HomeMy WebLinkAbout15102 Bolsa Chica St - CofO (19)C ERTIFICATE OF OCCUPANCY j
CITY OF HUNTINGTON BEACH _ys1 2 / 1 ` S
Date s
Address 1 y 1 fa t o i1. H r A _ 3 District it
Business Name GALK03 CUNd:.,Tisi3C IONJ Tel.
Business Type OFFICE FOR P.ESIDENTIAL REMODELING COMPS. _Occ.Group B-2
BUILDING OWNER BUSINESS OWNER/MANAGER
I`N & Nd MGMT/ELNIER NIELSUa 1� RAid C Gir;LKETSIS [
Name _ Name
Home
Address1255O BROOKHURST Address16151 SANTA BARBARA j
City GARDEN GROVE Tel. r 14-5'..'-1901 City HB, CA Telme 714—$46O' S2
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Construction No. of Stories — Occupant Load 1 d Sprinklers
CONDITIONS OF APPROVAL
This Certificate of Occupancy
SHALL BE posted in a conspicuous place on the
premises and shall not be removed except by the
Building Official.
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DEPARTMENT OF COMMUNITY DEVELOPMENT i
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COMMUNITY DEVELOPMENT
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•�� � APPLICATION, FOR CERTIFICATE OF OCCUPANCY
B 9T CITY OF HUNTINGTON BEACH T
Leo DEPARTMENT OF COMMUNITY GE.'ELOPMENT jl DA E
HUNTtNrTON gam{ (PRINT OR TYPE ONLY)
t i �_ (District
Address 15iD� (�elsa ^"�-
—L(� >;G5 L.l : I 1 L�� Tel.
Business Name
I C ,�a w� tl a� l�'1 41�=--`^ `� — � Occ. Group
Business Type 4l C BUSINESS OWNERIMANAGER
BUILDIN_ G OWNER P S1 r
r'flatYL YIPS Lra: o� I� P.(.st Name_ FY'CLY_\ �✓ 1 Gl�
f T Pro . Mrt;a��— �ct �' I Gt .t�
tame �--�--�� � , Home i t � �, c �r n FiA 11 Q t�- .
Address 5 J� t i4)� Address � 1l GLt Horr(2 Tti I. � G S�
VC_ -) _ Gt � Tel.53`7 - U City- t
0` 6 rAe �0� a� Lt�i
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THIS USE WOULD BE DESCRIBED AS: ❑ CHANGE OF OCCUPANT
❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER ❑ ADDITIONAL OCCUPANT
❑ CHANGE OF USE
EXISTING BUILDING w
,,5� /s
7 n Occupancy Gr._ .-------Div._.
indicate former use, if any kZA� � , % o CJ /
� O
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. and
2. No electrical service applicants for occupfor ancy ancy in an existing y existing building
bu Id ngtlareereo reed t ce aschedule an electrical
certified safe. All p lication is filed.
fuse up' inspection in the Department of Community Development at the time this Epp
3vu�,
Change of occupancy or use inspection fee. Whenever it is necessade in the ary to make inspection of a building o:
premises in order to determine
if a change ay n different division oftthe same gerof roup of occupncy or use tancyhe uordin a
or premises which wou p shall
different group of occupancy, a change of occupancy inspection fee of $be paid to the city.Huntington Beach Fire Cade Section 10.208 requires that building numbers must th a minimum of four seinches in height with one half (1/2) inch stroke, and of a contrasting color from the background. Thesenumbers must be posted on your building in a location that is visible from tne street.
Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection and distribution por the
National Fire f rotection Association pamphlet 10 (see reverse side),
��FGr� usE 01� b� rZiT��f%-
6'S
(FOR OFFICE USE ONLY) ZONING
SUPPLEMENTAI. INFORMATION
PLAN CHECK NO. NO PARKING SPACES
OCCUPANCY GROUP ^ PERMIT NO, HEALTH DEPT APPROVAL-,
OCCUPANT LOAD---- ADMIN ACTION UTILITIES RELEASED
NO. OF STORIES
GP
�DA*TCHANGE
CERTIFICATE OF OCCUPANCY FEE $
APPR VEDBY OF USE OR OCCUPANC" FEE $
TOTAL $
COPYtMUNIIY DEVELOPMENT
75.039 Rev. 11/90
SUPPLEMENTAL INFORMATION
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1.
BUSINESS ADDRESS 1510 ral� 8015'-r L%'lI CCc C-d -� sul i, 7A
Vu►7h'rVDi l &-aCal , Ca-( I;�. ' 1)q L,- Y 7
2.
Person to contact in case of emergency-- E-rari < a (kP fhrS
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Telephone number: C- 57T, - 35a5 L71gl
ByC)-c,& �
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Does the building it question have elec#ric`�?
LrYes
No
(a) If No, are you requesting that the electricity be
❑ Yes
turned on?
p No
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4.
The building is sprinklered?es
El No
5.
Operations will produce dust/wood shavings or similar
material?
❑ Yes
Flo
6.
Operations will involve the repair or replacement of
❑ Yes
automobile parts?
A 0
l
If Yes:
(a) Describe the components repaired or replaced.
(b) Does the operation involve the use of an open flame?
❑ Yes
it
W-No
7.
The business is drinking, dining or assembly use that will
result in an occupant load of more than 50 persons.
❑ Yes
8.
The following- best describes my operation;
Retail Sales
Warehouse
Manufacturing / Distribution (describe process and end product)
Restaurant / Take Out Food
Medical / Dental
Other (describe)
sUPPLIMENTAL INFORMATION
- . V r.
SUPPLEMENTAL INFORMATION (Continued)
Does the operation involve any of the following materials? �❑Y�e�s
If Yes, indicate quantities:
Material Quantity
1. Flammable liquids
Class l-A
Class !-B
Class I-C
2. Combustible liquids -
Class !i
Class 111-A
3. Combination flammable liquids
4. Flammable gases
5. Liquefied flammable gases M-
6. Flammable fibers - loose
7. Flammable fibers - baled
8. Flammable solids -
9. Unstable materials
10. Ccrrosive liquids
11 Oxidizing material --gases
12. Oxidizing material - liquids
13, Oxidizing material - solids
14. (.organic peroxides
15. Nitromethane (unstable rnete iais)
16. Ammonium nitrate
17. Ammonium nitrate compoundmixtures
containing more than 600lh nitrate
by weight _
18. Highly toxic material and
poisonous gas
19. _Smokeless powder
20. Black sporting powder --
I hereby certify that the above information is true and correct to
the ct of my k wledge.
Signature D to
Government Code Section 65850.2(b) requires that the.City of Huntington Beach not issue the final
certificate of occupancy unless the applicant has met or is meeting the requirements o'i the South
Coast: Air Quality Management District (AQMD). The Department of Community Development must
obtain a written release from AQMD to show the applicant has complied with this law. The check
list on -the reverse side is designed to help the applicant and the building division to meet these
requirements.
1. The applicant (the same person who al*vlies for permits from the
Department of Community Development) must complete the check list
which can be obtained either from the Departnnent of Community
Development or at AQMD.
2. If all boxes in the list are checked "no", the Building Division can accept: the
check list as the release.
3. If there are any "yes" answers in the list, the applicant must contact an
AQMD engineer by calling (714) 396-2000 to kind out whether air permits are
required for the proposed construction project.
4. If air permits are not required, the applicant will obtain a written release from
AQMD.
S. If air permits are required, the applicant muss: submit the necessary permit
applications before the release can be issued.
Because of the time it may take for AQM0 to go through the above procedures, the applicant is
e.ivist,,d to contact AQMD immediately after applying for building permits.
ADDITIONAL SUPPLIMEW.P.. s. INFORMATION
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