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HomeMy WebLinkAbout10086 Adams Ave - CofO (2)-'J CERTIFICATEHOF OCCUPANCY CITY OF HUNTINGTON BEACH Sept. 6. 1988 "iceES DEPARTMENT OF COMMUNITY DEVELOPMENT Date HUNTINUON BEAM Address ^ 10086 Adams Ave. District Business Name Silk World Silk Plants Tel. - Business Type Silk plants & silk flowers occ Group_B-2 BUILDING OWNER BUSINESS OWNER/MANAGER Name Business Properties Developmc-it Name Tien -Lie Chen & Shou-P3ung Chen 17631 Pitch P.O. Box 19586 Home 12139 Candor Dr. Address Address Z 13-402-108 6 ci�y._.—Irvine TPI. �r74-890�3, Cerritos Home Tel. Construction No. of Stories Occupant Load 10 Sprinklered I� This Certificate of Occupancy DEPARTMENT OF COMMUNITY DE'; ELOPMENT ` SHALL BE poste.: in a conspicuous place on the premises and shall not be removed ex- cept by the Building Official. by--( !go z— flj APPLICATION FOR CERTIFICATE OF OCL:4''AN v CITY OF HUNTINGTON BEACH iel r DEPARTMENT OF DEVELOPMENT SERVICES A, HUNTINGTON MACH iVRtNT OR TYPE ONLY) il DATE Address Business Business `"44-C, ^4-q strict — BUILDING OWNER BUSINESS OWNERIMANAGER Z / Name j�zi:ilnZ5S �l? r� t y f%'" E?E�C 'l7e'; Name T&,x� — z ll&z � S�t✓—�c 'r. (" >�. Home Address��f f /L l 2 D �' . �'v X '~Y�' Address`��d Cx ✓w' L�t3Y�i'�' City_ T Y G.� 'Yr �' t % �' ! ��, Tel 7"V ;ity i._c,. ??- f A-3, �' /� �, r/ Home Tel. THIS USE WOULD BE DESCRIBED AS: C ❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER CHANGE OF OCCUPANT � ❑ EXISTING BUILDII,:C ❑ CHANGE OF USE AUG 1 7 198$ ❑ .{UUITIC "J�._ OCCUPANT Indicate former use, If any_ 6;._ Div :'OUARE FT. OF BUILDING TO BE OCCUPIED ' O `""M NITM DEVELOPMENT BUILDING mvisloN NOTICE: 1. Occipancy of any building is prohibiter: 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 safq_ All applicants for occupancy In an existing building are : equired to schedule an electrical 'fuse up' inspection in the Department of Development Services at the time this application is filed. 3. Change of occupancy or use inspection fee. Whenever it i,3 necessary to make inspection of a building or premises in order to determine if change may be made in the character of occupancy or use of the building or premises which would piacr- ,ne building in a different divisirn 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 10.298 requires that budldi ig nu 'hers mist be a minimum of four (4) inches ire height With one half (112) inch stro4:e ano of a cont Asting color from the background. These numbers must De posted on your building in a I )cation that is ,.'JDle from the street. 5. Huntington Beach Fire Code Section 10.301 inquires fire extinguisher selection arid distribution per tho National Fire Protection Association pamphlet 10 (see reverse side). SUPPLEMENTAL INFORMATION (FOR OFFICE USE ONLY) ZONINGt�L—,� OCCUPANCY GROUP-- I� "' _^ PLAN CHECK NO. NO. PAPKINGSPAe.E-87� OCCUPANT LCAD ld PER,viIT NO. HEALT>�fi��PT. APPROVAL NO. OF STORIES ADlviiiN. ACTION U,TkL'ITIES RELEASED _r _ CERTIFICATE OF OCCUPANC(Cv S 5 r APPROVE Y D TE CHANC-E OF USE OR OCCUPE S TOTAL $ yes« 75-039REV DEVELOPMENT SERVICES`S--- SUPPLEMENTAL INFORMATION (Continued) Does the operation involve any of the following materials; ❑Yes I Yes, indicate quantities: Material Quantity 1. Flammable liquids Class 1 •A. Class I-B Class I-C 2. Combustible liquids Class II Class III -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 II. Oxidizing material - gases 12. Oxidizing material - liquids _ 1`s. Oxidizi -%q material - solids 14. Organic peroxides 15. Nitrometha:je (unstable materials) 16. Ammonium nitrate 17. Ammonium nitrate compound mixtures containing more than 60a nitrate by weight _. 