HomeMy WebLinkAbout10184 Adams Ave - CofO (2)�
'CERTIFICATE OF OCCUPANCY
Address District
Business Name Tel.
Business Type it
oocGmup
8U|L0NGC*V`�,-R 8US|NEGGOWN�R/MANAGER
_
Nom,'l]J�l l Name
Address,Home
Address
moo
Home
C'ity Tel. City GTel.
Construction No. ufStories 1Occupant Lvou �1�Sp,ink|em
`
CONDITIONS OFAPPROVAL
Th;s Certificate uf Occupancy
SHALL BEposted |naconspicuous place c,the
premises and shol|not bnremoved except bythe
Building Official.
DEPARTMENT OFCOMMUNITY DEVELOPMENT
by
0
COMMUNITY DEVELOPMENT
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MIA
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HUNTINGTON BEACH
APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTING TON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT
(PRINT OR TYPE ONLY)
ATE
Address s--z � District
Business Name � /l.� /%1 � ioii� Tel.
Business
Business Type
RI III niton r)XA/NFR
Name L1Si`A1/Css _ 860/-L/,- fi�S
Address
city IkW /V I5' Tel
THIS USE WOULD BE DESCRIBED AS:
Occ. Group
BUSINESS OWNER/MANAGER
Name �� >✓i')iCy'1� `-�C�-`fV���
Home 1 f`'I�i�i��: ✓C `*�
Addres/st-=::�
City `� � �U r Home Tel.6t -S
t"-.3
9�I
E COntS
TRUCTED BLDG. .ElCHANGE OF OWNER
EXSTING BUILDING ❑ CHANGE OF USE
Indicate former use, if any Occupa icy Gr
SQUARE FT. OF BUILDING TO BE OCCUPIED t
O CHANGE OF 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 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 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 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 four(4)
inches in height with one hall' (Yz) 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 perthe
National Fire Protection Association pamphlet 10 (see reverse side).
(FOR OFFICE USE ONLY)
SUPPLEMENTAL INFORMATION
OCCUPANCY GROUP PLAN CHECK NO
OCCUPANT LOAD PERMIT NO. —
NO. OF STORIES ADMIN. ACTION_
� CERTIFICATE OF OCCUPANCY FEE
A VED B ATE CHANGE OF USE OR OCCUPANCY
TOTAL
ZONING f ��
NO PARK G
SPACES
HHDEPT. APPROVAL
U LITIES RELEASED
$
I
75.039 Rea. 6/88
COMMUNITY DEVELP.
4
SUPPJEMENTAL INPOAMATION
1. BUSINESS ADDRESS
�. Person to contact in case of emergency:
Telephone number:
3. Does the building in question have electricity? (3 Yes
a. If No, are you requesting thet the electricity be es
turned on? 0 No
4. The building is sprinklered? J OYes
0 No
5. Operations will produce dust/wood t.;iavings or similar
material? []Yes
0410-
6. Operations will involve the repair or replacement of ®Yes
automobile parts? W-Nn---
If yes:
(a) Describe the components repaired or replaced.
(b) Does the operation involve the use of an omen flame? OYes
®No
7. The business is drinking, dining or assembly use that will
result in an occupant load of more than -50 persons. ®Yes
S. The following best describes my operation:
Office Only
Retail Sales
warehouse
Manufacturing/Distribution (describe process► and end
product)._
Rea tau rant,/Take -0-uTE oo
Medical/Dental
Other (describe) _ ,a,!'L2 =Jz2 IL At ) C1----
0
SUPPLEMENTAL INFORMATION (Continued)
Does the operation involve an.1 of the following materials? Oyes
es, i dicaa-Ee quant ties:
Material Qu2.ntity
1. Flammable liquids
Class
I -A
Class
I-B
Class
I-C
2. Combustible liquids
Class
II
Class III -A
3.
Combination flammable liquids
4.
Flammable eases
5.
Li2uefied 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
14. Org,anic peroxides
15.
Mitromethane (unstable materials)
16.
Ammonium nitrate
17.
Ammonium nitrate compound mixtures
!
containing more than 60% 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
of my knowledge.