tel. ifs' ZCity�—Home Tel._ 14, THIS USE WOULD BE DESCRIBED AS: ❑ NEWLY CONSTRUCTED BLDG. 2!TCHANGE OF OWNER ,.CHANGE OF OCCUPANT PIN EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT Indicate former use, if anyQPMME'\ l2-f Occupancy Gr. Div, SQUARE FT. OF BUILDING TO BE OCCUPIED��` NOTICE- 1. Occupancy of any building is prohibited and a business license will not bF issued until the building has been inspected and a certificate of occupancy is issueu. 2. No electrical service will be released for any existing building until the service has been inspected and certified safe. All applicants for occupancy in an existing building are required to schedule an electrical 'fuse up' inspection in P department of Community Development at the time this application is filed. 3. Change of occupancy H,... , inspection fee. Whenever it is necessary to make inspection of a building or premises in order to deterl...ne if a change may be made in the character of occupancy or use of the building or premieres 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 must be (. ,ninin um of four (4) inches in height with one half (1/2) inch stroke, and of a contrasting color from the backgl ound. 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 requires fire extinguisher selection and distribution per the National Fire Protection Association pamphlet 10 (see reverse side), TRAFFIC IMPACT FEE , _ . _� DATE PAID _ AMOUNT RECEIVED _ __ (FOR �rFICE USE ONLY) �� NAME �� _ ZJNING � ti—LZ i OCCUPANCY GROU-1? PLAN CHECK NO. -�+�'/ _ NO PARKING SPACES I OCCUPANT LOAD PERMIT NO HEALTH DEPT APPROVAL _ N OF STORIES ADMIN. ACTION _ UTILINES RE..I:A,ED �Ofilj--j.. CERTIFICATE OF OCCUPANCY FEE $ t S� a-.> 3 AMKOVED BY DA1 E CHANGE OF USE OR OCCUPANCY FEE $' TOTAL $ S3^ s-039Rev. va7 COMMUNITY DEVELOPMENT 10 -71i~ 0 � � SUPPLEMENTAL INFORMATION c 1. BUS!NESS ADDRESS A A�r� 1 2, " o t Person to contact in case of emergency- U12 att j /fir p h Telephone number: 3. Does the building in question have electriciiy? Yes 101 No V (a) If No, are you requesting that the electricity be ❑ Yes turned on? ❑ No r 4, The building is sprinklered? ❑ Yes f e rir K No 5. Operations will produce dust/wood shavings or similar �? material? ❑ Yes No f; I 6, Operations will involve the repair or replacement of ❑ Yes automobile parts? X No 1 If Yes: t (a) Describe the components repaired or replaced. (b) Does the operation involve the use of an open W ❑ Yes JK No „, 7. The business is drinking, dining or assembly use that will result in an occupant load of more than 50 persons. ❑ Yes XNo 1 R fj 6. The following best describes my operation; Office Only Ceta l Sale ;' Vtarehouse Manufacturing / Distribution (describe process and end product) Restaurant / Take Out Food Medical / Dental Other (describe) — I I Spit AEMENTA !NFORMATION 1 SUPPLEMENTAL INFORMATION (Continued) {' Does the operation involve any of the following materials? ❑ Yes o If Yes, indicate quantities: ^ Material Quantity 1. Flammable liquid class I -A Class i-B - Class I-C 2. Combustible liquids Class 11 Class 111-A 3. Combination flammable liquids 4. Flammable gases _ 5. Liquefied flammable gases 6. Flammable fibers - loose 7. Flammable fibers - baled 8. Flammable solids 9. Uratab(e materials 10. Corrosive nquids 11. Oxidiziog material - gases 12. Oxidizing material - liquids 13. Oxidizing material - solids 14. Organic peroxides 15. Nitromethane (unstable materials) 16. Ammonium nitrate �! i7. Ammonium nitrate compound ):fixtures containing more than 60% nitrate _ by vr�ight 18. Highly toxic material and poisonous gas 19. Smokeless powder 20. Black sporting powder �- 1 hereby certify that the above information is true and correct to the best of my knowledge. Signs ure South mast Air Quality Management District � 21865 E. Copley Drive, Diamond Bar, CA 91765-4182 ` ' O (909� 396-3529 • http://%%rmv.agmd.gov l •. Air Quality/ Permit Checklist California State Law Code 65850.2 prohibits cities from issuing an occupancy permit without clearance Isom the local air quality agency. This checklist will determine if you need to obtain cicarance from the South Coast Air Quality Management District (AQMD). Company Name: v Property Address: 1 4. _t1 do 1o _ 45 City:y Zip Code: !3 Contact Person: v Title: e-jC-- Type of Business: n _ , t�2Q� Telephone: ('i _ Applicant (print name) "f rEIY}�A `f' h4(orV Signature: • Will the facility have any of the following equipment? YES[ ] NON Charbroiler Dry Cleaping Machine Spray Booth Printing Press (screen/lithographic/flexographic) Internal Combustion Engine (greater than 50 HP (excluding motor vehicles) Boiler/Combustion Equipment (greater than 21VIM BTLi/hr. maximum input) Abrasive Blasta ,,g Cabinets/Rooms Baghouse/Cartridge�Type Dust Filter/Scrubber Motor Fuel Storage & Dispensing Equipment • Will any of the following operations be performed? YES[ ] NO �Q' Application of Paints and Adhesives / � Etching, Plating, Casting or Melting of Metals Plastic Molding, Extruding or Curing Mixing and Blending of Liquids and/(,Powders Storage of A yids, Solvents, Organic Liquids or Fuels Production of Fume, Dust, Smoke or Strong Odors If you answered "NO" to both questions, this checklist is your cleara,-rce from AQMD. If you answered "YES" to either question, you must contact the AQMD to determine if air quality permits are required. If permits are needed, AQMD will assist you in submitting permit application(s) and there provide you with a-i;7arance letter, If you have any questions, please call f AQMD s Snnala Business Assistance office at (800)-CUT-SM0G, and press 41. i 1