18. Highly toxic material a-,] poisonou2as _ 19. Smokeless powder 20. Black sporting owder I hereby certify that the above inf(,rmation is true and correct to the best of my knowledge. Signature =-� n e v (0562D) (12/8/86) SUPPLEMENTAL ?NFORMATION 1. F, SINESS ADDF.ESS C'U <7" �.d"�S Xr�^ 2. Person to contact in case of emergency: X,(�''/�� Telephone number: �/ r/' —Z-�; S-�z 3. Does the building in question have electricity? Dyes Z_N o a. If No, are you requesting that the electricity be ,9'es turned on? 0:10 4. The building is sprinklered? DYes j9W 0 5. Operations will produce dust/wood shavings or similar material? ❑ Yes p�No 6. Operations will involve the repair or replacement of DYes automobile parts? P�o If yes: (a) Describe the components repaired or replaced. (b) Does the operation involve the use of an aspen flame? Dyes fi?�No 7. The business is drinking, dining or assembly use that will result in an occupant load of more than 50 persons. QYes ;�,INo 8. The following best describes my operation: Office Only xRetail Sales_ are. ouse m-nufacti;:irig/Distribution (describe process and end pl oduct ) Restaurant/Take Out Food Medical/Dental other (describe) (0562D) (12/8/86) .I CERTIFICATE OF OCCUPANCY G1TY OF HUNDNGTON BEACH �jri i 7;_19RO `� DEPARTMENT OF COMMUNITY DEVELOPMENT Date HUNnNOON %ACV Address 10086 Adams �kVe. District Business Name STIR Word. Tei. 962-3791 _ Business Type Silk plants ratail Occ. Group B2 BUILDING OWNER BUSINESS OWNERIMANAGER Name Business Properties Name Nellie S. i hu Horde Address _1763)_Fitch St. Addracc `-gl City Tss i ne Tel.47d--1n0rl City fT11nf-;;}qj-n1 npnct, Horne Tel.gFd-79.sfi Construction No of Stories --- Occupant Load 91 Sprinktered This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and shall not be removed ex- cept by the Building Official. DEPARTMENT OF COMMUNITY DEVELOPMENT by- J� w APPLICATION FOR CERTIFICATE OF OCCUPA Y CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT HUNTIh .CTON DEKH i PRINT OR TYPE ONLYi AHIresS �D 'tS� �Q!7„'/S ,Q�' -. • yTr �._ C''� �/'/ Busr less Name Business Type _��L��Q.N BUILDING OWNER f.� DACE Disloc,_ Tel 04051C Occ. Group BUSINESS (WINERVANAGER Name BU/S&eS.S ��op��7"/'�S Name Hom- Address/1�3 �!fi !�_.— Address�930y S�ClSRLI'$Gt LAI , City. �VlN�'_ e/3. c?.zq!���� //�� `-_�_Tefl l i9(i Cih,: _!T_�._ Home T^I.�� —�2_3y THIS USE WOULD BE DESC.FIBED AS: i .J NEWLY CONSTRUCTED BLDG CHANGE OF OWNER ❑ C' MANGE OF OCCUPANT ❑ EXISTING BUILDING ❑ CHANGF OF USE ❑ ADDITIONAL OCCUPANT Indicate former ,,;e, if airy _ ___ -� � Orcurancv Gr. Div SQUARE FT OF BUILDING TO BE CUPlED---� __,/ NOTICE: 1. Occupancy of any building is prohibited and a business license will not be issued until the building has been inspech.�d and a certificate of occ oancy is Issued. 2. No electrical service will be relea� I for any existing building until the service has been inspected and certified safe. All applicants f r occl_. ancy in an existing building are required to schedule an electrical `fuse up' inspection in the Departmen f Community Development at the time this application is filed. 3. Change of oc--upancy or use inspection Re_-. Whenever it is necessary to make inspection of a building or prey-- in order t.