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Home My WebLink About10128 Adams Ave - CofOSouth Coast Alit QUALITY MANAGEMENT DISTRICT 21865 E. Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-2000 AIR QU A7AIN PERMIT CHECKLIST for nonrF-sideatiai buildings only Company Name: �9 � F Location of Property:. P__ City: _ le- [� Zip Code:��Y Contact Pennon: v _pTitle: Telephone Nurnbe�i�T_ d `� f Fax Number: __ — Type of Industry/Business: �'��!'� ,f r eZ 2�& To apply for a nonresidential building permit, you must complete this checklist. If you have any questions about completing this checidist, 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)? 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? r 5. Will refusing of any liquids or soiids 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 BT-U/hr be operated at the facility 8. Will any acids, solvents, or motor fuel be used or stored at the facility? [ ] ] 9. Will any organic liquids or gases be reacted or produced? [ ] i9 10. Will any ovens be used to dry or curt products at the facility % [ ] 11. Will any CFC (Freon) recycling machines operate at the facility? Applicant: l) c% Signature: (Print name cl ly) 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 Cod"st Air Quality Management ]Distr et (AQM D). Please read the regairemen: s on the back-- of the checklist. (800) 388-2121 #..,awi 6 Jme APPLICATIC N FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH 0 DE :)ARTM(=NT OF BUILDING & SAFETY HUNTINGTON BEACH '% ` ATE (PRINT OR TYPE ONLY VV �a ttdt 0, 1 Address _ / " U ° i �� ?i� � ve Ae,;.7 " e�L=t` !� a GGr�j Disliic9 Business Name__ L1 �s�r �� ` Gt'�•� Tel Business Type ��,%r �� / _ 4 Ocr. Group BUILDING OWNER �• f K v 11j CO c11 � ' 07 BUSINESS CV4 ,MANAGER Name _TI'�" {' r' �j Name`�� Home Address F,7i_ l/f. v , � 2e'L11 /f AddressJ://� City � C%[. ' f�7Ciy� Tel V-v city 1� <� ' '!�i)` Home Tel.' `'Y� THiS USE WOUP n BE DESCRiBED AS: f s ,, p -' ❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER ❑ CHANGE OF OCCUPANT G 7 EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT Indicate former use, it any ,q, Occupancy Gr Div. SQUARE FT, OF BUILDING TO BE OCCUPIED Q� °� W�C�K. r"`� Zj�� NOTICE: 1. Occuprrtcy of any building is prohibited and a business license will not be issued until the building has been inspecte ' ano 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 'fuss up'nspection 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 determine if a cnange may be made'n the character of occupancy or use ofthe 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 that building numbers must be a minimum of foc,r (4) inches in height with one half ('iz) 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 distribution per the National Fire ?r tection ,Afsisociation pampoiet 10 (see reverse side). ,.l till _ ( OR 0 IC USE NLY) ZONING OCCUPANCY GROUP ; 'FA PLAN CHECK NO NO PARKING SPACES _ OCCUPANT LOAD 'd 2. PERMIT NO . HEALTH DEPT APPROVAL ADMIN ACTION UTILITIES RELEASED r CERTIFICATE OF OCCUPANCY FEE $ A PROV 8 DATE CHANGE OF USE OR OCCUPANCY FEE $ TOTAL $ FORM: 7SA39 REV 2102 RE -ORDER SAND DOLLAR 714-842-1149 L SUPPLEMENTAL INFORMATION MER - BUSINESS ADDRESS 011?J9_14- 2. Person to contact in case of emergency 7�( Telephone number: OX 3. Does the building in question have electricity? i Yes No (a) If No, are you requesting that the electricity be ❑ Yes turned on? ❑ No 4. The building is sprinklered? ❑ Yes �No 5. Operations will produ(,e dust/wood shavings or similar material? n Yes XNo 6. Operations will involve the repair or replacement 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 The business is drinking, dining or assembly use that will �No .result in an occupant load of more than 50 persons. P,, Yes No 8. The following best describes my operation; / Office Only Retail Sales 1AFa*eh iz,\Alzor Man ufacturin 4 / Distribution (describe process and end product) Restaurant/Take Out Food Medical / Dental Other (describe) SUPPLEMENTAL INFORMA fCx,1 Does the J l$ r's. indi"-- t ��;..,;?:3 itt�: " M rsaj Class 5-A Class I-B Mass I-C _ .oriil;tistid�lal itCq,dS Class 11 Class Ill'v _ Co t'ciiiiiicZble lizdiiit�t s �. F}ammab,e gages 5. l�lt�uefied fla-,�r�aable gases 6. Flammable fibers - ioose s - Flammat;le fibers -baled 9. Fiammabie so, 3. l.lnsfiabl�� sri�atei+ial�; 1Q, 11 _ Oxidlzing material uses 12. 