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Home My WebLink About10104 Adams Ave - CofO (3)APPLICATION! FOR CERTIFICATE OF OCC urjANC:Y CITY OF HUNTINGTON BEACH DEPARTMENT OF BUILDING & SAFETY tn,NTV4GTO t BEACH (PRINT OR TYPE ONLY) Address / le-0 iz .5, /T k1/ l"'" tie,711 e B e:'k Business Business 3 --z--) 2- DATE District d Tel.�t/ 3 %O ae,"-C Occ. Group BUILDING OWNER BUSINc5SOV'NEruMANAGER Name _ siS�, ,x,�tr4v74;ae �- Home Address / 7 ,� 3 i /" ,�C �` Address City i7i'r_%1 /r �i7- Tel City C21/-� Home Tel. y? Lf-? 7 a-rj THIS USE WOULD BE DESCRIBED AS: ❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER N/C'HANGE OF OCCUPA, IT LJ EXISTING BUILDING / ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT Indicate former use, if any �' /c f �' >r*� Occupancy Gr.�.Div SQUARE FT. OF BUILDING TO BE OCCUPIED. i 6 6 � = � 7 NOTICE: 1. 2. 3. 4. 5. /171hIMcttn Z Cc Occupancy of any building is prohibited and a business license will notbe issued until the buildil\ng has been inspected and a certificate of occupancy is issued. 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 Commurity Developrrent at the time this application is filed. Change of occupancy or use inspection fee. Whenever it is necessary to make inspection of a building or premises in order to determ ne if a change may be made in the c naracter of occupancy or use of the bui. ling or premises Which would place the building in a different diviF,on of the same group of occupancy o - in a different group of occupancy, a change of occupancy inspection fee of $ shall be paid to the city. Huntington Beac:a Fire Code Section 10.208 requires that building )umbers must be a minimum of four (4) inches in height with r'iie half (1/2) inch stroke, and of a contrastir,g color from the background. Thase numbers must be p,;sted on your building in a location that is visible from the street. Huntington Beach Fire Code Section: 10,301 requires fire extinguisher selection and distribution per the National Fire Protection Association pamphlet 1 (see reverse side). 5/07 .26 _ (FOR OFFICE USE ONLY) U �� ZONING OCCUPANCY GROUP I OCCUPANTLOAD 1-7 NO. F TORIES i PLAN CHECK NO. PERMIT NO. ADMIN, ACTION - NO PARKING SPACES — HEALTH DEPT APPROVAL UTILITIES RELEASED — CERTIFICATE OF OCCUPANCY FEE CHANGE OF USE OR OCCUPANCY FEE $ TOTAL $ FORM 75-039 REV 2102 PE -ORDER SAND OOLLPR 71"-842-1148 131"i4 wO.ABs•: SUPPLEMENTAL INFORMATION 1. 13USINESS ADDRESS ,I69/ce"'61 ,92a� 2. Perszn to contact in case of emergency. ell Telephone number: 7/4rv�''C� 3. Does the building in question :ave electricity? 1:3 Yes ❑ No (a) If No, are you requesting that the electricity be ❑ Yes turned on? r' No 4. The building is sprinklered? ❑ �'es El -No 5. Operations will produce dust/wood shavings or similar material? ❑ Yes `C -I Jo 6. Operations will involve the repair or replacement of ❑ Yes automobile parts? t- - o If Yes: (a) Describe the components repaired or replaced. (b) Does the operation involve the use of an open flame? C1 Yes -C 4o 7. The business is drinking, dining or assembly use that will result in an occupant load of more than 50 persons. ❑ Yes Q-N o 8. The following best describes my operation; Oti„e Onfy ®_k -ReiV-Sa es W--ehouse Manufacturing / Distribution (describe process and end product) Restaurant/Take Out Food Medical / Der,`cai Other (describe) SUPPLEMENTAL INFORMATION 'Continued', 11 1 Does the operation involwe any cf the lollowing materials? 0 "(es If Yes, indicate quantities: Material Quant,�ty Flammable liquids Class I -A Class I-f3 Class I-C 2. Combustible liquids Class 11 Cla,,, 111-A 3. Combi'-tion flamm---a-b-)e- liquids 4. F-Ia—mm-WD-e gases 5. Liquefied flammable gases 6. Flammable fibers - loose 7. Flammable fibers - baled T Flammable solids 9. --Un-ii'able materials 10. Corrosive liquids 11. Oxidizing maier!al - oases 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 I hereby ceri,'y the above information is true and correct to the best of my knowiedge. Signature Date Seth Coast AIR QUALITY MANAGEMENT DISTRICT 21$65 E. Copley Drive, Diamond Bar, CA 91765 41 82 (909) 396 2000 AIR QUALITY PERAHT CHECKLIST for nonresidential buildings cnly Company Name: �% I -5'/C % 'Ir t' Location of Property: City:� -� /—fir i �L �,-� G /�-- Lip Code: c� Contact Person: X /l rL Telephone Number: ('/V -- 3 Z P- — Za-r -, Fax Number: _ // C/ l F-— ! 