- determine if a chang, may be made in the character of occupancy or use of the building or prem'3es which would place the building in a different divisiun of the same group of occupancy or in a different group of occupancy, v change of occupancy inspection fee of $ ____ _�� shall be paid to the city. 4. Huntington Beach Fire C-)de Section 10.208 requires that building nu nbers rrsit be a minimum of four (4) inches in height with one half (',z) inch stroke, and of a contrasting color from the background. These numbt rs musi be p )stud on your building in a location that is visible from the street. 5. Huntington Beach Fire Cu.le Section 10.301 requires fire exr, igursher selection and distribution per the National Fire Protection Association pamphlet 10 (see reve•se side). SUPPLEMENTAL INFORMATION OCCUPANCYC;ROUP_�" OCCUPANT LOAD --. NO OF STORIES ------ — APPIV ED 8Y DATE 75-009 R1, 6:88 (FOR OFFICE USE ONLY) Li KC `(jfsJ toNlN<, PLAN CHECK PERMIT Nn ------- -- _. _. r{fur Ti 'Wf PT APP;,OvAL —.-- -- -- _— Af)h1IN ACTION______—____ 'l;TN ITIFS RE FA:;ED C,ERTIFI,,ATE oI OC " tIPANC r F Ff CHAN,aE OF USE L'r ----- TOTA1_—�___- SUPPLEMENTAL INFORMATION 1. BUSINESS ADDRESS G'�rV� CAL{ 2. Person to contact in case of emergency: s Telephone number: :1 14, - 712? 3. Does the building in ruestion have electricity? Q Yes y ONO a, If No, are you requesting that the electricity be :3Yes turned on? ❑ No 4. The building is sprinklered? Yes ONO 5, Operations will produce dust/wood shavings or similar material? ❑ Yes 40"No 6. Operations will involve the repair or replacement of Oyes automobile parts? ti2to If yes: (a) Describe the components repaired or replaced. (b) Does the operation involve the use of an open flame? ❑ Yes ONO 7. The business is drinking, dining or assembly use that will result in an occupant load of more than 50 persons. Yes OY 0 8. The following best describes my operation: Office Only. C ,,--1�etail Sales warehouse Manufacturing/Distribution (describe proces- _.d end product) Ake staurant Ta ;e Out---Fo--6-d-- % aH ca' Der'_a1 ���; (12/8/86) CERTIFICATE OF OCCUPANCY CITY OF HUNT.INGTON BEACH Address 1 r� 0 8 F" ? T) A M .1� District Business Name h IIr' ► R N, Rllr; i , TEI. 1 Business Type GIFT SH00 — RF.TATT. Occ. croup >, _ BUILDING OWNER BUSINESS OWNER/MANAGER Name BUSINESS PROPERTIES Name DAVE DETRO Home Address{"(_i�5?7 >~TTC14 Address G.ggg jjnjzrr� Horr. City T i? 11 T k C Tel. City r n c T A N, € c' A Tel. Construction No. of Stories Occupant Load _? 7 Sprinkiers CONDITIONS OF APPROVAL tl/01 Date This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and shall not be removed except by the Building Official. DEPARTMENT OF COMMUNITY DEVELOPMENT by ,P. 14 COMMUNITY DEVELOPMENT ti APPLICATION FOR CE'RTIFICI TE OF OCCUPANCY i CITY OF HUNTINGTnN BEACH ' i DEPARTMENT OF COMMUNITY REVEL,":PMEN'irY�yJ y NUN nNGTON BE40i DATE (PRINT OR TYPE ONLY) ddr s I Q0IFE T i'_z Ifi � U �G ; �1 Distric! � tJ — � us�• ess Name_IA � /'" �lais _ T'Pt. Business Type ViLTtTt=T� �%� p "" ---- t R L 'a-R LE 5 Occ. Greco -- BUILDING OWNER A BUSINESS OWNER11WANAGER Nap1e � s I A.