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HomeMy WebLinkAbout15122 Bolsa Chica St - CofO (5)�� �► APPLICATION FOR CERTIFICATE OF OCrUPANCY CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT (PRINT OR TYPE ONLY) 11uNNK"r+ ON BE4C" I/Address /B siness Name PACIFIC PO'RER S( DATE Distrla Tel a-� %� /q 1 u /Business Type Mane ufacturr _ — BUSINESS OwNERiMAQNAGER BUILDING` OWNER--�— _< I.GIISItsd)r! -- ✓ Home I �-- Name -r-'� Address ✓Address 15122 B015a Chica St. '649 _Home Tel.-ean-F' CA 92649 _Tell8�8-2691 City H City Huntington Beach, T IS USE WO1LD BE DESCRIBED AS: ^RANGE OF OCCUPANT ❑ CHANGE OF OWNER J = ❑ NEWLY CONSTRUCTED BLDG ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPI�NT EXISTING BUILDING Div._ Occupancy Gr._---- dicate former use, if any S ARE FT. OF BUILDING TO BE OCCUPIE building is prohibited and a business license will notbe issued until the build ng has b e d NOTICE: 1. Occupancy of any g existing building until the service has been inspected an inspected and a certificate of occupancy is issued. are required to schedule an electrical L 2. No electrical service will be released for any lication is filed. certified safe. All applicants for occupancy in an existing building time this ty Dection of a building or 'fuse up' inspection in the Departmentffee. Wh nleverr it isn necessary emake i spaoruseofthebuilding 3. Change of occupancy or use inspectionbe made in the character of occupancy in a different division of the same group of occupancy or in a premises in order to determine if a change may or premises which would place the building ancy inspection fee of $ I` different group of occupancy, a change of occup be paid to the city. 08 re, and of a contrasting color from the background. These - Huntington Beach Fire Code Section 10.508 requires that building numbers must bminimum of four (4 4' t with one half (/z) inchstreet.k inches in height our building in a location that is visible from the numbers must be posted on y wires fire extinguisher selection and distribution per the 5. Huntington Beach Fire Code Section 10.301 ei 0 (see reverse side). is National Fire Protection Association pamphlet I' TRAFFIC IMPACT FEE N� QAIL DATE PAID �� 1 AMOUNT RE (FOR --�— ^ (FOR OFFICE USE ONLY) ZONING NAME �� NO. PARKING SPACES SUPPLEMENTAL INFORMATION PLAN CHECK NO. HEALTH DEPT APPROVAL,----- If OCCUPANCY GROUP PERMIT NO UTILITIES RELEASED OCCUPA T LOAD 4 ADMIN ACTION NO. Or IE �J�j'j CERTIFICATE OF OCCUPANCY FEE $ D TE CHANGE OF USE OR OCCUPANCY FEE $ APP E BY TOTAL COAIIMUNITY DEVELOPMENT 75.039 Rev. 1 i190 r SUPPLEMENTAL INFORMATION 15122 Bo1 itYPPI �lw' 1 I:3USINESS ADDRESS to contact in case of emergency' Bruce A. 714/898_ 2691 2. Person Telephone number: © Yes question have electricity? the building in q ❑ No 3. Does ❑Yes requesting that the electricity be ❑ No (a) If Nio, are you turned on? f� Yes 4. The building is sP rinklered? ❑ No produce (just/wood shavings or similar will p❑ C Yes 5. Operations No material? ❑ Yes involve the repair or replacement Of U No g. Operations will automobile parts? It Yes: onents repaired or replaced. the comp (a,) Describe f an open flame? � eration involve the use o op 0 Yes E No (b) Does th,., dining or a.s semoly use that will ❑ Yes 7 The business is drinking, occupant loar+ of more than 50 parsons. fix] No result in an The following best describes my operation; g, Office Only Retail Sales product) and end p Warehouse rocess / Distribution (describe p Manufacturing xanuf ?ng of AC Power Sources s Restaurant/Take Out Food Medical / Dental Other (describe) SUPPLEMENTAL INFORMA110N i SUPPLEMENTAL INFORMATION (Continued) of the following materials? O Yes 0 U No DOes the operation ;evolve any li If Yes, indicate quantities: Quantity Material 1. Flammable liquids Class I -A Class I-B Class I-C 2. Combustible liquids Class It Class III -A _ flammable liquids 3. Combination d 4, Fiammable gases Liquefied flamm-. Ae gases i__ r 6. Flammable fibers -loose F Flammable fibers - baled _ 7. g Flammable solids g Unstable materials 10. Corrosive liquids --- material - gases Oxidizing I }: . material liquids 2 ' 1, Oxidizing _ 13. Oxing material - solids idiz l 14. organic peroxides`: materials) unstable 15. Nitromethane ( __ i Y 16. Ammonium nitrate compound mixtures tethanm6Q°lo nitrate i7 Ammonium nitrate containing ----- 1 by weight material and 18Highly toxic poisonoss gas 19. Smokeless powder ,�_-- � 20. Slack sporting powder rl ____---- the above information is true and correct to b certify that hereby f m knowledge. best o Y the b Q/ /. E'er _--- -- Zg?gPna&ure Date - _ C4 _ 1 j fib soutb Coast J MANAGEMENT DISTRICT Alp, QUALITY 0 21865 E. Copley Drive, Diamond Bar, CA 91765-4.82 (909) 3 AIR QUALITTy gEp-NUT CHECKLIST for nonres' dential buildings only 9 1�1V c� eULLDj' Company Name: .nic Location of Property: I �� L-.