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HomeMy WebLinkAbout10132 Adams Ave - CofOJ� APPLICATION FOR CERTIFICATE OF OCCUPANCY Cli .' OF HUNT[NGTON BEACH / DEPARTMENT OF RF ILDINS 3 SAFETY KUMRVGTON L-VN (PRINT OR IV PE ONLY) `. i ('g r DATE Address �0 C 3� °*' 'L District Business dame ZAIh t "XFL C 4 _ Tel. 7 rle Business Type 'y� 0,0 � .2, 6L144_4� _ Oce. Group BUILDING OWNER BUSINESS OWNERIMANAGER Name— L6 IM,e r . " aS Name_ Hcme C3r-� r Address 12 G �ff /�++ � �C7, ,% Address �' -AS �l_ �z r 1 ✓.ram^ 2� L2 City % Tel. City 14,4 �� ome Tel. THIS USE WOULD BE DESCRIBED AS: ❑ NEWLY CONSTRUCTED 2,0G. W CHANGE OF OWNER ❑ CHANGE OF OCCUPANT ❑ EXISTING BUILDING ❑ CHANGE GF USE ❑ ADDITIONAL OCCUPANT Indicate former use, if any Occupancy Gr. Div. SQUARE FT. OF BUfLDIN S 1*0 BE OCCUPIED t am � 1 PAD 104-61 NOT110E: 1. Occupanny of arty 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 elei:trica► service will be released for any existing building u0i the service has been inspected and certified safe. Ali applicants for occupancy in an existing buidin7 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 .tecessaryto make inspection of a br.!ilding or premises in order to determine if a change may be made in the character of occupancy or use of the t ,Aiding or premises which would place the building it 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 Firs Code Section 10.208 requires that building numbers must be a minimum of four (4) inches in height with one half (tie) inch sirou), and of a contrasting color from the background. These numbers must be posteo on your building in a location that is visible from the ,Ftreet. 5, Huntington Beach Fire Code Section 10.3C1 reg,_,res fire extinguisher selection and distribution per the National Fire Protection Association pamphlet 10 (see reverse side). �61 tv'ritt�iE_-- (FOR OFFICE USE O LY) - ZONING -- OCCUPANCY GROUP 5 PLAN CHECK NO OCCUPANT LOAD 1A PERMIT NO NO. OF STARIES ADMIN ACTION CERTIFICATE OF OCCUPAII'CY FEE 0PRO y DATE CHANGE OF USE OR OCCUPANCY FEE TOTAL NO PARKING SPACES —� HEALTH DEPT. APPROVAL — UTILITIES RELEASED FORM.75-039 REV.2102 RE -ORDER 8AND DOLLAR 714-842-1148 E ; � ""'� i , ;•� �"' .� -r'�' SUPPI_EMPENTAL INFORMATION 1. BUSINESS ADDRESS 2. Person to contact in case of emergency- 77 L( l Telephone number: 3. Does the building in question have electricity? lki 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 produce dust/wood shavings or similar I material? ❑ Yes 2 No 6. Operations will involve the repair or replacement of ❑ Yes automobile parts? Ca" No If Yes: (a) Describe the components repaired or replaced. (b). Does the operation involve the use of an open flame? U Yes ❑ No 7. The business is drinking, dining or assembly use that will result in an occupant load of more than 50 persons. ❑J es No 8. The following best describes rrvy operation; Office Only Retail Sales Warehouse Manufacturing/ Distribution (describe process and end product) Restaurant/Take Out Food Medical / Dental Other (describe) SUf •�'i.E;".'E�'S�i'AL !i`f"f:;r"-��lr"s"'I�"' SUPPLEMENTAL INFORkwtATION (Continued) Does the operation involve any of the following materials? r0 Yes C No If Yes, indicate quantities: Material Quantity 1. Flammable liquids Class I -A Class i-B ..�...�. ..� Class I-C 2. Combustible liquids Class !1 Class tJI-A 3. Combinai.-ion flammable liquids 4. Flammable gases a. Liquefied flammable gases - 6. Flammable fibers - loose 7. Flammable fibers - baled 6. Flammable sulids 9. Unstable materials Y� 10. Corrosive liquids 11. Oxidizirg material - gases 12. Oxidizing mate}ia! -liquids _-.{°�.•-.