* 55 �a2� � �e�� � �'C' �ZO Add7ej�� i' f 1 a L4 Address' 1 9 `� "Y eZj c i\- Ity i✓//t.' g � 1 '4 Tel. "f�iweit-yr—j: r ES "� Home TeI - - l 59 rH9S USE WOULD BE DESCRIBED A5: NEWLY CONSTRUCTS' PI.OG. ❑ CHANGE OF OWNER X CHANGE OF OCCUPANT X EXISTING BU°_DING ElCHANGE OF USE ❑ ADDITIONAL OCCUPANT I\\ndica�e former use, if any 7h s a_ �},2 r Occupancy Gr. Div. 5&`,RE FT. OF BUILDING TO BE OCCUPIED NOTICE: 1. Occupancy of any building is prohibited and a bus)siess license will not be issued until the building nas been inspected and a certificate of occupancy is iSSL:sd. 2. No electrical service will be released for any existing building until the service has been inspected and certified safe. All applicantr 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 inspect:en 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 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 Se0ion 10.208 requires that bui,..,ng 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. H,.ntington Beach Fire Code Section 10.301 requires fire extinguisher selection and distributio. the National Fire Protection Association pamphlet 10 (see averse side). —119�-c r__ K--K- 3 3n 16 SUPPLEMENTAL INFORMATION OCCUPANCY GROUP. OCCUPANT LOAD NO. OF ST RIES — ,,.�_"k £PP9 'VE .2. (FOR OFFICE USE ONLY) 'IPA ZONING d� -AN CHECK NO. — NO. PARKING SPACES — PERMIT NO. HEALTH DEPT APPROVAi ADMIN. ACTION UTILITIES RELEASED — p CERTIFICATE OF OCCUPANCY FEE $ [ CITE 'CHANGE OF USE OR 00--UPANCY FEE $ TOTAL $ 75-039 Rev, 11/90 COMMUNITY DEVELOPMENT y SUfPPLEMEN'TAL INFORMATION 1. BUSINESS ADDRESS t00e& '�c'� IAS ` ��C: %�1�► `-C©tom � ��- COU0 2. Person to c: �Itact in case of emergency't,N vC Telephone nu►nber: 6,,17-& 1 3. Does the building in question have electricity? M/ es ❑ No (a) If No, are you requesting that the electricity be ❑ Yes turned on? C1 No 4. The building is sprinklered? ❑ Yes - 13'No Operations will produce dust/wood shavings or similar material? ❑ Yes 0�10 6. Operations will involve the repair or replacement of r Yes automobile parts? Lwi` 0 If Yes: (a) Describe the components repaired or replaced. (b) Does the operation in:,c!ve the use of an open flame? ❑ Yes I3INo 7. The, business is drinking, dining or assembly use that will result in an occupant load of more than 50 persons. L7 Yes WNo 8. The following best describes my operation: Office Only Retail Sales Warehouse= Manufacturing / Distribution (describe process and end product) Restaurant/Take Out Food *'edical / Dental Other (describe) SUPPLEMENTAL . `INF0RlR4A'd` ON (Continued, Uses "the operationinvolve` any of the following materials? ❑ Yes No If Yes, indivate quanVties: Material Quantity `!. Flammable liquids Class !-A Class 1- !3 Class I-C 2. C rr;bustible liquids Class 11 Class Ill- : Combination flammablb liquids T­ammable� gases 5. Liquefied flammable gases Flarn-ma b;e fibers - loose �Fiammable fibers baled ��._.�..___....-_.._ Flarr'ma k _1 solids 9_.._._a.._ Unstable materials liquids 11. Oxidizing material gases 12. Oxidizing material liquids .I Oxidizing material - solids 14 Organic peroxides 15. Nitromethane (unstable materials) 16. Ammonium nitra} 17, ,ammonium n, compound mixtures containing than 60% nitrate by weight 16. �T Highly toxic material and ,m Poisonous _ gas 19. Smokeless powder 20. Slack sporting powder Aereby certify that, the _ above information is true and correct to the best f Wmy4noledge. .r% ao 9 4. Signature Date V �J WIT City of Huntington Beach 2000 MAIN -STREET .� ,ALI FORNIA 92648 DEPARTMENT OF COMMUNITY DEVELOPMENT Building 536-5241 Planning 536-5271 Hous ng 536°527 0 Government Code Section 65650.2(b) requires the City of Huntington Reach Building Division not tc issue the final certificate of occupancy unless the applicant has met or is meeting the requirements of '-he South Coast Air Quality Management District (AQMD). The Building Division must obtain a written release from AQMD to show the applicant has complied with this law. The check list on the reverse side is designed to helr the applicant and the building division to meet 'these requirements. 