HomeMy WebLinkAbout15102 Bolsa Chica St - CofO (20)1' 1
HUNTING ON 9W..H
APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT
(PRINT OR TYPE ONLY)
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Address /J�10�ca�5t ri�%G�°-`.__ �ll_L,--6_ District.
C � �I d:_Y1 is.....c� � i~V\ nct S e vw�S_ Tel
Business Name t�
Oc4. Group
Business Type
l j r
BUILDING OWNER a,(% '-�16rUSe�0 te-�, [BUSINESS OWNEi'CIMANAG£R }
Marne /C7 I.t�11 �St f Name 1 '�It"' 'j.
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Address SL2- i`GEL�Ctt� Address Ll*
City �L�V\ CA_?Z TeI �203t city nisi r it Rorie Tel----"'
THIS USE WOULD BE DESCRIBED AS: j
❑ NEWLY CONSTRUCTED BLDG
EXISTING BUILDING
Indicate former use, if any
SQUARE FT. OF BUILDING TO BE OCCU
L�! CHANGE OF OWNER )B11CHANGE OF OCCUPANT
CHANGE OF USE Li ADDITIONAL OCCUPANT
I
occupancy rt DIV �---- I
51
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 `-as been inspecteJ and
certified safe. All applicants for occupancy in an existing building are required to schedule an electrical
'fuse up' inspection in the Departmon 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 buildingg or
premises in order to determine it a change may be made in the character of occupancy or use of the bu.iiding
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 teach Fire Code Section 10,208 requires that building numbers must be a minimum of four (4)
inches in height with one halt (1✓2) 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 Protection Association pamphlet o (see reverse side).
�� 4`
DATE PPtID ..._
AEuVOUuaT lxEcl=lvEc3 -- `
OCCUPANCY GROUP--
OCCUPANT LOAD
NO. OF STORIES
+xci•=..rrsa
r
76-039 tRev.1/97
(FOR OFFICE USE ONLY)
Z'JNIN! G
PLAN CHECK O
NO PARKING SPACES
Fr RMIT N0 _ _ --_ —
HEALTH i H l7EPT APPROVAL
ADMiN ACTION.--,---,,----
ILTILITIES RELEASED I
0 �
CERTIFICATE OF OCCUPANCY FEE
$ l
CHANGE OF USE OR OCCUPANCY FEE $ f _
TOTAL
$
4C..i4.4
SUPPLEMENTAL INFORMATION
t, BUSINESS ADDRESS 15"1 %� `��, iSca�. i� t i; cL� l�2 �o..cl (xV F If : (A q s�t�j
2.
Person to contact in case of emergency
Telephone number;
ads.
Does the building in question have electricity?
Y"s
0 No
(a) If No, are you requesting that the electricity be } Y)e—Vj-,Yes
turned on?
❑ No
4.
The building is sprinklerea 7
Yes
❑ No
5,
Operations will produce dust 1 wood shavings or similar
material?
d Yes
No
6.
Operations will involve the repair or replacement of
Yes
automobile parts?
19 No
i
If Yes:
(a) Describe the components repaired or replaced.
�
1
(b) Does the operation involve the use of an open flame?
Yes {
�o l
7.
The business is drinking, dining or assembly use that will
f
result in an occupant load of more than 50 persons.
E3 Ye
No
8.
The following best describes my operation;
Office Only
Retail Sales
arehouse_,5 PIu6 6in�.t, t -
I
5
nnu" fffic uring / Distribution (describe process and end product)
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Restaurant / Take Out Food
Medical / Dental
Other 'described
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1
SUPPLEMENTAL INFORMATION (Continued)
Does the operation involve any of the following materials? 0 yes
No
Yes, indicate q��antitl�s:
Material Quantity
1. Flammable liquids
Class ipf
Class 1-B
Class 1-0
2. Ccmbu¢tile iigtsids-_�,.._..�...�..,__.��_..s_._..,
Mass 11
Class 111-t1 - e._.. .w,.,we-m..,...,....,._...__,.
3. ombi nation flammable liquids
4, l~lml"nale gases �.._,..��........ ._..��.. __�.._...�....�._.._�..� mwM.,.. .___...,_.,,._.....�.
S. Liqu fled flammable gases
6. Flacnmable ,.fie¢�s�_ loose �a..�._....�...,.��..�.,..__.� v...�. , ,.,.......�,
7. Flamm le� fibers - baled
i3. �la�n�a'le soi►cts„�._.�...._._.a��... _ �..
�, t.lnsta�ie b�aatc€��zls
11, Oxidizing � material ,..�„gases -- �......,�,,..Q...W.�...�e,..�..�. ...�..�.�..�,�_�.�...� �,_.., :.
�- tldl�imtato�al liquids
T3. 3idizit 9 material solidsT47—
O rganic peroxides
-6r- ni oniun1 nitrate �.w.._ .... .
7, ernsr:¢sr�iu� m d it tt G,w cosnpouna mixture;
c;ntain ng more than 60fIo nit:eto
by weight
poisonous gas
1 hereby ce,,ipy that the above inf rnnation is tree and correct to
, the east a my kriow,odge
i1cMiir Date
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South Coast
Al"R QUALITYMANAGEMENT DISTRICT
21865 E. Copley Drive, Diamond Sar, CA 91765-4182 (909) 396.2000
AI. QUALITY PERMIT CH EC11 LIST
for nonresidential buildings only
Company Name: ' r,&,aJ , ,is`� , n t t 1-114
Location of Property: LuL d_ un4 E
city yip Code:15
Contact Person: -k�`1�t�(I�"_ InT/�.l (rl_ Title.- _ 1
Telephone Neunber: 0 ~ b 1) -153) 0 Fax NumberJ: t y ,� .z - ocl q
Type of Industry/Business: 1 1 - t2e f
To apply for a nonresidential building permit, you must complete this checklist. If you have any
questions about completing this checklist, please call (800) 388-2121.
YES NO
l .
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
solueb ts, adhesives, paints or coatings?
[ j
4.
Will dust or smake be generated at the: facility?
5.
Will .refiring of any liquids or solids be done at the facility?
j
6.
Will any plating or coating of materials be done at the facility?
j I
7.
Will any combustion equipment rated greater than 2,000,000 BTU/hr be
operated at the facility?
[ �
g.
Will any acids, solvents, or motor fuel be used or stored at he facility?
[ j
9.
Will any organic liquids or gases be reacted or produced?
[ j
10.
W ill any ovens be used to dry or cure produce w the facility?
[ )
11:.
Will anv ,FC (Freon) rec�y.,cling! machines overate at the facility?
Applicant: � . �f '� Signature:
-
(Print name clearly)
If you have marked "NO" in all the boxes, rm air quality permit is not needed at this rime,
and this ch cklist is your written release.
If you marked "YES" in any of the boxes, you must contact the South Coast Air Quality
anatgoineut Diana (AQ1N JD). Please read the requirements on the back of the checklist.
(800) 388-21 1
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