-......�___._ 13. Oxidizing material - s-)lids 14. Organic peroxides 15. Nitro Methane (unstable materials) 16. Ammonium nitrate 17. Ammonium nitrate compounv mixtures containing more than 60% nitrate by weight 11 Highly toxic material and �T poiaonous gas 19. Smokeless powder 20. Slack sporting powder I herebA certify that the above information is true and correct to the b s of y nowledge. Si. store South Cast AIR QUALITY MANAGEMENT DISTRICT 21865 E. Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-2000 AIR QUALITY PER -NUT CHECKLIST for no7i esidential bu' dings only Company Name: Jar/ Location of Property: 11)13, 4 City: n w/ k-'�� .�,-z �� Zip Code: Contact Person: P Title: e _ Telephone Number: _ �/�% y �5 /� D Fax Number. Typc of Industry/Blisiness: � r � n2 To apply for a nonresidential building permit, you must complete this checklist. If yc s have any questions about conspleting this checklist, please call (800) 388-2121. YES NO 1. Will the facility have a charbroiler? [ ] [ . Will any internal. combustion engine with greater Than 50 horsepower operate at the facility (excluding motor vehicles)? [ j o ] 3. "Nill operations at the facility involve mixing, blending, or processing of solvents, adhesives, paints or coatings? [ ] t E'A, 4. Will. dust or smoke be generated at the facility? [ ] [?.; 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 BTTJ/hr be operated at the facility? [ [ 8. W<- any acids, solvents, or motor fuel be used or stored at the facility? [ ] [ 9. Will any org&iic liquids or gases be reacted 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 tb.e yfailfty?Applicant: lZ� S �� C1�Ci Signature:' (Print name clearly) If you have marked "NO" in all the boxes, an air quality peznit is nD! nerAed at, IE-s time, and this checklist is your written release. If you marker; "YES" in any of the boxes, you must contact the South Coast Air Quality Management Dist iict (AQIVD?). Please read the requirements on the back of the checklist. (800) 388-2121 NOTICE OF REQUIREMENT'S (a0-VTR --NIE d a CODE SECTION 65850.2 (AJB,3205) California State Law (Government Code 65850.2) prohibits the Building Departments from issuing a final certificate of occupancy unless all requirements of the local air quality agency art met. All applicants are required to complete the air quality permit checklist. The checlist is de igned to aid the applicant for a nonresidential building permit only. If the answer to any of the questions is "YES," the Buildii g Department must obtain a written release ffrom the local air quality agency verit,,ing that the applicant is in compliance. 1. All nonresidential building permit applicants must complete this the -mist. 2. If the answers to ill questions are ' :tiQ," the Building Department can acc: pt the checklist as the w:itteri release. 3. If any question. are answered "YES," the applicant must contact the AQMD by calling (800) 388-2121 to determine whether air quality permits are required for any equipment which may be operated at the site. if the AQ1MD determines that air quality permits are not required or tha all requirements have peen met, a written release will be issued. 4. If air quality permits are required and applications have not been submitted, the applicant must submit the necessary permit appl�cation(s) and appropriate fees before a---ritten release will be issued. AQ D is committed to expediting all clearance letter requests. However, it ruay take several weeks to verify compliance with all requirements. Therefore, you are ad-vised to contact AQiM immediately after applying for building permits. revised "S 1 r- (800) 388-2121 2,3 At APiUCATION F Off. C� TIF CZE OP OCCUPANCY ';21TYPP-AU 1T11 GT0-N B-E. ACH - DEPARTMENT OF BUILDING & S,-FEl T. (3"d Floor —1110istApplyIn-persox) Bt.sisLess License : � Datw 1 ~ ! S - 6 y Address �10 t 12- ARAM S Avg.. Business Naive tA a, a R.:-.