HomeMy WebLinkAbout15102 Bolsa Chica Rd - CofO (4)a Iff APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OFHUNTINGTON REACH
` nEP AR MENT OF COMMUNITY t3EVEL0: li ENTyE
�J
HUNTIWTON BEA04 r/ dA
(PRIM' OR TYPE ONLY)
Address I
Business Name
Business Type
R�District.
'
Tel i
Oce Group �� 1
BUILDING OWNER 8L)SiNESS OWNERrivtANAGER
Name Name Sot v e_ l�s<,;��. en
Home
Address ,a , f'-A&l � `Z�1� � Addre:;s �. 1. �_----.- J
r 7t r 1 f
city- , ` c ----- T I = l ts';-itv_'jjj';) Hc„ Tel.g
i
THIS USE WOULD BE DESCRIBED AS.
EWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER 7N, CHANGE OF OCCUPANT
EXISTING BUILDING CHANGE OF USE El ADDITIONAL OCCUPANT
Indicate former use. it any, Occupancy Gr Div
0��
SQUARE FT. OF BUILDING TO BE OCCUPIED..��„ _ � t 6 �C� � ` �='M�-C' # 10 i(i r P
NOTice 1
Z
3.
Occupancy of any building is prohibited and a business license will not be issued until the building has been l
inspected and a certificate of occupancy is issued. II
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
`fus4 up' inspection in the Department of Community Development at the tit -OF, this applicarion is filed.
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 maybe 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.
Huntington Beach Fire Code Section 10.208 requires that building numbers must be a minimum of four (4)
inches in height with one half (V2) 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.
Huntington Beach Fire Code Section 10.301 requires fire exhnguishe� selection and distribution per the
National Fire Protection Association pamphlet 10 (see reverse side).
f '.' .... (FOR OFFICE USE ONLY)
F_. S 1 Pc AN +: HPi `K NO _._._�_ _. � N4) PARKi
OCCUPANCY GROU — - _ �__ r._ _ _.__ � . ivG SPACES
0CCUPANT LOAi __ _,. I`F-Rkt1 NO '4F:ALTH #KEPT APPROVAL---
No. OF Y RIES
ADM'N .A 7iC�N<«_._ ;ITIIITIES, RELEASED
ICERTWI'.:ATE Of- 01"CIUPANCY f EF c ,n '3 l
A V O Y 5, TE .. _ CHANGE OF USE OR OCCUPANCY FZE S �
TOTAL
75-039 Rev,1197 n
SUPPLEMENTAL INFORMATION
BUSINESS ADDRESS
2.
Person to contact in case of emei 1/ QYRe ke4k
gency-
Telephone nuriber;
3.
Does the building in question have electricity?
Yes
(a) If No, are you requc
y ,u� sting that the electricity be
tl No
El Yes
turned on?
L7 No
4.
The building is sprinklered?
Yes
C1 No
5.
Operations will produce dust/wood shavings or similar
material?
El Yes
io
6.
Opera,,'ions will involve the repair or replacement of
11 Yes
aulomebile parts?
Flo
,r
If Yes:
(a) Describe the components repaired or replaced.
1r
(b) Does the operation involve the use of an open flame? El Yes
4.
The business is drinking, dining or assembly use that
will
result in an occupant load of more than 50 persons.
Cif Yves
'g
8.
best describes my operation;
Th=Off-c—e
Only
Re,��Sales
Wareho
anuf—a turfing / Distribution (describe process and end
product)
Restaurant r Take Out Food
Medical /%dental
i
Other (describe) --
-- {
wi.ii" F"4El4iEN TAL. lNFOR1tiiAiiiON
9
SUPPLEMENTAL INFORMATION (Continued)
Dtltie operation Involve any of the IoHowi q rviuteriaaa? Yes
Ji,ate quantities:
M,ateriai x n
ible liquids
a i-A
yS 1-
.xnbustible ItIquids
Glass is3. %
torirsicsn flsrrfaligictsr�w� n.. > C1..
4. Flammable gases [\J D �
Liquefied. flarra*rf°faF. gas.
