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10088 Adams Ave - CofO (3)
_ ] *n'op^,wnvonONpc^xri ___�--__---- nwo District i Business Name nm. ' Business Type ______—_ mcc arouv_—���_—___ � aouoINaoa�Isn | ----'------ oumwsse —'---'���� / wom* . ! ' *^mo �| Admressmddre, � city_ � ' Tel o* ccrisioi.tm No of Sic,** mzupu Lcad _____ Sprinklers cOwoITmwS xppnoVAL This Cartifi, ate of Occupan,:y promises and shall vot be removed excer;* I)y the Building Official DEPARTMENT OFCOMMUNITY DEVELOPMENT w ~--- '--------- ����` COMMUNiTY DEVELOPMENT APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTING'; ON BEACH DEPAqTMENT OF COMMUNITY DEIIE','IPMENT NOTICE: I'V i I 111 ot i 'air f i a , h e e n No electrical serVice jrlr11,1', fw, beeii im pectod art ,nfe A;' an electrwal f-A! ij;), 17 it tiw 1!iib applt,,at-on is f0e(- 111spe Change of occupancy or use Inspection fee. IN' ii it is T -Ctlr- of a buit'ding or 1! ;Tljl It 0; rr i-,e of Itle butiding prem!ses :it v;tl ,vl,;:d -1 tol 'i a!" ,,i litl� CA 11; Z) rent qt',Jj 0! (,hx ge shaf L uo �lald to the 4 tl d i it) us!' Er -I M , r! i ryl U, T' I Of !0LJ r (4) Ht ritington Beach Fie Code Section I ir cne; in holght will' orf� rilr:i tir,g fi,,) ., the backoi oi;rd These mjt,lf,ers mos, BE p,p.fk!(j J1,1 rit, tiet Kunlii,.aton Beach Fire Code Section 1C, per r1l ;(-V( f.z, ddt�j 'I (FOR 0RCF 3NICti :511 f ..L' I Ili t'ts tM L'I'/r'Ep T I FTCz' TF OF 0(Cl(jJI'ANi;Y BPP1�T:�Etd ' {_ JI-11 (;0A8T AIT? QUALITY MANAGENEN T USTRICT PERI'Afl-T ING CHECKLIST :0fAMERCIAL BUIL DINGS ONLY F y :I -`I t' U,:;; :2i'-' I NTI ;=:27AZ: COMB?FS I iil27 L'2l 1 2i - :1.".l:".. .1 ii2Y _ i..i S7F?, I) -)EL: _.1J? t:<'_ T,e:r„s' JNl r!,V:. 2!i't:I.27", BLENDING, OIL Y <, t..-., it. '.., _ .;r ?.. .2:`". i:irl7F..=.t', i'` , i'F:I2i'i`: OP r?. ; 7(7UR FAtIC T L=,"i Y t_'.F'EA'T'F: 1.14Y DUSTS OR SMOKE: 4. L<' ES YOUR FACILI`t'Y REF:I'NE A21Y LIQUIDS OR SOLIDSRECY.AT:M ANY METALS? DOES WUR *1-TLIT`Y F'.T_,A'rE OR COAT ANYTHING? I?O'S YOUR FACILTT`s" HAVE ANY COMBUSTION EQUIPMENT (I.E., 130TLFRS, FURI7ACE5, i.-ZOILERS, BAKING OVENS, E'rc). DOES YOUR Fi,.^.ILITY HANDLE OR STORE �JRF; SOLVENTS OR MOTOR FUELS? DO YOU USE OR STORE 2W ACIDS? 9. DO YOU USE ANY CHEMICAL PROCESSES? I o . DO YOU USE ANY SOLVENTS FOR CLEAN UP? w. ARE YOU A DRY CLEANER, RESTAURANT, BuDY SHor, GASOLINE STATION, PRIN'TE.?, OR PART' COPIER? IF YOU DO NOT KNOW THE PNSWER TO A QUESTIUPI, MARK IN THE "Y91 Contra. IF YOU HAVE MARKED ANY QUESTIONS IN THE "Y« COLUM-N' YOU LIST CONTACT THE SOUTH ;OAST.' AIR QUALITY MANAGEMENT DISTRICT LOCATED AT 9150 FLAIR DRIVE, E:j MONTE CA, 91731. PLEASE CALL PUDLIC INFORMATION AT (818) 572-6283 OR CUSTOMER SERVICE- AT (818 572— 5347. jQB ADDRI SS, a. . r i .SAT ` �a,i STt3NATtIRFs: SUPPLEMENTAL INPORMAw^IGN BUSINESS 1i'DDRES5 2. Person to contact in catsi of emergency _-- Telephone numbor: 3. Does the building in question have electricity? e a. If No, are you regutiating that the electricity be turned on? 4. The building is sprinklered? 5. operationj will produce dust/wood shavings or mixilar material? 6. Operations will involve the repair or replacement of automobile parts? if yes: (a) Describe the components repaired or replaced. p Yes 13 No Cayes C7 No C7Yes ONO Oyes ONO Mes (2No (b) Does the operation involve the use of an u flame? OYcs P No 7. The business is drinking, dining or assembly use that will result in as occupant laud of more than 56 persons. C]Yes JUNO E. Th,: following best describes my operation: office only �?'°�`" i- i` Sales^> V"ere�oui-e .wr " Hanufacturing/Distribution (describe process and end product) F igrrE721Fe— VM~od Medical/Datntal Other (describe) (0561D) (12/8/86) S7PP-F,Fe,NTAL INFORMATION (Continued) Does the operation invGlve any of the f(Ilowing trazerials? cjye.� ONo es, —I�l�-equaMtl- Material Quantity 1. Flammable liquids Class I -A Class 1-B Class I-C 2. Combustible liquids Class II Class III -A 1 Combinaticn flauimabejjaiids 4. Flammable gases 5. Liouefied flammable gases . Flammable fibers - loose 7. Flammable fibers - baled 8. Flammable solids 9. Unstable materials 1: ,orrosive liquids 11. oxidizing mater.