1. The applicant (the same person who applies for permits from ,te Rizild.ing Divisipn) must complete the check list which can be obtained either at the Building Division or at AQMD. 2. If all bones in the list are checked "no", the Building Division can accept the check list as the release. 3. If there are any "yes" answers in the list, the applicant must contact an AQMD engiree'r by calling ('714) 396-2000 to ind. out whether air permits are required for the proposed construction project. 4. If air permits are not required, the applicant will obtain a written release from AQMD. F. If air permits are required, the applicant must submit the necessary permit applications before the release can_!je issued. Because of the time it may take for AQMD to go through the above procedures, the applicant is advised to contact AQMD immediately after applying for Building permits. ice._ y SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT (Nonresidential Buildings Only), Location of Subject Property: 149LI906-& 19P,4,9. r 7/o r [ &X & Property Owner Name: _605, r eo ?" Phone # 4 74 - e mp Name of the Person -reparing this form in prir.;: a ..ignai; e Name • VX cJt %IZ0 Signature The person preparing this form must ne the same=person applying for building permits. Please answer the followinq questions regarding your proposed occupanc of the subject building. IF YOU DO NOT KNOW THE ANSWER TO A QUESTION MARK IN THE "YES" COLUMN: AQMD PERMITTING CHECKLIST YES NO 1. Does your facility use any internal combustion engines greater''than 50-HP? 2. Does your facility involve mixing, blending, or processing any solvents, adhesives, paints or coatings? 3. Does your facility create any dusts or smoke? 4.. Does your facility refine any liquids or solids - or reclaim any metals? +•--, 5. Does 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? _ E/ 7. Does your --facility handle or store solvents or motor fuel? 8. Do you use or store any acids? 9. Do you use any chemical process? 10. _ Leo you use any solvents for clean. -up? 11. Are you a dry cleaner, restaurant with a r.harbroiler, body shop, gasoline station, printer, or part coater? 12. Is the sub4ect building located within one thousand (1,000) fees` of any school? _1 PROPERTY LINE TO PROPERTY LINE. 33RADES 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 must contact the South Coast Air Quality Management District located at: 21865 E. Copley Drive Diamond Bar, C'A 91765-4182 Please call: Plan check (714) 396-2000 (1360D-2) r-rr........w o«r�r�.r. rv...... ter.'..... •nras.rv.ra.e.<r.. .. .r. .ar r rr-------------------------------- CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BFACH 1101/0-d: Date Address f r S r n r. A n. District Business Name Ni?Cre E f�ITC;+ Tel. Busines3 Type U? 'T :;h, r- _ RT{TA iT. Occ. Group BUILDING OWNER BUSINESS OWNER/MANAGER Name BUSINESS PRGPERTILL- Name DAVE L FTItG Home Address]'F: 1 FT',"t"f; Andress � r: r.< <r pr. r C s City 1 i2 V T N F' C h j L Cit Tel. to a Tel. 7t+dt�tl_.iG r y r � .�r i—r`'/; Tel. Construction No. of Stories Occupant Load ' ! Sprinklers CONDITIONS OF APPROVAL DEPARTMENT OF COMMUNITY DEVELOPMENT This Certificate of Occupancy SMALL BE posted in a conspicuous place on the premises and shall not be removed except by tho by Building Official. COMMUNITY DEVELOPMENT J� APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH �t DEPARTMENT OF COMMUNITY DEVELOPMENT HUNTINGTON BFAOi (PRINT OR TYPE ONLY) 1 1 UAT Addr s ����1c✓ 't=N 1 g�-+�',.