�Eli" Zip Cade: City: ��-1 ,rlv, 7�� C� Contact Person: f� etc l l � r _ Title: 17C�.a r - --- Telephone Number: 1G Yq� - 2-6 7 / Fax Number-. 3�! - /��� Type of industry/Business: To apply for a nonresidential building permit, you must complete this checklist. If you have any this checklist, please call (800) 388-2121. questions about completing YES NO 1. Will the facility have a charbroiler? 2. Will any internal combustion engine with greater than 50 horsepower [ } operate at the facility (excluding motor vehicles)? Will operations at the facility involve mixing, blending, or processing of [ } solvents, adhesives; paints or coatings? [ } 1 4. Will dust or smoke be generated at tha facility? [} 5. Will refining of any liquids or solids be done at the facility? } (,. Will any plating or coating of materials be done at the facility? 7. Will any combustion equipment rated greater than 2,000,000 BTU/hr be operated at the facility? 8. Will any acids, solvents, or motor fuel be used or stored at the facility? [ 9, Will any organic liquids or gases be reacted at the faor cility? 10. Will any ovens be used to dry or cure p [ }] 11. Will any CFC (Freon) recycling machines operate at the facility? 7 �� < e �!1 r ,� �� Signatwe: G Applicant: rT (Print name clearly) If you. have marked "NO" in all the boxes, an air quality Permit's B_Qt needed at this time, and this checklist is your written release. If you marked "YES" in any of the boxes, you must contact the South Coast Air. Quality Management District (AQMD)• Please read the requirements on the back of the checklist. (809) 388-2121 V r PAPLICAT 1N FUR-CE(i!"ATE OF OCCUPANCYCITY OF HUNTIN.GTON BEACH Hui.�vcra, er.MDEPARTMENT OF COMMUNITY DEVELOPMENT 1V (PRINT OR TYPE ONLY) DATE i Address = la�So '' rLZ,, BuIness Names District PF-chic F?p �� .SOvVcp Tel. 8 Jb- ZG 4f E&usiness Type � L9 e-K-0-.zc S/ /�3 Oc.,. Group BUILDING OWNER ., BUSINESS OWNER/M,NAGER Name— %✓tibj�IYV j Vy� r� �--- Name„ - Address N00 l w�k+�u.. �Y %L - - Home �jA MQ Address City nil5�� C.L 9(030 T c 4 ISIl i' I City__ Home Tel. i THIS USE WOULD BE DESCRIBED AS: ❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER ❑ CHANGE OF OCCUPANT IL�J EXISTING BUILDING � ❑ CHANGE OF USE r ^ _ ❑ ADDITIONAL OCCUPANT Indicj3te former use, if any Occupancy GrL�r����Div.___ SQUARE FT. OF BUILDING TO BE OCCUPIED --j - �5 1 )-oO NOTICE: ! 1. Occupancy of any building is prohibited and a business license will not be issued until the building has been I 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 I, 'fuse up' inspection in the Department of Community Development apt 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 r' or premises which would place the building in a different diW.ion of the same group of occupancy or in a different group of Occupancy, 1I a change of occupancy ir;pection fee of $ shall j be paid to the city. 4. Huntington Beach Fire Code Se tion 10.208 requires that building numbers must be a minimum of four (4) inches in height with one half (,/) 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 see reverse side). National Fire Protection Association pamphlet 10 i IN TRAFFIC IMPACT FEE DAi'E PAID AMOUNT RECEI';;7D NAME -- - (FOR OFFICE USE ONLY) S �3 ZONING — OCCUPANCY GROUP PLAN CHECK N OCCUPANT LOAD NO PARKING SPACES _%�iZ PERMIT NO. r NO. Or STORIES HEALTH DEPT APPROVAL ADMIN. ACTION_Izolqa UTILITIES RELEASED _ • '$ ERTIFICATE OF OCCUPANCY APPROVED BY$ DATE /CFEE HANGE OF USE OR OCCUPANCY FEE $ TOTAL 75-039 Rev.1/97 $ South Coast AIR QuAL,ITY.MANA.GEMENT DISTRICT 21865 E. Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-2000 i AIR QUALITY PERAHT CHECKLIST , for nonresidential buildings only Company Name:'CA�� low e.• Svyv� e Location of Property: City: i l�n 4 w �� �[^ Zip Code: 92-6 4 9 Contact Person: �� 1µ�t(�� Title: VIP• Telephone Number: ��L 9 ' 1•'--91 Fax Number: Type of IndustryBusiness:���""��° A-3ij 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 1. Will the facility have a charbreiler? [ ] 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 solvents, adhesives, paints or coatings? [ ]] [ ] Ems] 4. Will dust or smoke be generated at the facility? 5. Will refining of any liquids or solids be don`: at the facNty? 6. Will any plating or coating of materials be done at the facility? 7. Will any combustion equipment rated greater than 2,000,000 BTU/tu be operated at the facility? 8. Will any acids, solvents, or motor fuel be used or stored at the facility? [ ]] 9. Will any organic 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 the facility? [ ] Ff] Applicant: o\\r � &cam Signature: (Print name clearly) If you have marked "NO" in L 1. the boxes, an air quality permit is rat needed at this time, and this checklist is your written release. If you marked "YES" in any of the boxes, you mast contact the South Coast Air Quality Management District (AQMM). Please read the requirements on the back of the checklist. (800) 388-21121 ADDITIt P Ai. SUPPLEMENTAL, INFORMATION M