-al, - gases 12. OxidiKLinj material - liquids 13. oxidizing material - solids 14. organic peroxides 15. Nitromettiane (unstable materials) 1E. Ammonium nitrate 17, Ammonium nitrate compound mixtures containing more than 60% nitrate by wei.ght 18. Highly toxic material and __9.2isonous -.!.s 19. SmokelSas_., -wder 20. Black sportinS powder 1 hereby certify that the above information is true and correeL to the best of my knowledge. Signature Date (0�62D) (17/A/AIq) V i� 1-1 0 HUNTINGTON BEACH FIRE DEPARTMENT INTERDEPARTMENTAL REFERRAL FIRE L. FPARTMENT USE District `T 1 Date�� To: C t— Cat" 1', C J Department t C i From: Ex,( V- ki et, Station Address of Referred Subjects r� S� d- a n, S ee C SuEzject_ w �' �- C cL t' f% Y f - "7 �' ? It-- .� ,'72 Reviewed by _ �T f�` � � Teiephone Number REFERRED DEPARTMENT USE Disposition Ile . .a` �•it`�,�) � /J7 .w^'•'��.�°a�9`-/, �. I�OfsT +�1r�Il `P Date _ _ ° ,'� C"� _./ 'liigned s / rii • sf?r 'l n. d!Y e:- ':, • ROUTING White/Yellow Copy To: Referred Department Pink Copy To: Originator — Discard When Disposition Ce,-rnpleted Return White Copy To Fire Department When Disposition Is Completed Yellow Copy Retained By Referred Depnetment FD-012 (10/75) 0 CERTIFICATE OF occur'ANCY CITY OF HUNTINGTON BEACH Date Address 1 COL S District Business Name L Li--LK L To 1. Business Type k.- 1 Occ. Group F—P BUILDING OWNER BUSINESS OWNEWMANAGER L Name Name Address"( Home A&res� Cityis Tel. Home City Tel. L r— Construction Nu of Stories Occupant Load Sprinklers CONDITIONS OF APPROVAL DEPARTMENT OF COMIC— CITY DEVELOPMENT This Certificate of Occupancy SHALL BE posted in a conspicuous Place on the premises and shall not. be removed except by the by Building Official. COMMUNITY D;:VEI-OPMENT ���P, pl- APPLICAi PION FOR CERTIFICATE OF OCCUPANCY MI, CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT 7 _ HUNTINGTON scan+ DA E (PRINT OR TYPE ONLY( Address G'C $ R !_7J Ave• District — Business Name X I m ! 9) Ar kI 0-FL-T—A c Telo oG 8"R Rusiness Type —! Y�I a Y�S _�� t Y � I _ _ Occ. Group_ BUILDING OWNER BUSINESS OWNERIMANAGER C 51 M Name f) ASS /nv � . ' � Name _�_ Home -/- Address ^' 1 �SYPsc___ Address /dl rl c� ��a��C L it City =Ytr l ti12 , CA rP-�. Tel4a�_71200City__ r c _Home Tel_ `I S-0 THIS USE WOULD BE DESCRIBED AS: ❑ NEW-Y CONSTRUCTED BLDG I__I CF ANGE OF OWNER ❑ CHANGE OF OCCUPANT XEXISTINC BUILDING ;, HANGE OF USE ❑ ADDITIONAL OCCUPANT Indicate former use, if anv_- _.___- Occupancy Gr. —Div SQUARE FT OF BUILDING TO BE OCCUPIED" ©�O X _ NOTICE: 1. Occupancy of any building is prohibited and, a business license will not be issued until the buildir , has been inspected and a certificate of occupancy is issues;. 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 the Department of Community Development at the time this application is filed. 3. Change of occupancy oe dse inspection fee. Whenever it is necessary to make inspection of gilding o; premises in order to determine if a change maybe made in the character of occupancy or use of I, buildint, 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 10.206 requires that building numbers must be a minimum of four (4) inches in height with one half (1112) inch stroke, and cf 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 distrib,.Ition per the 3 National Fire Protection Association pamphlet 10 (see reverse side). Frz_ _t.I i Flo Tz--ifs - -------- ------ - �— 9z (FOR OFFICE USE ONLY) SUPPLFMENTAL INFOR41ATION OCCUPA14CY GROUP— PLAN CHECK NO — OCCUPANT LOAD uQ PERMIT NO NO OF S,ORIE �— AJMIN ACTION____ 'ERTIFICATE 0.