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Home My WebLink About10116 Adams Ave - CofOCERTI FICA i E OF OCCUPANCY [)E PARTMENT (,-CVNIUNITv DEVELoPME14T aP AC*1,1,:;— 1 116 &daMs, Alag D AC , W—BILTDALS & -TLLXZDC&-FI - Luslnp�s Type BRTnAT.S L-TUXED0,0x— BUILDING OWNF BUSINESS OWNERiMANAGER Name L. C. S-MUll/JaMea A ChriStensen Janna Z Segal 17631, ipitoh 16455 Vernc>n St. Awres.� Oty-- T.,.vine, CA 92714 474-8900,-,., Fountain -- This Certificate of Occupancy SHALL BE posted in a conspicuous place o, the premises and shall no! be removed ex- cept by the Buildino O'ficial DEPARTMENT ,-)F COMMUNITY DEVELOPMENT r;V fi AMACATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT P., THIS USE WOULD BE DESCRIBED AS: J, NOTICE: 0 f t -c- C� vvill not -t.__d uT;tTf ti ie t;�, iid rj has been :Ind a f 2No electrical service Yvfai bt� lw;- and Ali "1 11— tS11"(1 Iling 've re(lwi od lo an electrical up, 11 :r" 0C."'k thzs 1F, fi4j1 -1 dtfig or Change of occupancy or use inspdction fee. Vj�z,;�l fabu!" pfefr!"e, -.hlch Cv!;I!d J11, :I,)f "no 'IP'."ip of occupancy or w a 'cc 1-1 1;pawc .., ;,i ft)e of s0a;l to "be 4. Huntington Beach Fire Code Section J--" 18 tl-a,t h,;iri:"o mij h,rI,wwn(inr. of k)t IT 14) 1v71,-1ri",6 height 11,-g- 1. L11 , 14 f I :7 COF", 0o i.3, ,JN d. The�;e �iwfiber. 17'u-;t ri th-I! ftclkt :"V"M, Huntwgton Beach Fite Code Section J1--,ttb1I!iGn Pet the lil' Iov, r- IFOR OFFP� E USE ONLY) SUPPLEMENTAL INFORMATION V, osR7FiCATsoPOCCUPANCY CITY OF HUNTINGTON BEACH h/1E/�L Date Address 1G,116 AEANS District Business Name Tel. Business Type occ.omuv BUILDING OWNER ouomsayowwcn/MAwwosn �U;�Z�� bIIE�� Pu�L C�8�IK�l mu�o Name Home *aumou Amumso cityn'/'___2�� / — c/w Home n^/.�—__2� Construction No. mStories Occupant Load ___1' Sprinklers CONDITIONS opAPPROVAL DEPARTMENT OpCOMMUNITY DEVELOPMENT TI'suertnicate of Occupancy SHALL asposted ma^vnonmuou pt,ace on the promises and shall not uaremoved except by the by _____ Building Official. COMMUNITY DEVELOPMENT � � ----------------------------- ~---------------- -------------------- ------------------------------- b k APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH p (k� DEPARTME IT OF COMMUNITY DEVELOPMENT HUNTINGTON BEACH (PAIN,' OR TYPE ONLY) DATE Address/ �� `�%�� j7 S �._ �� / — District Business Name4e_-f1_f,Zj_ f /_;S �y , /�% %i1y_ TPI Business Types %/✓S��✓S.li.+VG s� f� `i✓ �� it/C� Occ Group BUILDING OWNER BUSINESS OWNERIMANAGER NamAuS %%GCS ��c��' iJFS Name_Home Addre>s/df ,! Address ,e,'�r Cit Home Te15�4+� rTHIS' USE WOULD BE DESCRIBED AS: NEWLY CONSTRUCTED BLDG ❑ CHANGE OF OWNER CHANIaE OF OCCUPANT EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT cate former use. if any — ;JJ J % c) I __Oc upancy Gr Div ARE FT. OF BUILDING TO BE OCCUPIED, y� C NOTICE: 1. Occupancy of any building is prohibited and a business license will not be issued until the building has beet inspected and a ceifificate of occupancy is issued. N r electrical service will be released for any existing building until the service has been inspected ano certified safe All applicants for occupancy in an existing building are required to schedule an electrical 'fuse up' inspection in the Departmerc 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 cl- ange may be made in the character of cl= pancy or use of the building or premises which would place the'luilding in a different division o` the same group cf occupancy or in a different group of occupar^y, a change of occurancy inspection fez of $ shall be paid to the city. 4. Huntington Beach Fire Code Section 10.208 requires that building numbers must be a minimum of four(4) inches in height with one half (1/2) in0 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 fire extinguisher selection and distribution per the National Fire Protection Association pamphlet 10 (see reverse side). (FOR OFFICE USE ONLY) SUPPLEMENTAL iNFORMATION OCCUPANCY GROUP PLAN CHECK NO _ OCC,-jPANT LOAD PERMIT NO ( NO. OF `STORIES f ADMIN ACTION < CERTIFICATE OF OCCUPANCY FEE A OV BY --� DATE CHANGE OF USE OR OCCUPANCY FEE TOTAL 75-039 Rev. 11/90 CCMP4UNITY DEVELOPMENT ZONING NO PARKING SPACES HFALTH DEPT APFf20VAL UTILITIES RELEASED SUPPLEMENTAL INFORMATION_ 1. BUSINESS ADDRESS .s ��! = ,,��.