HomeMy WebLinkAbout10142 Adams Ave - CofO (2)CERTIFICATE OF OCCUPANCY
CITY OF.HUNTINGTON BEACH
11/1 111
Dale
Address 1°P140 ADIiN4
District
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Business Name
Tel.
R%STAIIIiANT
A
{
I
Business Type
Occ. Group
BUILDING OWNER
BUSINESS OWNER/MANAGER
i>IIuI, ?'RU k.R'P_:,5
Name
Name
_
i
Address 17bi 1 t'ITCH
Home 1114
Address
DALLAZ
City IRVINE Tel. r
City - G:iRDLh
! itUVr Home
I
1
250
i
Construction. No. of Stories
Occupant Load _ Sprinklers
CONDITIONS OF APPROVAL
Comment*: FIRE DEPT. I'tSWiIT
REc I D FUR T1S iL;I,BLY
7
'
This Certificate of Occupancy
SHALL BE posted in a conspicuous place on the
premises and shall not be removed except by the
,Building Official
DEPARTMENT OF COMMUNITY DEVELOPMENT
by
.J. de,
rn�an+croN etwc /�
Address
Business
Business
5 rq PI v-, f 10Xr ,i r?9
AfTLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT
(PRINT OR TYPE ONLY)
o. w ninir_ n 11co
Name /2 e14 �D e_'
Address 6 y
r
City —� �Ura� Tel.
THIS USE WOULD BE DESCRIBED AS:
ro-a DATE
District
Tel /419 i5-f3•-33I6
Occ. Group 5
BUSINESS OWNER/MANAGER
Name To liL,l Ae4g
Home
Address ��� ��� pR
City�- Home Tel-� L� r
❑ NEWLY CONSTRUCTED BLDG. � CHANGE OF OWNER ❑ CHANGE OF OCCUPANT
EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT
Indicate former use, if any Occupancy Gr. Div.
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 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
'fuse tip' 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 may be made in the characte, 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.
4. Huntington Beach Fire Code Section 10.208 requires thatbuilding numbers must be a minimum of four(4)
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 location that is visible from the street.
5. Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection and dist,' bution per the
National Fire Protection Association pamphlet 10 (see reverse side).
L4`iY1 LtlL�i� 'r(f1 R: _ /�i=5�Y7S- � � /L�• - L A
TRAFFIC INIPAIJT FT
DATE PAID
AMOUNT RECEIVED
NAME. 7
SUPPLEMENTALINF(
OCCUPANCY GROUP_
OCCUPANT LOAD
NO. OF STQ@IES
TION
(FOR OFFICE USE ONLY)
PLAN CHECK NO.
P.-RMIT NO. —
ADMIN. ACTION_
ZONING C(=_
NO. PARKING SPACES —
HEALTH DEPT APPROVAI
UTILITIES RELEASED —
CERTIFICATE OF OCCUPANCY FEE $
CHANGE OF USE OR OCCUPANCY FEE $
TOTAL $
75-039 Rev.1/97 COMNa3NITY DEVELOPMENT
SUPPLEMENTAL INFORMATION
1. BUSINESS ADDRESS
2. Person to contact in case of emergency -
Telephone number:
3. Does the building in question have electricity?
Yes
❑ No
(a) If No, are you requesting that the electricity be
❑ Yes
turned on?
❑ mo
i
4. The building is sprinklered?
Yes
❑ No
5. Operations will produce dust/wood shavings or similar
material?
❑ Yes
No
6. Operations will involve the repair or replacement of
❑ Yes t
automobile parts?
No
j:
If Yes:
i
(a) Describe the components repaired or replaced.:.
(b) Does the operation involve the use of an open flame? ❑ Yes
9 Nc•
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
Retail Sales
Warehouse
Manufacturing/ Distribution (describe process and end product)
estaurant Take Out Food
Me ica / Dental
Other (describe)
4
SUPPLEMENTAL INFORMATION l+
SUPPLEMENTAL INFORMATION (Continued)
Does the operation involve any of the following
materials? L7 Yes
jrF No
If
Yes, indicate quantities:
Material Quantity
1.
Flammable liquids
C::ass I -A
Class I-B
Class I-C
2.