- OCCUPANCY FEE P116 ED DAT CHANGE OF USE OR OCCUPANCY FEE TOTAL 7;--039 Rev, 11190 COMMUKTY CEVELOPNIENT 7ONING NO PARKIN(, SPACES — HEALTH DEPT APPROVAL UTILITIES RELEASED — %�-LIPPLEMIENTAL INFORMATION 1. BUSINESS ADDRESS 100o?y Mams 4-f. 2. Person to contact in case of emergency • r N ,S. K I m Telephone number: 3. Does the building in question have electricity? Yes ❑ Nc; (a) If No, are you requesting that the electricity :tee ❑ Yes turned on? ❑ No 4. The building is sprinklered? ❑ Yes No 5. Operations will produce dust/wood :shavings or similar material? ❑ Yes X No 6. Operations wilt involve the repair or replacement of ❑ Yes automobile parts? X No If Yes: (a) Describe the components repaired or replaced. (b) Does the operation involve the use of an or ^n flame? ❑ Yes K No 7. The business is drinking, dining or assembly use twat will result in an occupant load of more than 50 persons. ❑ Yes K No S. The following best describes my operation; Office Only Retail Sales Warehou:.e Manufacturing / Distribution (describe process and end product) Restaurant / Take Out Food Medicai / Dental Other (describe) --&Wt c,� Atis rXxt,la.rtidv�� r SUPPUMENTAL INFORMATIQN SUPPLEMENTAL INFORMATION (Comfinued) Coes the operatior involve any of the following materials? ----- If Yes, indicate qUantities: Material 1. Flammable liquids [)!aaa '-A Class /-8 ���� C\aon |-C -----'---- ------ 2. Combustible liquids Class // 3. Combination flarnmabis liquids Class Ili -A - 4. Flammable gases '-----'-- -----' 5. Liquefied fiammab!a gases ____ _____ C. F�am/nab|o fra - loose ______ _ 7. Flammable f�ber� - baled ____mo____ 8. Fiumable mo}idm ------'------nn-------- �� Unptab(o etsri-!o 10 Corrosive }iqu|da -----------`----'— ----------------------- 12. Oxidizing material - |iquids �����`O������`�����������������������`�� 13. x�dizlng n`atwria| ' solids.________ 14. Organic peroxides ------ -------'---- 1E. Nitromethune (unstable materials) �������������������� 16. Ammonium nitrate 1T Ammonium nitrate compound mixtures r,ontaining more than 6096 ni1rrte by weight 18. High! /oxio nnntarie) anl poisonous gas 19. Smokeless powder 20. Black B|aok sporting powder Quan1 I herepy certify that the ab3ve information Signature is true and correct to ?1_2_�l q --) SOUTH COAST AIR QUALITY MANAtGMMENT DISTRICT (Nonresidential Buildings Only) Location of Subject property:_/003 ,? �'401-S 4b�. 1tL-,11� �LsCA Property Owner Name: .>�f - dtr Phone 7 L 70 Name of the Person Preparing this form in prin147 an signature Name: S'ANC, S. �� i M Signat axe: The person preparing this form .must be the same pezxon 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" COLS: Aim PERMITTING CHECKLIST YES NO 1. Dols your facility use any internal combustion engines greater than 50-HP? 2, Does your facility involve mixing, blending, or proedssing any solvents, adhesives, paintu or coatings? --L 3. Does your facility create am dusts or smoke? V - 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, fvtnaces, broiler, baking ovens, etc.) rated greater than 2,000,000 BTU/HP-7 _ V 7. Does your .tacility handle or store solvents or motor fuel? S. Do you use or store any acids? 9. Do you use any chemical process? .0� Do you use any solvents for clean-up? - 11. Are you a dry cleaner, xestaure nt with a charhroiler, body stwp, 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. GMDES K-12. If you have marked "NO" in all columns, you do not need an Air. Quality permit at tit>s time. If you have marked any questions in the "YEES" 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 (714) 396-2000 (1360d-2) City ®f Huntington Beach 2000 MAIN STREET CALIFC7':IA 92648 > DEPARTMENT OF COMMUNITY DEVELOPMENT Building 536-5241 Planning 536-5271 Housing 536-5271 Government Code Section 68850.2(b) requaras 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. 1. 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 Division 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 (71.4) 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 tle release can be issued. Because of the time it may tame for AQMD to go through the above procedures, the applicant is advised to contact AQ1-W 9mmediately after applying for Building permits. (1360D)