HomeMy WebLinkAbout15070 Edwards St - CofO0
/e APPLIGOAT;ON FOR CERTiFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
f, 01- r DEPARTMEN ' OF BUILDING & SAFETY "
HUWi'eVGfON OiiKTi a '?`1
+f'RIN, OR TYPE ONL r, 1 to Al
V ,
DATE
Address t 7 _EF r�u� t� `: 1�_l ft i�.l tivlyT. ! ^ ,�'� el -2.1.�'� District
BusinessName.7gp uF C.H- w
Business Type =t'�T/ +tl2AW _ Oce. Group? S v
BUILDING OWNER BUSINESS OWNERIMANAGER
Home
�it-sne �'• `:1.�.. � rs�.-�t�i _ R r_ r,�,t�°(r�5 ._.._. Name �� �.�..�.3_C=!.�,.�!'�r�y..,_. r
Address i3� i c � IJt sir G Address.i5��
citytte ����4`�lttlyla.t" �C� �t ���� ��_.a...�.7zl�il�F; � � �».._...
' 7 �:' ,a�cf Clty_� �> �t�� �� ..__Hol;ie Teri. a:%b • 9 'a.
T����-HIIS USE WOULD HE DESCRIBED AS:
t_.t NEWLY CONSTRUCTED BLDG. TM--J\ CHANGE OF OWNER CHANGE OF OCCUPANT
EXISTING BUILDING ❑ CHANGE OF USE: ❑ ADDITIONAL OCCUPANT
Indicate former use, it anY4. 'w Gr Div
SQUARF. FT. Of BUILDING TO BE OCCUPIED --SLl—':b - ' G" t•_�.
NOTICE: 1. Occupancy of any buiiding 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 aervice has been inspected and
certified safe. All applicants for occupancy in an existing building are required to schedule an electrical
Use up' inspection in the Department of Community Development at the time this application is filed.
3. Change or occupancy or use inspection tee. V"henever it is necessary to make inspection of a building or
promises in order to determine if a change may be made in the character of occ! ipancy 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 c ` occupancy inspection fee of $ .., shall
be paid to the city..:.F._n..,
4. Huntington [leach Fire Code Section 10.208 requires that building numbers must Le a minimun7 of four (4)
inches in height with one half (112) 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 reverse side).
OCCUPANCY GROUP...._,...- ",�,
OCCUPANT LOAD
NO. STORIES
.lt��t:Gc�✓t
AP O E BY
PLAN CHECK NO _ NO PA'KINt SPACF5
PERMIT NO �. � ..__ 4_ ,.. _ ...,,, HUALTH DEPT APPROVAL
AC)MiN UTILITIFS RELEASED
CERTIFiCAn OF OCCUPANCY fFE t .�:..
CHANCEL OF USiv. Oil OCCUPANCY 1`E.1 $���
TOTAL:,.u.. m.
tORM 764D) REV 210:1 RC ORI IN SANlit)C,MAR'141!V tMri
26A
SUPPLEMENTAL INFORMATION
1. BUSINESS ADDRESS I t Q`X,,�{° ' ,. `.y`(, 4Lfrj lili(.K I ill
2. Person to contact in case. of a-mergenc
Telephone number:
3. Does the building in question have electricity?
(a) If No, are yoo requesting that the electricity be
turned on?
4. The building is sprinkleredl?
5. °` Operations will produce dust / wood shavings or similar
material'?
6. Operations will involve the repair or repla::ement r.f
automobile parts?
If Yes:
(a) Describe the components repaired or replaced.
Yes
❑ No
❑ Yes
❑ No
❑ Yes
a No
0 Yes
Fa, N o
0 Yes
,0 W
(b) Does the operation involve the use of an open flame? ❑ `-!es
❑ No
7. The business is drinking, dining or assembly use that will
result in an occupant load of more than 50 persons, Yes
❑ No
8. The following best describes my operation;
Office Only
�
a;e
areho e
Manufacturing / Distribution (describe ,process and and product)
<:l4estaur' ", a I c e nut Food
Medical % Dental
Other (describe) . _
SUPPLi-WENTAL INFORFVlATJC%,l (OoitfinUed)
f 7 1 t hereby curtifvhbove tat the ai(If0troaflon is, ruol Qnd correct to
tile best of my knowledge,
'IF
South Coast
AIR QUAU TY MANAGEMENT DISTRICT
218G6 E. Copley Drive, Diamond Bar, CA 9176a•4182 (909) 396.2000
AIR QUALITY PEMMIT CRE(J UST
for nonresidential buildings only
Company Name: ��-, kFa:'+� T
Lar,,ation of Property: ` , Tc;, 6- .5 .7,
Zip Code.'