0xidixing material _ liquids 1 C�x'tdi�ing material -scuds 1 organic peroxides 15. Nitromethane (unstable r„aterial ) _ �._ _. w._.____.•...�._..r...____._.._._. 16, �_.___._..___..�.�w _,..__. ___._ �_�...._ _�.... Ammonium nitrate _�.,_,. � .....___ 17. Ammonium nitrate compound mixtures taiisiRc� more than SQ1;6 nitrate _ by weiyrit 19.� highly toxic material and poisonous gay 19. Smokeless powder 20. Black sporting powder l hereby certify that the above information is true and correct to the best of my knowledge. ignature // Date 15 i HUNTHJGTON SBEACH Address Business Business APPLICATION FOR CERTIFICk"': OF OCCUPANCY CITY OF HUNTINGTON L :ACH DEPARTMENT OF BUILDING & SAFETY 0 '7/ (PRINT OR TYPE ONLY) (�r BUILDING OWNER Name 8L,6kat�� i ^ `�� _ Name. Ac Home Addressj Adddressl_—_z City Tel. 4?y THIS USE WOULD BE DESCRIBED AS: ❑ NEWLY �, --I .'i1?L 3TED BLDG El CHANGE OF OWNER EXISTING BUILDING ❑ CHANGE OF USE Indicate former use, it any !! _ Occupancy Gr SQUARE FT. OF BUILDING TO riE OCCUPIED�I�� c. Group BUSINESS OW 3 I//� Home Tel. I Of CHANGEOF OCCUPANT ❑ ADDITIONAL OCCUPANT Div 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 o` occupai.cy 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 Departm nt c Community Devolopment at the time this Gpplication is filed. 3. Change a! 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 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. Iuntington Beach Fire Code Section 10.208 requires that building numbers must be a minimum of four (4) inches in height with one half (VP) inch s'.roke, 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). OCCUPANCY GROUP OCCUPANT LOAD NO. OF STORIES APPROVED BY DATE y 'LM:75.039 REV 2102 REORDER SAND DOLLPR774-b4,-i-,B (FOR OFFICE USE ONLY) ZONING PLAN CHECK O NO PARKING SPACES PERMIT NOHEALTH DEPT APPROVAL ADMIN. ACTION UTILITIES RELEASED _— CERTIFICATE OF OCCUPANCY FEE CHANGE OF USE OR OCCUPANCY FEE $ TOTAL $ 6 APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH DEPARTMENT OF BUILDING & SAFETY (PRINT OR TYPE ONLY) Address Business Business _ 0 17�� 2- / D`ATF District f art Tel Occ. Group— _ f BUILDING OWNER B :SINESS OWNERIMANAGER i Name ► `t t rya - `�y��` k _ Name_ Home Address . ?2 t"" t "_ r�i €e Address _ City. r �, ' { �. 9( a o Tel ' d :.;6-hy ._—,Home Tet _ Ti-IIS USE WOULD BE DESCRIBED AS: NEWLY CONSTRUCTED BLDG. ❑ CHANGE OP OWNER C14ANCE OF OCCUPANT ® EXISTING BUILDING ❑ CHANGE OF USE Q ADDITIONAL OCCUPANT indicate former us• if any moo? 4) it /; Occupancy G,, $' Div. SOUARE FT. OF BUILDING TO BE OCCUPIED t2 v w I t"i ✓' NOTICE: 1 Occupancy of any building is prohibited and a business `: cense will not be issued until the building has been inspected and a certificate of occupancy is issued. 2. No electrical service Wil' 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 e?^ :tricat '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 may be made in the character of occupancy or use of the building or premises Whicl, ,..vould place the building in a different d"Asion of the same group of occupancy or it a different group �ucupan(.y, a change of occupancy inspection fee of $ shall be paid to If- 4, Hunting", Fire Code Section 10.208 requires that building numbers must be a minimum of four (4) inches I. i With one half (1/2) inch stroke, and of a contrasting color from the background. These number s! 4 posted on your building in a location that is visible from I.he street. 