�'J /'�S V 2:; 2. Person to contact in case of ernergency•.,�4-2-4/22 Z_ Telephone n xnber: ' 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 the repair or reNlacement of automobile parts? If Yes: (a) Describe the components repaired or replaced. -mac Y es ❑ No ❑ Yes ❑ No ❑ Yes - No ❑ Yes -bkm ❑ Yes No (b) Does the operation involve the use of an open flame? ❑ Yes -IS� No 7. The business is drinking, dining or assembly use that will result in an occupant load of more than 56 persons. ❑ Yes 1 N o 8. The following best describes my operation; Office.. �` Reta�ouse es :: - are Manufacturing / Distribution (describe process and end product) Restaurant/Take Out Food Medical / Dental Other (describe) LV- SUPPL!RENTAL INFORMATION SUPPLEMENTAL INFORMATION (Continued) Does the operation involve any of the following mime,-ials? El yes '-E I'l o �f -yes, indicate auar,titie�s: . Material Quantity 1. Flammable liquiGs Class I -A Class l --B--- Class I-C 2.Combustible liquids Class II Class Ill -A 3. Combination flammable liquids 5-----D-quefied flammablegases Flamrr—lai;ie— fibers loose T Fiammable fibers baled g. Ci-n--si-ab!I:T—m—ater—iais i 6orrosive liquids 1. —6x-ng material -gases idizi 12Oxidizing material - liquids 13< Oxid;zing material - solids 14. Organic; peroxides 15. Nitromethane (unstable materials) 16. Ammonium nitrate 17. Ammonium nitrate comp,)und mixtures containing more than 60% ritrate by weight 16, Highly toxic mateyitand poisonous gas 19. Smokeless powder 20, Black soort.,ig powder I hereby, certify that the above information is true ana correct to the bpsf of my knowledge. Signature ate ta! City ®f Huntington, Beath 2000 MAIN STREET .�. CALIFORNIA Q2648 DEPARTMENT OF COMMUNITY DEVELOPMENT Building 535-5241 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. 1. The applicant (the same person who applies for Pgrmits 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 (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 P910. 5. If air permits are required, the applicant must submit the necessary permit applications before the releas-e can be issued. Beca•se 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. (1360D) SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT (Nonresidential Buildings Only, Location of Subject Property- ^ 4g-2A /?.S /-) !/C= __ Property Owner Name: Phone # Name of the Person Preparing this form in print a gnature Name:,L�%UL Signatur, The person preparing this form must be the same p p p g 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" COLUMN: AQMD PERMITTING CIiECKLIST YES NO 1. Does your facility use any internal combustion engines greater than 50-HP? 2. Does your facility involve mixing, blending, or ti processing any solvents, adhesives, paints or coatings? 3. Does your facility cre,,te any dusts or smoke? - - 4. Doss your facility refine any liquids or solids or reclaim any metals? _ 5. Does your facility plate or coat anything? _ 6. Does your facility have sny 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? _ 7c 10. Do you use any solvents for clean-up? it 11, Are you a dry cleaner, restaurant with a charbroi'ler, body shop, gasoline statiun, printer, or part coater? 12. Is the subject building located within one x thousand (1,000) feet of any school? PROPERTY LINE TO PROPERTY LINE. GRADES K,-12. If you have marked "NO" in all columns, you do not need an Air Quality permit at this time. If you have marLYd 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 (714) 396-2000 (1360D-2)