HomeMy WebLinkAbout10114 Adams Ave - CofO (2)APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT
(PRINT OR TYPE ONLY)
7/20/99
DATE
Address _ 10114 Adams Street, Huntington Beach 92646 District
Business Name Stater Bros. Markets 4147 Tel(714)963-0949
Business Type Ret97I LSunezat Xk_et _ Occ Group
BUILDING OWNER BUSINESS OWNER/MANAGER
Name Business Properties Partnership No. t>la5ne Stater Bros. Markets '
Address P. 0. Box 19586 Home Address-
21700 Barton Road (P.O. Box 150) T
City Irvine, CA 92713-9586 Tel City Colton, CA 92324 Home Tel.
THIS USE WOULD BE DESCRIBED AS:
❑ NEWLY CONSTRUCTED BLDG. CHANGE OF OWNER ❑ CHANGE OF OCCUPANT
® EXISTING BUILDING CHANGE El ADDITIONAL OCCUPANT
Indicate former use. if any Retail Supermarket _ _Occupancy Gr Div
o-perated by Aj�e��jon's
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 buildinl 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
'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 maybe made in the character of occupancy or use of tha huilding
or premises which would place the building in a different division of the same group of occup; r in a
different group of occupancy, a change of occupanc%, '.ispection fee of $ _ shall
be paid to the city.
Huntington Beach Fire Code Section 10.208 requires that building numbers must be a minis of four (4)
inches in height with one half (1/2) inch stroke, and of a contrasting color from the backg, . and. 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).
Ni W4=, ob4 1zR `t (-z-t (cl o1 1,J o7
*__,j fry 'I^ +£.: .71:trr
DAtti FAI
(FOR OFFICE USE ONLY) CC),
14AME ..._._ ZONING
OCCUPANCY GROUP PLAN CHECK NO NO PARKING SPACES
OCCUPANT LOAD . 4 PERMIT NO HEALTH DEPT APPROVAL
NO. OF SY
�— ADMIN ACTION— — UTILITIES RELEASED
CERTIFICATE OF OCCUPANCY FEE $APPR DATE CHANGE OF USE OR OCCtiPANCY FEE
TOTAL $ �lJ
75.039 Rev. 1/97 � '.f hRU :(; Y _jF%1ENT
WU� VJ)020--`
South Coast
AIR QUALITY MANAGE11
21865 E. Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-2000
AIR QUALITY PERMIT CHECKLIST
for nonresidential buildings only
Company Name: Stater Bros. Markets #148
Location of Property: 7101 Warner Avenue, Hunting',on Beach 92647
City: Huntington Beach
Contact Person: Phillip J. Smith
Zip Code:
92647
Title: • P • , Controller
Telephone Number: (909) 783-5287 FaxNumber:__(909) 783-5035
Type of IndustryBusiness: Retail Supermarket
To apply for a nonresidential building permit, you must complete tl ds checklist. 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)?
[VJ [ ]
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?
[ ] [ ✓jam
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?
7.
Will any combustion equipment rated greater than 2,000,000 BTU/hr be
operated at the facility?
[ ] [v]'
8.
Will any acids, solvents, or motor fuel be used or stored at the facility?
[ ] [co]"
9.
Will any organic liquids or gases be reacted or produced?
[ j [ vj-�,
10.
Will any ovens be used to dry or cure products at the facility?
[ ] [ 4
11.
Will any CFC (Freon) recycling machines operate at the f ity'
[ ] [ ]
Applicant: Phillip J. Smith Signature:
(Print name clearly)
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 (AQMD). Please read the requirements on the back of the checklist.
(800) 38S-2221
1NFORN."ATk."iI
w 1
BUSINESS ADDRESS
SUPPLEMENTAL INFORMATION
7101. Warner Avenue, Ndntington Beach 92647
2. Person to contact in case of emergency- Steve Landry, Dist.
Telephone number: _(909) 822-5740 _
3. Does the,.'building in question have electricity?
(a) If No, are you requesting that the electricity be
turned on?
4. The building is sprinklered?
5. Operations will produce dust/wood shavings or similar
material?
6. Operations will involve tl: , repair or replacement of
automobile parts?
If Yes:
(a) Describe tl . cL,�.ponents repaired or replaced.
�9 Yes
❑ No
❑ Yes
❑ No
❑ Yes
J29 No
❑ Yes
ES No
(b) Does the operation involve the use of an open flame? ❑ Yes
E9 No
7. The business is drinking, dining or assembly use that will
result in an occupant load of more than 50 persons. Yes
❑ No
8. The following best describes my operation;
Office Only
aWT erf ous_e
Manufacturing / Distribution (describe process and end product)
Restaurant/Take Out Food
Medical / Dental
Other (describ6)
SUPPLEMENTAL INFORMATION (Continued)
Does the operation involve any of the following materials?
If Yes, indicate quantities:
Material Quantity
1. Flammable liouids
Class I -A
Class 1-13
Class - I-C
?. Ccmbustible liquids
Class 11
Class 111-A W
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. Nitromethai,e (unstable ;materials)
16. Ammonium nitrate
t
❑ Yes'
;! No
17. Ammonium nitrate compound mixtureQ
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 be my knowledge.
r-_l _ July 20, 1.999
hil ri °�!Vffft Date
V.P., Controller