HomeMy WebLinkAbout10063 Adams Ave - CofOJs APPLICATION FOR CERTIFICATE OF OCC ANCY
:x CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT
HHU. IP GTON RACK (PRINT OR TYPE ONLY) V DATE
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Address �.�� District
Business Name �f 1 D rrf� Tel. - zo
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Business Type __E �' ��-C->� f- Orc. Group_ _ o
BUILDING t)WNEk Lyy+ B S �ES�S OLWNERII/yPANAGER
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Address ` Address
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THIS USE WOULD BE DESCRIBED AS:
❑ NEWLY GONSIiUCTED BLDG. ❑ CHANGE GF CWNER E CHANGE OF OCCUPANT
0 EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONA!_ OCCUPANT
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Indicate former use, if any _Occupancy Gr.Div.
SQUARE FT. OF BUILDING TO BE OCCUPIEDfZ�
140TICE: 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. Na electrical service will be released for any existing building until the :r°rvice has been inspect d and
certified sate. All applicants for occupancy in an existing building are t =_,ulred to schedule an electrical
'fuse up' inspection in the Department of Commu0,Developmen' at the time 'his application is filed.
3. Change of occupancy or use inspection fee. Whenever it is -,,pessary 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 buildleig
or premises which would place the bulding 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.
=7. Huntington Beach Fire Code Section 10.208 requires that building numbers must be a minimum of four (4)
inches in height with one half (1/2) inch stroke, and of a contrasting color from the backi.;ound. These
numbers -ust be posted on your buila;ng 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 reverse sJe).
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TRAFFIC IMPACT FE "
DATE PAID
Al
NAME
(FOR OFFICE USE ONLY)
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ZONING
OCCUPANCY GROUP
~ PLAN ,,HECK NO.
NO PARKING SPACES
:s
OCCUPANT LOAD
PERMIT NO.
HEALTH DEPT APPROVAL
NO. OF STORIES ' ADMIN. ACTION
UTILITIES RELEASED
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? CERTIFICATE OF OCCUPANCY FEE
A�OV D BY
.
DATE CHANGE OF UST OR OCCUPANCY F_-E
TOTAL
$�
75-os9
Bev, 1/a7
COMMU71ITY DEVELOPMENT
SUPPLEMENTAL INFORMATION
1.
.BUSINESS ADDRESS
2.
Person to contact in case of emergency, 3�
Telephone number:
h 3.
Does the building in question have electricity?
C1 Yes
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(a) If No, are y requesting that the electricity be
C�'"jfes
turned on?
No
4.
The building is sprinklered? erne ��� —} � ✓1.�e
1 C'C
5.
Operations will produce dust / wood shavings or similar
material?
0 Y s
o
6.
Operations will involve the repair or replacement of
Yes
automobile parts?
If Yes.
(a) Describe the components repaired or replaced.
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(b) 'Does the operation involve the use of an open flame?
C] Yes
�1-No
7:
The business is drinking, dining or assembly use that will
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result in an _occupant load of more than 50 persons.
L7 Yes
P
y o
4
8.
The following best describes my operation;
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Retail aWi --
Warehouse
Manufacturing / Distribution (describe orocess and end product)
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Resteurant / Take Out Food
Medical / Dental
Other .(describe)
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SUPPLEMENTAL INFORMATION
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SUPPLEMENT AL INFORMATION(Continued)
Does the operation involve any of the following materials? ,��Yyes
®'No
If Yes, indicate quantities:
Material _ Quantity
1. Flammable liquids
Class I -A
Class I-B
Class I-C
2. Combustible liquids
Class 'I
Class III -A
3. Combination fiammabie liquids
4. Flammable gases
5. Liquefied flammable gases
6. ` Flammable fibers - loose
7. Flammable fib:;rs - baled i
T. Flammable solids
0. Unstable material :
s ..
'10. Corrosive liquids
11. Oxidizing material - gases
12. -Oxidizing material = liquids
13.. •' Oxidizing ' maternal - solids
14. Organic peroxides
15. Nitrornethane (unstable materials)
1e ,mrnoniam nitrate
17. Ammonium nitrate compound -mixtures
containing more than 60"/o nitrate
by weight
i8.� Highly toxic material and
poisonous as- - r
19. Smokeless powder
20. Flack sporting.. powder
I hereby - certity that the : bove-- information is Yrue and correct to
the best of my knowledge.