6 / '? Type of industry/Business: e' - --,i� 2 c J To apply for a nonresidential building permit, you must complete this checklist. If you have any questions about completing this checklist, please call (800) 388-2121. YES NO 1. Will the facility have a cha:rbroiler? ( ] [ 2. Will any internal combustion engine with greater than 50 horsepower operate at the facility (excluding motor vehicles)? [ ] [ L]--- 3. Will operations at the facility involve nixing, blending, or processing of solvents, adhesives, paints or coatings?L}- 4. Will dust or smoke be generated at the facility? [ ] [ �}- 5. Will refining of any liquids or solids be done at the facility? 6. Will any plating or coating of materials be done at the facility? [ ] Ci} 7. Will any combustion. equipment rated greater than 2,000,000 BTU/hr be opera*t!d at the facility? [ } [ 8. Will any acids, solvents, or motor fuel be used or stored at the facility? [ ] [� 9. Will any organic liquids or gases be reacted or produced? [ ] [ A---- 10. Will any ovens be used to dry or cure prod=, is at the facility? [ ] [ a 11. Will any CFC (Freon) recycligachines operate at t; ;cility? Applicant: ��"' ? ''Z�,t ,U -uSignature: (P It name clear j If you have marked "NO" in all the boxes, an air quality permit Is not 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 (AQM1D). Please read the requirements on the back of the checklist. (800) 388-2121 4iM+ g t.b..�Je: if Aa ...v.✓ eIsiar„ ..e "% '� �r:jl x..✓E: APPLICATION FOR CERTIFICATE OF OCCUPANCY t . CITY OF HUNTINGTON BEACH DEd�ARTMENT OF COMMUNITY DEVELO!'MENT '� 1• HUNTNGTON BFnU1 (PRINT OR TYPE ONLY+ b 4TE ,Address 1p `p�5 District Business Name �{ Tel Business Type Occ. Group BUILDING OWNER BUSINESS OWNER/MANAGER Name &� I a. ne-1- 0. N S - Home t .2 �2- '1 PaAddress /+OKI,1, 3%3U �� Address/ City t.— /� d--Sg _Tel •T�_!!�5 _119CIIy �',`f L ! �1—�c_�� H mE( Tel-4 5 -707 THIS USE WOULD BE DESCRIBED AS: ❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER ❑ CHANGE OF OCCUP,'.NT XEXISTING BUILDING �/ ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT Indicate former use, if anv r�_� (� _—_— Occupancy Gr SQUARE FT. OF BUILDING TO BE OCCUP'ED =--� — 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 intii 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 =fled. 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 character of occupancy or use of the building or premises which would place the Ouildinq in a different division of the same group of occupancy or in a different group of occupant a change of occupancy inspection fee of S shall be paid to the city. 4. Huntington Beach Fite Code Section 10.208 requires that building numbers must be a minimum of four (4 j 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 vocation that is visible from t, a street. 0. Huntington Beach Fire Code Section 10.301 requires fire extinguisher selectic- and distribution per the National Fire Protection Association pamphlet 10 (see reve.se side). Tt-ttvFFIC4F'?'sr,"r'f FVr DATE AMOUNT BaCitiVED iiitlME OCCUPANCY GROUP OCCUPANT LOAD�� NO OF STORIES -- r APPAOVE9 BY " DATE (FOR OFFICE USE CN[Y) ZONING�' ._ PLAN CHECK N o'C1 PARKING SPACES PERMIT NO ..()�� 14' ALTH DEPT APPROVAL ADMIN ACTION _.._w UTit iTIES RELEASED CERTIFICATE OF OCCUPANCY FEE $ CHANGE OF USE OR OCCUPANCY FEE $ — TOTAL $^ 75-039 Rev. use COMMUNIT" DEVELOPMENT SU1PP'.,EMENTAL INFORMATION 1. BUSINESS ADDRESS 1 e!0 4' Adam :5 2. Person to contact n case of emergency.S Telephone number; 3. Does tiie building in question have electricity? Yes ❑ No (a) If No, are you requesting that the electricity be ❑ Yes tui-ned on? ❑ Nr) 4. The building is sprinklered? ❑ Yes IX No 5. Operations will produce dust/wood shavings or similar material? ❑ Yes f No 6. Operations will involve the repair or replacement of ❑ Yes automobile parts? 