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HomeMy WebLinkAbout10076 Adams Ave - CofO�I APPL.ICATtON FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT RUNnNGTON (PRINT OR TYPE ONLY) jj31 Co 2- 0 d. 01 DATE I()0� Pcdams Ave fttlt111,�c)l �Cadn Oq 9264., Address District p 3usinessName Shiurta TeL�I—�IGz-G(�2 Bus.ness Type � t � �S urn�fi Occ. Group BUILDING OWNER BUSINESS OWNER/MANAGER Name QsUsiysS groe7 '( a., Inc, Name ttn cti �u�idlna4 v` Address ( �'3 ( I f�l/1 P� &0X 57g Addrecc E "f 6FfZ�FtP �� City l(�vlrt� CA��623 Tel. 9u9 — City AYdod a(!e gW5 CA99_k_a Home TelA09'89q-04� THIS USE WOULD BE DESCRIBED AS: NEWLY CONSTRUCTED BLDG. CHANGE OF OWNER CHANGE OF OCCUPANT EXISTING BUILDING N CHANGE OF USE ❑ ADDITIONAL OCCUPANT Indicate former use, if any `lt"UmOccupancy Gr. Div. SQUARE FT. OF BUILDING TO BE OCCUPIED )� — 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. All applicants for occupancy in an existing building are required to schedul? 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 in the characterof 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 minimum of four (4) inches in height with one half (1/2) inch stroke, and 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 requires fire extinguisher selection and distribution per the National Fire Protection Association pamphlet 10 (see reverse side). TRAFFIC IMPACT FEE DATE PAID AMOUNT RECEIVED _ NAME tS ©2 - Z _ F-rtz_ =Ir., (FOR OFFICE USE 01, i_Y) OCCUPANCY GROUP PLAN CHECK NO. _ OCCUPANT LOAD — PERMIT NO NO, OF STQ�64S ADMIN ACTION �- �z /-d! CERTIFICATE OF OCCUPANCY FEE APPROVED DATE CHANGE OF USE OR OCCUPANCY FEE TOTAL t 75-039 Rev. 1/97 COMMUNITY DEVELOPMENT e i�j ce 5 ,(` AsS�- , y ZONINGS.- r F/ ?� NO PARKING SPACES HEALTH DEPT APPROVAL UTILITIES RELEASED $ 51 SUPPLEMENTAL INFORMATION 1. BUSINESS ADDRESS 100-t& Ad vis ALA— kj-)n+jj),tan bpoa1 CA 926 y�, 2. Person to contact i case of emergency Telephone number: -0C1off l _ 3. Does the building in question have electricity? h, Yes ❑ No I; (a) If No, are you requesting that the electricity be ❑ Yes I; turned on? ❑ No 4. The building is sprinklered? i ® Yes ❑ No 5. Operations will produce dust/wood shavings or similar material? ❑ Yes # allo 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 operation involve the use of an open flame? Y Yes QMFNo 7. The busine.s is drinking, dining or assembly use that will result in an occupant load of more than 50 persons, Ell"Yes ❑ No 3. The following best describes my operation; Office Only Retail Sales Warehouse Manufacturing / Distribution (describe process and end product) Restauran Take Out Food Me ical /Dental Other (describe) SUPPLEMENTAL INFORMATION SUPPLEMENTAL INFORMATION (Continued) Does the operation involve ant of the following materials? 0xes No If Yes, indicate quantities: _ Material Quantity 1. Flammable liquids Class I -A Class I-B Class I-C 2. Combustible liquids Class II 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. Unstable materials 10. Corrosive liquids 11. Oxidizing material - gases 12. Oxidizing material - liquids 13. Oxidizing. material - solids 14. ` "Organic peroxides 15. Nitromethane (unstable materials) 16. Ammonium nitrate 17. Ammonium nitrate compound mixtures containing more than 60% nitrate by weight 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 krdawledge. Signature Date SoLth Cow AIR QUALITY MANAGEMENT DISTRICT 21865 E. Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-2000 AIR QUALITY PE32MT CHECKLIST for nonresidential buildings only Company Name: Shiarla RW-acJrztwCa Location of Property: JW_� (g A (�dM5 ft Ue- City:--h�wnn�fppl Fled 1i C,l — Zip Code: 12 bCi6 Contact Person: SQfl/lbi Sa41WLb-1 4f_'A- Title: _ ta Telephone Number: 1 gCiq) S39 - ()q 0 Fax Number: CS0 ) $3q-0� 0 Type of Industry/Business: To apply for a nonresidential building permit, you must complete this chec-klist. If you have any questions about completing this checklist, please call (800) 388-2121. YES NO 1. Will the facility have a charbroiler? 2. Will any internal combustion engine with greater than 50 horsepower operate at the facility (excluding motor vehicles)? [ ] ICJ 3. Will operations at the facility involve mixing, blending, or processing of solvents, adhesives, paints or coatings? 4. Will dust or smoke be generated at the facility? [ ] PcJ 5. Will refining of any liquids or solids be done at the facility? [ ] [ICJ 6. Will any plating or coating of materials be done at the facility? [ ] [XJ 7. Will any combustion equipment rated greater than 2,000,030 BTU/hr be operated at the facility? 8. Will any acids, solvents, or motor fue: be used or stored at the facility? [ ] 9. Will t.ny organic liquids or gases be reacted or produced? [ ] -<] 10. Will any ovens be used to dry or cure products at the facility? [ ] V1 11. Will any CFC (Freon) recycling machines operate at thp facility? [ ]j Applicant: S" S�{UJt dt✓1 cL Signature: (Print name clearly) If you have marked "NO" in all the boxes, an air quality permit is ngtt needed at this time, and this checklist is your written release. If you marked "YES" in any 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 ADDITIONAL SUPPLEMENTAL INFORMATION