Flammable fibers - loose
i7. Flammable _fibers - baled . 0_
mable solids
• `�. l�atital�l 6i9���'f'f��ls y
Iv
Oxidizing material • 'ases,....._,_ .,......_ ..__ .....Ajj 0
12, Oxidizing material w liquids R_.. .w. _..w NjY�
14. Organic peri.,mi des nJ �
i . Nitrorn than,,, s f sta Se mat eialw B _ a
_
17. .�emFflonium ." 0r;A'te o[?mpound y mixtuCcs,
containing more than 0%v nitrate� f
y eveigl�t i`�
poisonoos gas f 4%
0 �Elack port?mg b_powde#
l hereby certify tip;t the above, info rim Lion is tMe and correct to
o
_.... .�e
na Ura ate
South Coast
AIR QUALITY MANAGEMENT DISTRICT
21865 E. Cop'ey Drive, Diamond Bar, CA 91765-4182 (909) 396-2000
for wxwesidential build xigs only
Company Name: l Jye il-
Location of Property: ' 1 r r C d� ZA 1le- -'
City; Zip Code:
Contact Person: f 1re c t ' --Title: �. i �_r 1� �a�- _
Te? ephones Number: 7 t Fax Nur..zber. j G
Type of Industry/Business: r �� WC flyN�t-UU
�,
To apply for a nonresidential building permit, you must complete this checklist. If You have; any
questions about completing this checklist, please call (800) 38$2121.
YES NO
I. Will the facility have a charbroiler? [
2. Will any internal combustion engine with greater than 50 horsepower
operate at the facility (exc!,uding motor vehicles)? [ �
3. Will operations at the facility involve mixing, blending, or processing of
soWents, adhesives, paints or coatings? [
4. "Will dust or smoke be generated at the facility?
`. Will refining of any ligiuds or solids be done at the facility?
6. Will any plating or coasting of materials be done at the faciliq?
7. Will any combustion equipment rated greater frran 2,000,030 ETU thr be
operated at the facility?
S. Will any acids, solvents, or motor fuel be used or stored at the facility? [
9. W21 any organic liquids or gases be reacted ox produced? j
10. Will any ovens be used to dry or cure products at the facility?
11. Wi11 any 94C (Freon) recycling ma nines operate at the f ii y? [
.A,pplicant
(Print name clearly
If you have marker "NO" in. All the boxes, an air quality per-mit is act needed at this time,
and this checklist is your written release.
If you marked "X '" in any �fti`ae bores, yogi must contact the Truth Coast Air Quality
Management Dissect (AQ* ). Plea.Te read the requaremea is or-, the back of the checWist.
(800) 88-2121
M'rlTiUn3
NUNCE 017 RLQU"AR-1,:-`,4ENT.S
GOVERNMENT COD F SEA -rj(,.), N
65850.2 W33205),
CAME swe I xv Oplvmment 17010 SAW) PrATFS the 'Building TX' :wml
issuing a final x! of tlh,-, jo-zjj c-jr q-,.r_qitv kaency are
met ful ;PpRemms af'' rcqui!�'d to v-,.- all- ponni-, Th, cfic'AOist is
&sIgned to aid the upplic-:.�,, f6r norin�sijcntia! baiidnp'-'.rrl-lh oni' Y thant"'wer v-, any of
is "YE"" dw 13,1102, Depaninvat must L-arn th'- local
Lei i�
quality. vomf-vin,, tr%:
1. All nom-osjdcjjtj:,-j
z if Me at" sv-cmm 5ill
ll
h%"rU the flv�klist
3., If any jvy""CW MUR MAWL Q AQNP) hh cG.11ing
uj v'ho'!VT at quol
1POM-lifs OTe Auc'Pir4'i] for equipmmt
ld11 ry'w", he. off' xatcd '7� tlh'.- siv�' If0i,2 At Nfl) that aii qua,fty 7j:,Crr%jtS zre
not reqKad or Hmi Al r''qZ;-n-moab ll-avQ t!eePl Met, a U-Ift'lan relca,�:e will bi�, issued,
4. If Wr qually are �eqjuizcdl -nil apphc�iti4�ris havz rwt been si�bmdtte4el the applicant
Ti suhnm,-, tdi,- oux! appropriate -,'ee%� bdore ;.' et as
re'Wase uill b,� issued,
AQMD is committed to cnpcdking all cieax;wce lrcr rqucsts Ilowever, -'t takc wvi�ral
%ealcs v� verif*v compl."Inct, V'.ith Z'M' vou 9-re, adivised to contaict AQNP,,)
imm ediately affter applying ft,,., lYjujjdLrjg p- S
(SOO) 388-2121