( --Telephone 71y-96Z'7777 Business Type (—' ©tax L A' 4< Dn-4 Pronerry Owner information Business Owner Name ?Name T Ataw-00 Address ! "N` n!!CIL +Home Address 5l�ry��_ C-r. li �E^iGCtlGI? City Tel. City f t� ash, .4 t��` Tei . 3 4 2.- a.B K THIS USE WOULD E DESCRT}.;ED AS: r Nemly Constructed Building or C��rsting Building CHECK ALL THAT APPLY: QChange of Owner ZChatlge of Occuip�ant QChange ofUsc QAdditional Occupant Indicate former use, if any w ,c Q, �t k``e',ta u Does the building have electricity? Yes NO Q If No, are you requesting that the electricity be turned on? Yes Q No El The building is sprinkiered? Yes ---.,,,,rr Operations will product dust/tivood sliavings or similar material? Yes No Ca Operations will involve the repair or replacement of automobile parts Yes Q No E If yes: Describe the components repaired or replaced. ,.t Does the oiler r solve the use of vvelding or ripen flarne? Yes Q No ET The busine, ticincr, dining or assembly use that will result in an occunan� load of more persons. Yes © No The following best describes zny operation: L1 Office Orly QRetail Sal s ❑Medical/Dental aRest-lrxalzt/Take Out Food ❑Warehouse ElManufacturinglDistribution (describe process and end product) Other (describe) Office Use Only. - Zoning: -Z��_ Sq Ft Occupied:RIDE) Occ Group: 15', Occ Load:_ Stories: I Parking Spaces: TIF Revie;v: Y/ N A t PaidS: Paid BEFORE Final inspcsion Auildina Permit' _ Entitlerne>.it':: Coinments +IA_ Planner Initials:_ BldglPlan Chec ' _._ ._ _ CofL! if J l` South Coast Air Quality Management District 21805 E. Copley Drive Diamond Bar, CA 91765-4182 (909) 296-3529 htpp:,'www.agmd.gov Air Quality Permit Checklist California Government Code 65850.2 prohibits cities from issuing a C^rfl+fcate of Occupancy to a business ithout clearance from the local air quality agency. This checklist will deteirn.ine if you need to obtain clearance from the South Coast Air Quality Management District (AQMD). Company Name: A ;S W \-Q-) Property Address: 3 Z a lvt S _ City: Zip Code:ti� Contact Person: ; t �i `f Title: Type cf Business: (Dt &I LItiO "w�f Telephone:.() 7 �q '�6Z--7 7 71 Applicant: (print name) -St ,.,.t.Si,3-/AJ Signature: • Will the facility have any of the following equipment? Yes No Q- Charbroiler Dry cleaning machine Spray Bo3th Printing Press(screen/lithographic/flexograpluc) internal combustion engine (greater than 50HP) (excluding motor vehicles) Boiler/combustion, equipment (greater than 2 million BTU/hr. maximum input) Abrasive blasting cabinet/room Baghouse/cartridge type dust filter/scrubber Motor fuel storage and dispensing equipment • Will any of the following operations be performed? Yes 0 No Application of paints or adhesives Etching, plating,.casting, or melting of metals Molding and blending of liquids and/or powders Storage of acids, solvents, organic liquids or fuels Production of acids, solvents, organic liquids, or fuels Production of fumes, dust, smoke or strong odors • if n•ou answered "No" to both questions, this checklist is your clearance from AQ14T). • I.f you answered "Ye;" `- either question, you must contact AQMD to determins if air quality permits are required. If permit- wt 7'ed, AQNID will assist you in submitting permit application(s) and then provide you with a clearance ` •t ' ,` ran call AQ1Y0 at their Small Business .Ass stance Office at (800) 358-2121.