HomeMy WebLinkAbout10120 Adams Ave - CofO (4)11
CERTIFICATE O`" OCCUPANCY
CITY OF HUNTINGTON 6EACf I
2/G6/96
Date
10120 ADANIS
Address District
Busi^,ess Name Tel.
�.`�'Y"Gli'ly'(:SLOT ri n ) r�
Business Type _ g Occ. Group
BIJSINESS F ii DING OWNER EUGEI USl 5��01I F j ANAGER
Name Name
17631 PITCH Home 5252 WARDLO?•!
.',!dress Address -
1 V CA. .4 ( ^UyU N < CA. H8me - 7
City . Tel. City 40 Tel.
Construction No. of Stories Occupant Load Sprinki-ars
G�NDITIONS OF APPROV^
DEPARTMENT OF COMMUNITY DEVELOPMENT
This Certificate of Occupancy
SHALL BE posted in a conspicuous place on the
premises and shall not be removed cxcept by the by
Building Offiriai.
COMMUNITY DEVELOPMENT
APPLICATION FOR CERTIFICATE OF OCCUFVNCYCITY OF HUNTINGTON BE:^.CHDEPARTMENT OF COMMUNITY DEdELOPMEN
HUNnNLTON W4CH DATE
(PRINT OF TYPE ONLY)
,/Address \ O t 7-O AD AM 5 ,AV C , _ District
/Business Name 02� �2 � Cb, b t�' Slot CO-T _ Tel.
1-1�usiness Type lhb eqO tz-p S Lc'r ea, z Occ. Group
r
BUILDING OWNER BUSINESS OWNERIMANAGER
ydme RV!^CNe _
� ame �I r� e- �t"O Ir7 2 � �' �� /, r
/ddress �� 1 ch f-r-:s-r^ / Address Svc` le, tv1.
ity i�) t n e � Zr� (� Tel,�L4'1 nop -61y L Q A F)�&tc k CA. Home Tel Ll2;7-b5
THIS USE WOULD BE DESCRIBED AS: \
O❑ WLY CONSTRUCTED BLDG. ❑ CHANGE OF OVv„tH CHANT" OF OCCUPANT
XISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT
(Indicate former use, if any21�?Q—zsS Occupancy Gr. Div.
SQUARE FT, OF BUILDING TO BE OCCUPIED t( Ofl
N ICE: 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 urtil the service has been inspected and
certified safe. All applicants for occupancy in an existing building are required to schedule a:1 electrical
( 'fuse up' inspection in the Departmer.1 of Community Development at the time this application is filed.
3. Change of occupancy or use inspection tee. 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 the building
or premises which woul•' ^e the L'ailding in a lifferent division of the same group Of occupancy or in a
different group of occupancy, a cha-iga of occupancy inspection fee of $ shall
be paid to the city.
4. Huntington Beach Fire C -de Section 10.208 requires that building numbers must be a minimum of four (4)
inches in height with one half (1/2) inch stroke, and of a contrastinn 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).
TRAFFIC IMPACT FEE -
DATE _
DATE PAID /
AMOUNT RECEIVED
NAME 1-1
SUPPLEMENTAL INFORMATION
OCCUPANCY GROUP
OCCUPANT LOAD
NO. OF STORIES
- 6 - 76
,Af-F O ED BY DATE
/
75-039 Rev. 11/90
(FOR OFFICE USE ONLY)
PLAN CHECK NO
PERMIT NO _—
ADMIN ACTION_
CERTIFICATE OF OCCUPANCY FEE
CHANGF OF USE OR O CUPANCY FEE
TOTAL f /� �jE—�
COMMUNITY DEVELOPMENT
17
ZONIN
NO PARKIN(JI BRACES
HEALTH DEPT APPROVAL—...
UTIU': iES RELEASED
SUPPLEMENTAL INFORMATION
i. BUSINESS ADDRESS IOD 12ID A&2s,kx 3 A — .
2. Peraon to
contact in case of
emergency- 62 emse- /Slessr nc�do
Telephone
number:
.311 H2 L-5y t-
3. Does the
building in question
have electricity?
Z—Yes
❑ No
(a) If No,
are you requesting
that the electricity be
❑ Yes
turned on?
❑ No
a,. The building is sprinKi;:rA�J? ❑ Yes
ONo
5. Operations will produce dust / wood shavings or similar
material? ❑ Yes
allo
6. Operations will involve the rerair or rep;acement of ❑ Yes
automobile parts? )) No
If Yes:
(a) Describe the components repaired or replaced.
(b) Does the operation involve the use of an open flame? ❑ Yes
F� No
7. The =siness is drinking, dining or assembly use ihat will
result i an occupant load of more than 50 persons. ❑ Yes
® No
8. The following best describes my operation;
Office Only
Retail Sales
WarehJse
Man�ifacturing / Distribution (describe process and end product)
Restaurant / Take Out Food
Medical / Dental
Other (describe)
SUPPLEMENTAL 1NFORMATIOP?
SUPPLEMENTAL INFORMATION (Continued)
Doe, the operation involve any of the following materials? ❑ yes
No
If Yes, indicate quantities: I
Material Quantity
1. Flammable liquids
Class I -A
Class I-B
Class I-C
2. Combustible liquids
Class II
Class Ill -A
3. Combination flammable liquids
4. Flammable gases
5. Liquefied flammable gases
6. Flammable fibers - loose
7. Flammable fibers - balea
8. Flammable solids
9. Unstable materials
10. Corrosive liquids
11. Oxidizing material - gases
12. Oxidizing material - liquids
13. Oxidizing material - solids
i4. 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 ting powder
I hereby certify that the above information is true and correct to
the best of my knowledge.
i ture Date
SOUTA COAST AIR QUALITY MANAGEMENT DISTRICT
(Nonresider tlal Buildings Only)
Location of Subject Property:_ l`D tt
Property Owner Name:_�0L5?_VN �s� R ill .C1.._�ac_ Phone #:.._--Li7 L1 -59,0o
Name of th�: person preparing this form in print and signature:
Sionat.46�Z4
kkQ,kkt_ -
Tht person preparing this form rr ust be the sa,:ie person ap ilding permits. Please answer the
following questions-E3arding your proposed occupancy of the subject building IF YOU DO NOT KNOW
THE ANSWER TO A QUESTION, MARK IN THE "YES" C,_'X.UMN:
AQM0 PERMITTING CHECKLIST
0*1
1. Does your facility use any internal combustion engines greater than 501•11P?
2. Does your facility involve mixing, blending, or processing any solvents,
adhesives, paints or coatings?
3. Does your facility create an} dusts or smoke? _.
4. Does your facility refine any liquids of solids or reclaim any ; atals?
5. Does your facility plate or cent anything?
5. Does your facility have any combustion equipment (i.e. boile-, furnaces,
broiler, baking ovens, etc.) rating greater than 2,000,000 BTU1HR?
7. Does your facrflity handle or store solvents or motor fuel? _
8. Do your use or store any acids?
9. Do you use any chemical ,process? —
10. Do you use any solvento for clean-up?-
11. Are you a dry cleaner, restaurant with a charbroiler, body shop, gasoline
station, printer, ter part coater?
12. Is the subject building located within one thousand (1.000) feet of any
schoo,? PROPERLY LINE TO PROPERTY LINE. GRADES K-12.
NO
If you have marked "NO" in all columns, you do not need an Air Quality permit at this time. If you have marked
any questions in the "YES" column you must contact the South Coast ".0, Quality Management District located at:
21865 E. Copley Drive
Diamond Bar, CA 91755-4182
Please call: Plan Check (909) 396-9.0t