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Home My WebLink About15242 Connector Ln - CofO1 r APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT is a�-A,_____ Hurrnr+croH sour DATE {PRINT OR TYPE ONLY) Ad res5 iZ•�CZ�'1 fl�� _ _ District Business Name- C � i�v�st�� _ .. Tel t Q"15$ VolBusiness Type. Occ. Group..g � BUILDING OWNER BUSINESS OWNERIMANAG'i Name VAtAU-0 U A -- Wf Name Address A\J4G_ _ Address TWIKwXr City �✓ rVa4 t, T City _t?k1 0 Qte, C Home Tel,UqNL- �75,� THIS USE WOULD BE DESCRIBED AS; P ❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER F OCCUPANT EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDIT".ANAL OCCUPANT f Indicate former use. If any ----Occupancy SOUARE FT. OF BUILDING TO BE OCCUPICDrrrr - .1 C-3kA- 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 I 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 ar 1cation Is filer), 3. Change of occupancy or use inspection Yee. 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 t or premises which would place the building in a different division of the same group of occupancy orJn a a-i different group of occupancy, a change of occupancy Inspection lee of $ r shall ; t7 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 half ('/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 10 (see revprse side), i TRAFFIC IMPACT FEE .ter r DA1`E PAID AMOUNT RECEIVED , iQ� 2 NAME'"" —"—"� (FOR OFFICE USE ONLY) SUPPLEMENTAL INFORMAY10 I 2ONINO) M11 OCCUPANCY CaROUP...PLAN CHECK NC.NO PARKING SPACES ._�. OCCUPANT LOAD . . rp _._- PERMIT NO.. _ HEALTH DEPT APPROVAL NO Or STORIES ADMIN_ ACTION UTILITIES RELEASED / Y CERTIFICATE OF OCCUPANCY FEE $ AMROVED BY D TE CHANGE OF USE OR OCCUPANCY FEE S TOTAL $ 760391av, t i/ue COMMUNITY DEVELOPMENT it l V � t e i I` SUPPLEMENTAL INFORMATION j i 1. BUSINESS ADDRESS (5�`��r1f►�G�it t r'A& 2. Person to contact in case of emergency•�e. U!n° Telephone number: Zip 3. Does the building in question have electricity? ff Yes. 6 0 No (a) if No, are you requesting that the electricity be ❑ Yes turned on? ❑ No 4. The building is sprinklered? a Yes No 5. Operations will produwe dust/wood shavings or simllar material? O Yes IT No k 6, Oporations will Involve the repair or replacement of ❑ Yes automobile parts? 13' No I If Yes; (a) Describe the components repaired or replaced. ` (b) Does the operation involve the use of an open flame? ❑ Yes a Ci No 7. The business Is drinking, dining or assembly use that will result in an occupant load of more than So persons. ❑ Yes U No 8. The following best describes my operation; Office Only ? Retail males Warehouse l Manufacturing / Distrlbutian (describe process and end product) Restaurant / Take Out Food � Medical / Oental £' Other (describe)- i SUPPLEMENTAL INFORMATION SUPPLEMENTAL INFORMATION (Continued) Does the operation Involve any of the followings materials? ❑ Ye l,NOF If Yes, indicate quantities,. Material Quantity ! n1. Flammable liquids Class 1-A ^. Class 1-B i - Class 1-C� 2, Combustible liquids i Class 11 Class 111-A- 3. Combination flammable liquids 4. Flarjonable gases- ' t 5. Liquefied flammable gases l 6. Flammable fibers - loose 7. Flammable fibers -baled 9. Flammable solids 91 Unstable materials 10. Corrosive liquids y 11. nxidizing rt)aterial - gases ; 12. Oxidizing material - liquids- 13. Oxidizing material - solids 14. Organic peroxides M Nitromethane (unstable materials) 16. Ammonium nitrate _ 17, 4mmonlum nitrate compound mixtures containing more than 60% nitrate by weighs -....-------- 16. Highly toxic material and poisonous gas 10. Smokeless powder 20. Slack sporting powder 1 I, here certify that the above information is true and correct to th a of my knowledge. 4 04 Signature Date Y l SOUTH) COAST AIR QUALITY MANAGEMENT DISTRICT i V (Nonresidential Buildings Only) � i Location of Subject .Property:-1<S;`�.._ j U,bl� �r�u�risr �� ___� Phone Property Owner Name:'! - Name of the Berson preparing this form in print and signature:. - l [ Y Signature. ! 1 The person preparing this form must he the same person applying for building permits. Please answer the of the subject building. IF YOU D© NOT KNOW # following questions regarding your proposed occupancy THE ANSWER TO A QUESTION, MARK 1N THE "YES" COLUMN: A©AAD PERMITTING CHECKLIST YES NO ` 1. Does your facility use any internal combustion engines greater than 50HP? 2. Does your facility involve mixing, blending, or processing any solvents, __✓ �� adhesives, paints or coatings? `� y 3. Does your facility create any dusts or smoke? ----- , r f 4. Does your facility refine any liquids or solids or reclaim any metals? ---------- � J 5. Does your facility plate or coat anything? 6. Does your facility have any combustion equipment (i.e. boiler, furnaces, broiler, baking ovens, etc.) rating greater than 2,000,000 BTUlHR? 7. Does your facility handle or store solvents or motor fuel? --- ---'�- - S. Do you use or store any acids? 1a 9. Do you use any chemical process? J 10. Do. you use any solvents for clean-up? -` 11. Are you a dry cleaner, restaurant with a oharbroler, body chap, gasoline station, printer, br part water? ". 12, Is the subject building located within one thousand (1,000) feet of any PROPERTY LINE TO PROPERTY LINE, GRADES K-12. _ _----- school? If you have marked "NO" in all columns, you do not need an Air Quality permit at this time. If you have marked Coast Air Quality Management District located at: _ any questions in the "YES" column you must contact the South 21865 E. Copley Drive Diamond Bar, CA 91765-4182 y Please call: Plan Check (909) 39a,2000 r 1 i w