�T:C9 9 C9 District s ess Name '�' `0 FIT s �' LA � � Tzt Zi�siness Type VGS tNzT Ei+ W - ET-Ikl L_ 54A LE 5 Occ. Group BUILDING OWNER BUSINESS OWNER'MANA TER Zress�6L_F I�� h Ac3dress� ` 9 1jy do ✓ t tl L `j 2 % I __Tel 7 J4"f 3%G!a n r r \�S Ii ----Home Tes-0-i-6-159 HIS USE WOULD BE DESCRIBED AS: ❑ NEWLY CONSTRUC5 ED BLDG ❑ CHANGE Of- OWNER CHANGE OF OCGL)PANT EXISTiNG BUILDING ❑ CHANGE OF USE ElADDITICNAL OCCUPANT Indicate former use, if any & Occupancy Gr Dry S ARE FT. OF BUILDING TO SE OCCUPIED NOTICE: 1. Occupancy of any building is prohli ., d and a business license will not be issued until the building has been inspected and a certificate of occupancy is issued. 2. No electrical ;eervice will be released for any existing boi!ding until the Service nas been inspected and certified safe. All applicants for occupancy in an existing building are required to schedule an electrical 'fuse up' im.:pection in the Depa, tment of Community Deveiupment at the time !)is application is flied. 3. Change of occupancy or use inspection iee. Whenever it is necessary to make inspection of a building or premises in order to determine if o :hange may be made in the characterof occupancy or use ofthe building or premises which would piace t' e building in a 'Ifferevt division of the same group of occupancy or in a different group of occupancy, a chal:ge of occupancy rnspr tion fete of $ _ _ shall be paid to the city. 4. Huntington Beach Fire Code Section 10,208 requires that building numbe~s must be a minin um of four (4) inches in height with o-ie half (Yz) 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 ;ire extinguisher selection and distribution per the National Fire Protection Association pamphlet 10 (see averse side). SUPPLEMENTAL INFORMATION OCCI�PANCY GROUP OCCUPANT LOAD NO. OF ST-QRIES — 75-039 Rev, 11 /90 (FOR OFFICE USE ONLY) PLAN ( HECK NO PERMIT NO -- --- ADMIN ACTION_ ZONING C� I — I>i;L- NO PARKING SPACES HEALTH DEPT APPROVAL UTILITIES RELEASED _ CERTIFICATE OF OC ,UPAn'rl g_ 5 �— CHANGE OF USE OR OCCUOANC`r TOTAL 5 — COMMUHITY DEVELOPMENT SUPPLEMENTAL INFORMA T 10P1 1. BUSINESS ADORESs (0O8 PcFJis 2. person to contact in case of emergency `-UAyG: -Dar rAo Telephone number: _ 5� 715�2 3. Does the building in question have electricity? lam' Yes ❑ Nu (a) if No, are you requesting that the electricity be ❑ Yes turned on? ❑ No 4. The building is sprinklered? ❑ Yes M'No S. Operations will produce dust / wood shavings or similar material? ` yes ❑iVo 6. Operations will involve the repair or replacement of Yes automobile parts? I(Ao If Yes: (a) Describe the components repaired cr replaced. (b) Does the operation involve the use of an open flame? ❑ Yes 1QZN o 7. The business is drinking, dining or assembly use that will result in an occupant load of more than 50 persons. ❑ Yes ` YNo S. i he following best describer my operation; Office Only Retail Sales Warehouse Manufacturing/Distribution (describe process and emd product) Restaurant/Take Out food Medical / Dental Other (describe) SUPPLIMENTAL INFORMATION SUPPLEMENTAt-. INFORMATION (Conilnied) nia`o� mz i� o.pa r i g ro an-. of "he CVV.�*,g N sr '63"1. inidk,-.ate ritiaMitios. Material L4 a n t tv i. !Z.@rrmiable I'laqu'ds Class ,Z"lass ("I'ass I-C 2 Combust'We Vc:iuki,o, Class 11 Cass IN -A as es flamniaNe gases -loose F.-_;nifilable fibe.