Combustible liquids
Class 11
t
Class 111-A
a
r
Cl.
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
pp
k
14.
_
Organic peroxides
15.
a
Nitromethane (unstable materials)
16.
Ammonium nitrate
17.
Ammonium nitrate compound mixtures
containing more than 60% n'-*,rate
by weight _
18.
Highly toxic material and
i
poisonous gas
^�
19.
Smokeless po%& Jer
20.
Black sporting powdet
pep
I hereby certify that the above information
is true and correci to
the b st of my knowledge.
Signature
Date
South Cast
AIR QUALITY MANAGEMENT DISTRICT
21865 E. Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-2000
AT12 QUALITY ]PERMIT CHECKLIST
for nonresidential buildings only
Company Name: _/Vl e--% L N Motdi n /6�y .
Location of Property: _ a a, GL s -rq� • _
f Zip Code: _ola6g4
intact Person: (� c� Title:
Telephone Number: 1 !Y_ 33<5 rp Fax Number:
Type of Irlustry/Susiness: _.�l/�P-e-/`O-,,L,�--r/./'
To apply for a nonresidential building permit, you must complete this checklist. If you have any
questions
about eompletir_g this checklist, please cell (800) 388-2121.
YES
NO
1.
Wili Vhe facility have a charbroiler? [ ]
N
2.
Will any internal comcustion engnze'u• `:1 ':eater than 50 horsepower
operate at the facility (excluding motor vehicles)? [ ]
[X1
3.
Will operations at the facility involve mixing, blending, or processing of
solvents, adhesives, paints or coatings? [ ]
M
4.
Will dust or smoke be generated at the facility? [ ]
(A
5.
Will refining of any liquids or solids be done at the fa ity? [ ]
M
6.
Will any plating or coating of materisls be done at the-,;ility? [ ]
[j(]
7.
Will any comb, stion equipment rrti,.d greater than 2,000,000 BTUihr be
operated at the facility? [ ]
[)C]
8.
Will any acids, solvents, or motor fiiel be used or stored at the facility? [ ]
[K]
9.
Will any organic liquids or gases be reacted or produced? [ ]
[M
10.
Will any ovens be used to dry or cup., Products at the facilitty? [ ]
[y]
11. Will any CFC (Freon) Q cycling machines operate at ti)e facili ? [ ] [ k]
Applicant: '' L( ram' 6 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 chec"dist is your written release.
If you marked "YES" in any of the boxes, you must conta .t the South Coast _fir Quality
Management District (A'ZMD). Please read the requirements on the back of the checklist.
(800) 388-2121
.AI)DMONAL SUPPLEMENTAL INFORMATION
i
0
APPLICATION FOR CERTIFICATE OF OCCUPANCY
i0a,
CiTY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT
HUNTPCTON awar
(PRINT OR TYPE ONLY)
Address _
Business
Business
3
DATE
District
Tel
Occ. Group_
BUILDING !OWNER BUSINESS OWNERIMANAGEF'
Name— Name i l-t 7 o
Home
—_ n
Address ' X %% Address / 7 t� a'�'/�� jl/
City A-titA Tel.__ City
THIS USE WOULD BE DESCRIBED AS:
❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER ® CHANGE 01: OCCUPANT
EXISTING BUILDING �,�-�/� ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT
Indicate former use, if any y r ' " ' Occupancy Gr. _�7A__ Div. �_
SQUARE FT. OF BUILDING TO BE OCCUPIED R'6
- �f -= e_Viy m r lei -ref "
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 schfduie an e!ectrical
'fuse up' inspection in the Department of Community Development at the time this apr.lication 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 may be made in the character of occupancy of use of the building
or premises which would place the building in a different division of the same group of oc :upancy or in a
different group of occupancy, a change of occupancy inspection fee of t shall
be paid to the city.
4. Huntington Beach Fire Code Section 10.208 requires that building numbers must be a minimun. of four (4)
inches in height with one half (1/2) inch stroke, and of a rontrastinc, color from the background. These
numbers must be aosted on your building in a location thiat is visib : from the street.
5. Hrntington Beach Fire Code Section ',0.301 requires fire extingui,IT?r selection and distribution per the
National Fire Prr,tection Association pamphlet 10 (see reverse side).