0 No If Yes: (a) Describe the components repaired or replaced. (b) Does the operation involve the use of an open flame? ❑ Yes W No 7. The business is drinking, dining or assembly use that will result in an occupant load of nore than 50 persons. ❑ Yes JV No 8. The followinci best describes my operation; ffice n y Ref -- a es Warehouse Manufacturing / Distribution (describe process and end product) Restaurant / Take Out Food Medical / Dental Other (describe) — 1�� SUPPLEMENTAL INFORMATION SUPPLEMEN-iAL &IRSFORMA7'lA ►U (Continued) Goes the operation involve ant, cf "wE fo lowing mat- rials`:' 0 Yes No If Yes, indicate quantities;__--- Nlaterial ")Uantat�,• 1. Flammable liquids ._.__.....W....�_---�_.— Class I -A Class l-s Class I -G 2. Combustible liquids �_._..._...,._-..s..._..,.-._._...__ ..._.—� Class } 1 Class Ill -A 3.-. Combination fiammable liquidw_-- 4. gases 5. Liquefied fiarnmaole gases 6. Flarnmable fibers - loose �.lamrr�able�fibers - baled i3 ��. _ irBanrrr� :1,�}e sc.iids g. .—��µt.3n�daf�ie �materiais 16 Corwosiv�! liquids 0,)-,, ir�g material gases 1?. Cxiciazing i,.aterial - liquid; i3. Cxidizi;ag material - so€ids 14. Organic peroxic •-!s 15. l`�litr o-m- ethane (unstable rr��?r� 16. Ammonium nitrate 17. nitrate co',iiirounCi mixt'lwe& containing more than 6VS ritl'a b:{ w,aight 18. highly toxic material and poisonous gas 19. Smokelesspowder_ _.-.._._..__....._..__.—... ___... `�0. Mack Msporting powciar.�.-._..,__.._-._.�w__._.._.�.,_.....w...�.�.... I hereby certify that the above information is }r�-,e and correct to the best of my knowledge. South Coast AIR QUALITY MANAGEMENT DISTRICT 21865 E. Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-2000 AIR QUALITY PERMIT CBECKLIST for nonresidential buildings only Company Name: Location of Property: -- In fb A,,I a City; e.�, ( �� Zip Code: Contact Person: _e ,fit ot Pulic-101 Title; Telephone Number: Z Z"i37 -/� / f Fax Number: 71 Type of Industry)Business: To apply for a nonresidential building permit, you must complete this checklist. If you have any questions about completing this checklist, please call (800) 388-2121. YES NO I. Will the facility have a charbroiler? [ N] 2, Will any i.rtemal combustion engine with greater than 50 horsepower operate at the facility (excluding motor vehicles)? 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? [ 5. Will refining of any liquids or solids be done at the facility? [ 6. Will any plating or coatu-zg of materials be done at the facility? [ 1 [^ 7. Will any combustion equipment rated greater than 2,000,000 BTU/hr be operated at the facility? [ ] 8. Will any acids, solvents, or motor fuel be used or stored at the facility? r" [ ] 9. Will any organic liquids or gases be reacted or produced? [ ] [ 10. Will any ovens be used to dry or cure products at the facility? 11. Will any CFC (Freon) recycling machines operate at the facility? [ [ Applicant: A O i v r�tJ0Signature:--r------ (Print game clearly) i If you have marked "NO" in all the boxes, an air quality permi, is not 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 (AQlt'f[D). Please read the requirements on the back of the checklist. (800) 388-2I21 �c NO I GONTRN"MEENT CODE SrCTUDN 65850.2 (AB3205) _H tlw Departments froni State Taw BuildIn.-, erfificalt" of -),:c Anx, th-e� local air quality apency are are Tequ_ checklist. The checkji`t is tho applican.: 51--,!, answ an, ,�;v, ;tonly. Ifthe er v, of YES," th;! !"u, ol -tat" a v, ritte- release from the local air % rif} ing that, tb,,: rl�,! i'l;an,* �i` -;C� baildiT-I- I , a,-3,,,-,wrs to cq!_ i% I'exunerr can accfpt the r-'ease, "u-I cor' et the AQN-fD :,-1hrio k Ca --,'-Ivit, -xe required for any lie ope,atu,(I fiA, - ,A, Q I �!r --s that air quality per. am or t!"at Al!-fi w7iit'p release NNili be issud. as o -11 rrmii� are 7i, �-x, t. not been submitted, the 1!11,,r4 ;-qpropriate fees before a iirl< tcrt vvfllt 1)c issued. oz-pmitteci to ex-ed4 al! cleLiran 1-tter - que,-,u,. However, it rriay take evera-, % f,compliance with. a_� you are advised to contact AQMD -'a, -1 y P,'cr applyike, for buPd-ing rennits. (800) 388-2121