Signature Dare ;k
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OCT 81 '99 11:51AM PUBLIC AFFAIRS P,1
youth, Coast
Air Quality Management District
21865 E. Copley Drive, •Diamond Bar, CA 91't35-4182
t909) 396-3529 • httpJ/www.agmd.gov
Air Quality Permit Checklist
Californ+p State Law Code 6395U.2 prohibits cities from issuing an occupancy permit to a
business without clearance from the local air quality agency. • This checklist will determine if you
need to wbrxin clearance from the South Coast Air Quality Management District (F.QMD).
Company Name:i
Property Address: In(-) 00 9 c w
City: - Z+p Code: -
Cuntacb Person; ��_,%. i "i"itle: M %�'!i /�, o-
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pe ofl3usiness: _�� iOA L (z- Telephone V/
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Appficant.(print nary.-)-_ r Signature: i—
• Will the facility have any of the following equiprent? Yes [ ] Ne [L]'
Charbroilrr
Dry cleaning machine
Spray booths
Printing press (screen(lithographic/flexographic)
Intern:W combustion engine'(greater than 53 HP (excluding motor vehicles)
.Boiler/combustion equipment (greater thin 2 million BTU/hr. ; aximum input)
Abrasive blasting cabinedrooni
Baghouse/cartridge-type d''ust filter/scrubber
Motor fuel storage and d°'.spensing equipment
• Will any of the following operations be aerfonned7 Yes[ j No [
Application of paints or adhesives
Etching, plating; casting, or melting of metals
Molding, extmdiM or our, >f plastics
Mixing and blending of liquids and/or poi*yders
Storage of acids, solvents, organic liquids, or fuels
Pry; Auction of fumes, dust,, smoke, or etrong odors
If you answered "No" to both questions, this checklist is your clearance from: AQM D. If, you
answered "Yes" to either question, y^u must contact AQMD to determine if air quality perichs
are required. If permits are needed, AQMD will assist you in submitting permit application(s) rind
then provide you with a clearance letter. You can call AQNID at their Small Business Asaistance
Office'It t300) 468.2.121.
' .' 'Rovue9Ft6ty� ti999
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Trancoae : [COFO ] COMMUNITY DEVELOPMENT [44311
Function,: [INQ] CERTIFICATE OF O C C U P k N C Y
Adc'r [100891 [ADAMS ] [ ] Issue Date [ 2142GO03 App.Rcv. ' 20420001
Business Name [THE LOFT ] Phone [7-4] [915,99131
Business Type [FURNITURE REPAIR/CANING AND RETAIL SALES] Occ. Group [F.-1,El
Building[WESTERN REALTY ] Addr [:-7112 ERRING ST, 6rE 200 ]
Owner City [LONG BEACH, CA _ 90806 ) Phone: [5621 [49000961
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Business [AL MACE ] Addr.^ 3071 [F:iTERzLLD RAY
Own/Mgr City [LAGUNA BEACH, CA ] Phone: [949] [4940148]
Commen":: [300 SQ FT OFFICE SPAC,. ]
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[NO SPRAYING OUTSIDE OF A SPRAY BOOTH. DUST COLLECTION SYSTEM REQrD ]
[FOR DUST PRODUCING W�CIIINES ]
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New? [N] Chg Own? [N1 Chg Occ? (Y) Old Bld? [Y] Chg Tse? [N] Add Occ? [N]
111 Former Use [PPTAIL BUSINES' ] Former Occ. Group [ ]
Sq.Ft.Occupied 11301 District l PC No ] Park!.ng Spaces ]
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Occ. Load " 51 Building Permit [ ] Health App. By
No. Of Storiej `' 1] Admin. Action { ] Zoiin; Use [CG ]
Wees: COFO [125.00) Ch. Occ. [ .001 special.? [N] .001 Total: [ 125 001
Building Appr. [LG ] Building Date '� 30320001
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Land Use Appr. [RR ] Land Use hate 12120001 COFO Nbr. [Tn08846]
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Issued By [J- Issue Date 21420001 Certificate Printed ? [N]
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Utilities: Gas Date' ] E1ec.Date ] Released By [ ]
[ 'PRT' OR TRANSMIT FOR MRN`J ]
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