73
TRAFFIC h4PACT FIFE �. Tfi"Z �r
DATE PAID PISr v N/aj6 CCIG///t lrrr
AMOUNT RECEIVED � r� v
NAME (FOR OFFICE USE ONLY)
ZONING
OCCUPANCY GROUP_A? PLAN CHECK NO NO PARKING SPACES
OCCUPANT LOAD PERMIT NO HEALTH DEPT APPROVAL_
NO. OF STORIES �— n _ ADMIN. ACTION UTILITIES RELDASED
5`U CERTIFICATE OF OCCUPANCY FEE S
APPROVED DATE CHANGE OF USE OR OCCUPANCY FEE g
TOTAL $
75-039 Rev. 1/97 COMMUNITY DEVELOPMENT
SUPPLEMENTAL INFORMATION
1. BUSINESS ADDRESS a�� 11 2-
2. Person to contact in case of emergency*
Telephone number: ay- 165 7?11
3. Does the building in question have electricity?
® Yes
❑ No
(a) If No, are you requesting that the electricity be
❑ Yes
tupried on?
❑ No
4. The building is sprinidered?
CT Yes
El No
5. Operations will produce dust/ wood shavings or similar
material?
F1 Y-S
W"No
6. Operations will involve the repair or replacement of
E) Yes
automobile parts?
Imo
If Yes:
(a) Describe the components repaired or replaced.
(b) Does the operation involve the use of an open flame? ❑ Yes
❑ No
7. The business is drinking, dining or assembly use that will
result in an occupant load of more than 50 persons, M Yes
No
8. 'The following best describer; rimy operation;
Office Only
Retail Sales
Warehouse
Manuf,%,tu ring/ Distribution (describe process and end product)
estaura � / Take Out Food
Medical / Dental
Other (describe) -_
SUPPLEMENTALINFORtvK ION
SUPPLEMENTAL INFORMATION (Continued)
Does the operation involve aRy of the following materials? ❑ Yes
No
!f Yes, indinate quantities:
MT ate+lal _ Quantity
1. Flammable liquids
Class I -A
Class I-B
Class I-C
2. Combustible liquids
;lass 11
Class Ill -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 materiais
10. Corrosive liquids
11. Oxidizing material - gases
12. Oxidizing material liquids
13. Oxidizing material - solids
14. Organic peroxides
15. Nltrc�methane (unstable materials)
16. Ammonium nitrate
17. Ammonium nitrate compound mixtures
containing more than 600/. nitrate
by weight
18. Highly toxic material and
poisonous gas,
1.9. Smokeless powder
20. Black. sporting powder
I hereby certify that: the above information is true and correct to
the best 9.f my knowledge.
Signature tl Dafe
South Coast
AIR QUALITY NIANAC,E.►`VIENT DPSTRICT
21865 Copley Drive, Diamorid Bar, CA 9,1765-4 82 (909) 396-2000
AM QUALITY ]PEPMUTi CHECKLIST
for/nonresidential buildings only
Company Nome: ��� %��'I � %1 f 1,2 "t1xc9 1,
Location of Property:�-
i
City: ;e lei 1 -1 °_ Zip Code: _ f'<f 6
Contact Person: a t'� f Title:r�r�_=
Telephore Number: Fax Number:
Type of JndustryA3usiness:-`'-
To rApply for a nonresidential builr7,,:,. g perrui, you must complete this checklist. If you have any
questions
about completing this checklist, please call (800) 388-2121.
YFS
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 vel.icles)?
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?
S.
Will refining of any liquids of 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 BVJ/hr be
operated at the facility.
[
[ k}
8.
Will any acids, solvents, or motor fael be used or stored at the facility?
9.
Will any orgarde liquids or gases be rer-ted 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: 7 _ Signa�"aro:
(Print name clearly)
If you have marked "NO" u-i all the boxes, an air quality permit is not needed at this time,
and this checklist is you, written release.
If you marked "YES ;n any of the boxes, you must contact the South Coast Air Quality
Management District (AQMi D). Please read the requirements on the back of the checklist.
(800) 388-2I21
ADDITIONAL SUPPLEMENTAL INFORMATION