5. Muntington b.,dch Fire Code 7lection 10.301 requires fire extinguisher selection and distribution per the National Fire Protection Association pamphlet 10 (sea reverse side). (FOR OFFICE USE ONLY) ZONING _...` OCCUPAW. r CpOUP_:. FLAN CHECK NO. NO PAFIKING SPACES ---- OCCUPAPN7 PERMIT NO. 12 % HEALTH DEPT APPROVAL — NO. OF STORIES' sr _ _ ADMIN. ACTION- ur.ILITIES RELEASED _ CERTIFICATE OF OCCUPANCY FEE $ APPROVED BY SATE CHANGE OF USE OR OCCUPANCY FEE .TOTAL $ rORM1 7 09 REV 21W RE•OROER SANI) 01-4AR 114.842.1140 pPi.l A ')" C'UPPLI4liUiiEN`i' L INFORMATION 1. BUSINESS ADDRESS I d - 'i—am's Av/ e' 2. Person to contact in case of emergency.: Telephone number: 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 .iroduce dust/wood shavings nr similar material ? S. Operations will involve the repair or replacement of autos-nobile parts? It Yes: (a) Describe the components repaired or replaced. (b) Does the operation involve the use of an open flame? 7. The business is drinking, dining or assembly use that wit( result in an occupant load of more than 50 persons. 8. The following best describes my operation; Office CQn1 etail �Sales� Ntareho su e Manufacturing / Distribution (describe process and end product) Restaurant / Take Out Food Medical / Dental Other (describe) , Yes No ❑ Yes C7 No ❑ Yes No ❑ Yes C(No ❑ Yes 7No ❑ Yes l�(No ❑ Yes N o TV 0 r Y o dion 4,11�ai -'iar,s Class N' Class HI -A. flarnmaWe. Nquk,-,�. 4. Flammable —L —1q 'u- - e- -f 7 is m. m a . . . ........ --------- ....... a t 10. Corrosive liquids Oxidiziag rriateriaf gase!E ,2. Oxjdiz�ng material liquids (57 .v .ij:jjjnq material solids Organic peroxides 15. Nitromethane (up-stabl e r- natqri a i s) TE--Amm�niurn nitrate' 17. Ammonium n1trate cornpourd mixtures containing more than 601�c niirate by weight is. Highly toxic material and poisonous gas 19.- Smokel,ess 20. Black sporting powder r r' by certify that the abtwe inforfnation is trup, and correct P-I re the est A inn knowledge. More Dat South Coast AIR QIJALiTY MANAGEMENT DISTRICT 21B65 E. Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-2000 AIR QUALITY PERMIT CH ECKLIST Company Name: Location of roperty: 2-c6 - A& V`P- City: A ( Zip Code: Contact Person:, Title: V1~V�- Telephone Number: bznhm. _�Ocfl Fax Number: 4/4 - S23 .,,pe of lndustry/F us;ness: �� , To apply for a nonresidential building permit, you must complete this checklist. if you have any questions about completing this checklist, please call (800) 338-2121. YES NO 1. Will &ie facility have a charbroiler? 2. Will any internal combustion engine with grea'.er than 50 horsepower operate at the facility (excluding motor vehicles)'! 3. Will operations at the facility involve mixing, blending, or processing of solvents, adhesives, paints or coatings? [ ] [Xf 4. Will dust or smoke be generated at the facility? [ ] j,s] 5. Will refining of any liquids or solids be done at the facility? [ ] [� 6. Will any platL- or coating of materials be done at the facility? [ I [Xj 7. Will any combustion equipment raked greater than 2,000,000 ETLr/hr be operated at the facility? [ ] [3tj 8. Will any acids, solvents. or motor fuel be used or stored at the facility? j ] 9. Will any organic liquids or gases be reacted or produced? j J 10. 'Will any ovens be used to drj or cure products at facility. [ ] [� 11. Will any CFC (Freon) recycling machines opera a4 file faculty l ( ] [ Applicant: �qM� P) ' Sign ire:_ (Print name clearly) If yot=. have marked "NO" in ail the boxes, an air quality permit i� not needed at this time, and this checklist is your written releaae. If you ma ked "YES" in any of the boxes, you must contact the South Coast Air Quality ManzgementDistrict (AQMD). Please read the requirements on the back of the checklist. (800) 388-2121