- -Jdied tanin able sfjiidzn 9. UnsaLlp rnate,iais 10 dazing iwaterial gases 12. Oxddizin­Um-a--te-riai liquids 13. Oxidizing material solids 14 (-: gaiiic aeroxide� onnetha 15. Min [unstable materials) 16. Ammonium nitrate _17_._A_m_m _c_;niur_r,, nitrate- compound mixtures containing more than 60% nitrate by weight 18. Highly toxic material and poisonous gas 19. Smokeless powder M Back sporting powder I hereby certify that the above information is true and correct to trie best f my no I doe, -3.4-0-94 Signature Late City of Huntington Beech 2000 MAIN STREET CALIFORNIA 92648 � JA DEPA fMENT OF COMMUNITY DEVELOPMENT Building 536-52 ; i Planning 536-5271 Housing 536-5271 Government Code Section 65850.2(b) requires the City of Huntington Beach Building Division not to issue the final certificate of occupancy unless the applicant has met or is meeting the requirements of the South Coast Air Quality Management. District (AQMD). The Building Division must obtain a written release from AQMD to show the applicant has complied with this law. The check list on the reverse side is designed to help the applicant and the building division to meet these requirements. I. The applicant (the same person who applies for permits from the Building Division) must complete the check list which can be obtained either at the Building Divisioni or at AQMD. 2. If all boxes in the list are checked "no", the Building Division can accept the check list as the release. 3. If there are any "yes" answers in the list, the applicant must contact an AQMD engineer by calling (714) 396-2000 to find out whether air permits are required for the proposed ` construction project. 4. If air permits are not required, the applicant will obtain a written release from AQMD. 5. If air permits are required, the applicant must submit the necessary permit applications before the release can_be issued. Because of the time it may take for AQMD to go through the above procedures, the applicant is advised to contact AQMD immediately after applying for Building permits. (1350D) 19 SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT (Nonresidential Buildings Only) Location of Subject Property: l©QPCO 89m,16 %27 46 Property Owner Name: �k'� Phone # 474- 0. op Name of the Person Preparing this form in print a ignat e Name:- ��+� <<J r' Signature The person preparing this form must be the samellperson applying for building permits. Please answer the following questions regarding your proposed occupancy of the subject building. IF YOU DO NOT KNOW THE ANSWER TO A QUESTION MARK IN THE "YES" COLUMN: AQMD PERMITTING CHECKLIST YES 1. Does your facility use any internal combustion engines greater than 50-HP? 2. Does your facility involve mixing, blending, or processing any solvents, adhesives, paints or coatings? 3. Does your facility create any dusts or smoke? 4. Does your facility refine any liquids or solids or reclaim any metals? 5. Does 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 motor fuel? _ 8. Do you use or store any acids? 9. Do you use any chemical process? 10. Do you use any solvents for clean-up? 11. Are you a dry cleaner, restaurant with a charbroiler, body shop, gasoline station, printer, or part coater? 12. Is the subject building located within one thousand. (1,000) feet of any school? PROPERTY LINE TO PROPERTY LINE. GRADES K-12. NO 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 must contact the South Coast Air Quality Management District located at: 21865 E. Copley Drive Diamond Bar, CA 91765-4182 Please call: Plan Check (1360D-2) (714) 396-2000 R1