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Home My WebLink About10046 Adams Ave - CofO (3)APPLICATION FOR CERTIFICATE OF OCCUPANCY > CITY OF HUNTINOTON- pEArH DEPARTMENT OF COMMUNITY DEVELOPMENT �� L HUNI'4MON BEACH . TE (PRINT CH TYPE CNLY) n Address _� l-� � � r ��' District Business Namely ,V. �''�'^ ---- Tel(-':'c�.�'_ i Business Type OCC. Group BUILDING OWNER BUSINESS OWNER/MANAGER Address.'��f City�� /�. '�,�' TYIk THIS USE WOULD BE DESCRIBED AS: r Name -- Home Address1'f/'i�o City %fi Af'—� N /'/,a 42 61(',?6 �me Ted j❑ EWLY CONSTRUCTED BLDG. �" CHANGE OF OWNER 'r�j''?, Ime*es. ❑ CHANGE OF OCCUPANT J�EXISTING BUILDING r ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT Indicate former use, if any �C_ �' i Occupancy C" Div, SQUARE FT. OF BUILDING TO BE OCCUPIED��% iT 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 re,eased 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 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 III the character of occupancy or use of the building 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 must be a mit of four (4) inches in h-'ght with one half (1/2) inch stroke, and of a contrasting color from the A. These numbers must be posted on your building in a location that is visible from the stree 5. Huntington. fieac. Fire Code Section 10.301 requires fire extinguisher selection ano r= ition per the National Fine Protection Association pamphlet 10 fsee reverse side). Afe?uIN! fiEGEI�� •1�+� � OCCUPANCY GROUP-.. OCCUPANT LOAD NO. OF S NIES /7 7 A PRGV- BY DATE (FOR OFFICE USE ONLY) PLAN CHECK NJ PERMIT NO _ ADMIN ACTION_ ZONING NO PARKING SPACES — iE:iLTH DEPT APPROVAL U1ILITIES RELEASED — CERTIFICATE OF OCCUPANCY FEE $ ^ l 5 r3 `00 CHANGE OF USE OR OCCUPANCY FEE $ TOTAL $. vo 75-639Rev.1/97 fir';,,. �, I'y .1 -. ;i-`" ,; F CV 313 1 C1 1 SUPPLEMENTAL INFORMATION 1 BUSINESS ADDRESS �. Person to contact in case of emergency - Telephone number%/S4� 3. Does the building in question have electricity'? LET Yes ❑ No (a) If No, are you requesting that the electricity be ❑ Yes turned on? .5 No 4. The building is sprinkiered'? ❑ Yes No 5. Operations will produce dust/wood shavings or similar material? ❑ Yes 4 No 6. Operations will involve the repair or replacement of ❑ Yes automobile parts? No If Yes: (a) Describe the components repaired or replaced. (b) Does the otszration involve the u-e of an open flamu? ® Yes No 7. The business is drinking, dining or assembly use that will result in an occupant load of more *han EJ persons. ❑ Yes No B. The following best describes my operation; Office Only Retail Sales Warehoue Manufacturing / Distribution (descr ba process and end product) Restaurant / Take Out Food Medical / Dental Other (describe) Does the o.p nredon Involve any of the following nnatorialo7 [] No indicate quantities: Material Quantity 1. F(omnnub}e liquids Class |-A {}(ona |-B 2. C|son |'C Combustible liquids Class |/ 8. Combination T|amrnob|e liquids 4. Flammable gases 5. Liquefied flammable gases G. Flammable fibers - loose 7. Flammable fibers - bided 8 Flammable mo/ido _ S. 10. _ Unstable n,ateriu(n Corrosive liquids ____ 11� Ox(diz/ng material - gases 12. ----'-- Oxidizing material /iqulda 13. Oxidizing material - `�oUdo 14. ° _ Organic pe,ouiuea is, Nibomothnna (unstable materials) 16. Ammonium nitrate 17. nitrate compound mixtures containing more tho^; 6096 nitrate by 18. ______________ Highly tonic material and poisonous gas 19. Smokeless powder 20. Black sporting puwdmr | ho`aby certify that the above information is true and correct to the ooat of my knowledge. Signaturri South coast Air Quality Management District 21865 E. Copley Drive, Diamond Bar, CA 91765-4182 ® (909) 396-3529 s http://www.agmd.gov Air Quality ]Permit Ch :list California State Law Code 65850.2 prohibits cities from issuing an occupancy permit without clearance from the local air quality agency. This checklist will determine if you need to obtain clearance from the South Coast Air Quality Management District (AQMD). Company Name: S x�/L S Property Address: — City: �{ U/U�iT.'/i/ ;�D�1 /S i Zip Code: 4L �- Contact Perso,,: �d �/fi �U�(1y� d� Title: _19244116� Type ofBusiness: Telephone: LI, ZZL Applicant (print name) �VlEQ Signature. C Will the facility have any of the following equipment? YES[ ] NO ) Charbroiler Dry Cleaning Machine Spray Booth Printing Press (screen/lithographic/flexographic) Internal Combustion Engine (greater than 501UT (excluding motor vehicles) Boiler/Combustion Equipment (greater than 2TvIM BTUihr. maximum input) Abrasive Blasting Cabinets/Rooms Baghouse/Cartridge-Type Dust Filter/Scrubber Motor Fuel Storage & Dispensing Equipment Will any of the following operations be performed? YES[ ] NO [� Application of Paints and Adhesives Etching, Platiag, Casting or Melting of Metals Plastic Molding, Extruding or Curing Mixing and Blending of Liquids and/or Powders Storage of Acids, Solvents, Organic Liquids or Fuels Production of Fumes, Dust, Smoke or Strong Odors If you answered "NO" to both questions, this checklist is your clearance from AQM]D. If you answered "YFsS" 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 suh"Mitting permit application(s) and then, provide you with a clearance letter. If you have any questions, please call AQM1)'s Small Business Assistance office at (A00)-CUT-SMOG, and press 41.