HomeMy WebLinkAbout10112 Adams Ave - CofO (3)CERTIFICATE OF OCCUPANCY
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CITY OF HUNTINGTON BEACH
Date t
I Address 10 1 12 ADaIt1:,
II
District
Business Name LGuPS TtiaLi. Ti tu'
Tel.
7;, 1 `• ^ t'
TA L B �iness Type : T1;x ice'
Occ. Group A
BUILDING OWNER
BUSINESS OWNER/MANAGER
DU'INES-t.' PROPEPTII;S
CE I.YL ;a hROUY i
Name
Na. ie
Address P.O. B G X 1 s 5& b
Home } t
Address 4 SC'2 `.A:IVG_U,
DR i
TRVlbE CA ilri^iii4- ��v. LS(3u,;A HILLE
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City . City Tel.Tel.
.f1!a h5ti--2711 i
Construction No. of Stories 1
Occupant Load F; Sprinklers
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CONDITIONS OF APPROVAI
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DEPARTMENT OF COMMUN'TY
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DEVELOPMENT t
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This Certificate of Occupancy
SHALL BE posted in a conspicuous place on the
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premises and shall not be removed except by the
by C ^.+
Buitdiny C?fficial.
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COMMUNITY DEVELOPMENT
__ _ ___.._._.__ --_— -- — _ ,_..—_--- -7
APPLICATION! FOR CERTIFICATE OF OCCUPANCY
�--�, CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT 12-••
HUNTINGTON BEACH (PRINT OR TYPE ONLY) DATE_
Address 1621 _ District_
Business Name �CF`- -i 'C3 ry��lS �• '?" 7� " 37�i �1��3
Business Type moc& MnutsOcc. Group -
BUILDING OWNER /BUSINESS OWNER/MANAGER
Name �!" SS a"f 14
/ C • Name C 443-/G'� 15 k-Ocllfl
Address_ C. R�X �G%OAddress Z 10 / r(,tv(1�1q+0h 0lr.
City_Gf-'// �t� TelCity LCt Ga L 1 1- �'f_d �' Home Tel. ? 1 `{)
THIS USE WOULD 13F DESCRIBED AS: Z
NEWLY CONSTRUCTED BLDG.OCHANGE OF OWNER HANGE OF OCCUPANT
EXISTING BUILDING CHANGE OF USE ❑ ADDITIONAL OCCUPANT
indicate former use, if any��f�t� A
Occupancy Gr.1.10 Div.
SQUARE FT. OF BUILDING TO BE OCCUPIED
3' In
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 schedule an electrical r`
'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 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.
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4. Huntington Beach Fore Code Section 10.20% requires that building numbers must be a minimum of four (4) k
inches in height with one half (1/2) inch stroke, and of a contrasting color from t! background. These
numbers must be posted on your building in a location that is visible from" a street.
5. Huntington Beach Fire Code Section 10.301 requires fire extinguisher se]L.,00n and distribution per the
National Fire Protection Association par, phfet 10 (see reverse side).
TRAFFIC IMPACT FEr--*ZA �" 2V11r,
DATE MAID
AMOUNT RECEIVED
NAME
) l�
SUPPLEMENTAL INFORMATION. (FOR OFFICE USE ONLY) /� ZONING.i 1 __!
OCCUPANCY GROUP PLAN CHECK NO. NO PARKING SPACES
OCCUPANT LOAD P E n M I T NO. F HEALTH DEPT APPROVAL
NO. OF STORIES ADMIN. ACTION UTILITIES RELEASED
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1-71 CERTIFICATE OF OCCUPANCY FEE $ ,
APP D 8 DATE CHANGE OF USE OR OCCUPANCY FEE $
TOTAL $_
75-039 Rev.11/90 COMMUNITY DEVELOPMENT
SUPPLEMENTAL INFORMATION'
1. BUSINESS ADDRESS 100`Z�/`��� A
2. Iverson to contact in case of emergenc;�
Telephone number: 14 1 '711-/- q54/-z70
W ° 351) - Z - Zo IDo
3. Does the building in question have electricity? Yes
❑ No
(a) if No, are you requesting that the electricity be ❑ Yes
turned tin? No
4. The building is sprinklered? ❑ Yes
X No
5. Operations will produce dust/wood shavings or similar
material? ❑ Yes
No
6. Operations will involve the repair or replacement of ❑ Yes
automobile parrs? No
If Yes:
(a) Describe the components repaired or replaced.
(b) Does the operation involve the use of an open flame? ❑ Yes
>ZI No
7. The business is drinking, dining or assembly use that will
result in an occupant load of more that; 50 persons. ❑ Yes
No
8. The following best describes my operation;
fa
Only
Sales
greh(ouse
Manufacturing / C stribution (describe process and end product)
Restaurant/Take Out Food
Me al / Dental
Cher describe)
e
SUPPLEMENTAL INFORMATION I
SUPPLEMENTAL INFORMATION (Continued)
Does the operation involve, any of the following materials? ❑ Yes
'VrNo
If Yes, indicate quantities:
Material Quantity
1. Flammable liquids
Class I -A
Class I-B
Class I-C
2. Combustible IiquiJ3
Class II
CInss 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
11. Oxidizing material - gases
12. Oxidizing material - liquids
13. Oxidizing material - solids
14. Organic peroxides
15. N:iromethane (unstable materials)
16. Ammonium nitrate
17. Ammonium nitrate compound mixtures
containing more than 60% nitrate
by we'i:iht
18. Highly toxic material and
poisonous gas
18. Smokeless powder
20. Brack sporting powder
I hereby certify that the above information is true and correct to
the best of my knowledge.
_ 12
Signature Date
SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT
(Non residential.Buildings Only)
Location of Subject Property: ---
Property Owner Narne:Pho
Name of the person preparing this form in print and signature:
Nam f�C .� ---�
�>_ __. Signatures_ —
The person preparing this form must be the same person 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" "OLUMN:
AQI4iD PERMITTING CHECKLIST
YES
NO
1. Does your facility use any internal combustion engines greater than 50HP?
2. Des your facility involve mixing, blending, or processing -try solvents,
:,1,*sives, paints or coatings?
3. Does your facility create aht 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,
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broiler, baking ovens, etc.) rating 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 Chem* -al process?
10. Do you use any solvbits for clean-up? _ X
11. Are you a dry cleaner, restaurant with a charbroiler, body shop, gasoline
station, printer, br part coater? _
12. Is the subject building located within one thousand (1,000) feet of "any X
school? PROPERTY LINE TO PROPERTY LINE. GRADES K-12.
If yol9 have marked "NO" in all columns, you do riot need an Air Quality permit at this time. If y3e havo marled
any questions in tho "YES" column you must contact the South Coast Air Quality Management Distt iat located at:
21865 E. Copley Drive
Diamond Bar, CA 91765-41`32
Please calk Plan Check (909) 396-2000