C on: Title: R r
Tclephon- aber:(:L °a �" �.x ', '� _ _ PaxNumber:(' 4.)
Type of Industiy/Busaness• �_� ` , r �, r. r, r, ;'%`
To apply for a nonresidential building perm It, you must compl-te this checklist. If you have any
questions about completing Ns checklist, please call (800) 388-2121.
1. Will the facility have a charbroiler9
2. Will any internal combustion engina with greater than 50 horsepower
operate at the facility (excluding motor v hicles)?
3. WitI operations at the facility involve mixing, blending, or processing of
solvents, adhesives, paints or coatings?
4. Will Must or smoke be generated at the facility?
5. Will refining of any ,iquids or solids be done at the facility?
5. Will any plating or coating of materials hw clone at the facility?
7• Will any combustion equipment rated greater than 2,000,000 BTU/lu- be
operated at the facility?
8. Will any acids, solvents, or motor fuel be used or stored at the facility?
y. Wi.?1 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) recy,.;,,.ng machines operate at the facility?
W—,S NO
.U.] [ ]
[I M
[4 )
[lle ]
Applicants y �� Y .t ; 4 Signature: -Y u 1 (Print name clearly)
If you have marked "NO" in All the boxes, an air quality permit is nQ1 needed at this time,
and this checklist is your written relecse.
If you nnatked',M11 in any of the boxes, you must contact the South Coast Air Quality
Mar,agement District (AQ,,M )). Plr-v a read the requirements on the back of the checklist.
(8uuj - 9-212I
1W
NOTICE OFREQUIREMI,"INTS
C3iliC7rialGi Stato l,.iLL" (iTt1L''�t'foll ut t 1i41;, C?' sh"� i,;) 1?i' hibit,; th 13iiihlini:, Dep,�t"t1'wnts from
l iiiiiii ; a tii7:il i s iliti att, of mct1l)xWt 1 i1�C .1Ii 1'l iji%?YsTlitiilta 4'+A�the l�14,a W-i, 1I1.1c^"ilty u,E,'elic;4 avo
irict. All applicant,,are tequiled. To tits' air quality rcrnlit s,:1���Ivti 1. `ll:° Lilac°Mist is
�ie:;i;{tint tc� airl tl.�+ �tl3lllia'� ttt t;r ti ni�frtr4�,rsl�ytit ;al isliil.�in�z it�rrc3it c�rli�". If tuck ila{;t��;r tia atiy csf
t1w lttlildimo DLa .jrttt,w°tit tiiu�;t ail^t<iiti a w1itivii rsa vlc 15� l�c�tii tix� lc�ra air
quality t Ilea" veri�yiri,; that the Wap, liRaut i."'i iIi rut»Iriplikatl(x
All 1+u11tlit1;, pclrl+it r l)pllcant,� tillu't complete this Ch Llirzt.
Ifthe aris%el,; to i1%i qfl�' tlomI it°' ` D::11 ?tt I101t E :i.l 4.4Vt'pt tile; 6:ifOCWN't
an the -w itt"11 raleaov,
],t arty qu(t Stikmit .=c otvv "`,C,l "YF'S. 1111, tdtiplicant must contact tilt AQ'N11) by c altin
(0) 188-'T) l to Oet�xn-i.,V} ii gaality pmnits r+ro. required for -,In equipment
LL"llic-h may bo operatod ,at the sits. l; tlw Ac Nii dcterntit %!,s tNit air quality perinits are
riot requirb.l or that ;ill regiiircmcnt9 liraLc' 11e ri uju, a written release will fie is cited.
4, If jir gjna i*t pcnni�.. are r,,q fired -1wl {ip1)lWations have vot bwl wtlbnIlmd, the vlpplicaut
must so"'wit 111L, itc't 4.,r}its pertilit applicati(m(s) and appropriatoe fees 1.7C"ta3w a wLitten
r�alc�a;,ce LLtll ll,� i;,:,tt"c$.
M)MO is c orrmittced to nxpcditillg all elearattl a letwr rqueasts. Ikkwever, it may take 4;cv>ral
.kNeeks to vor"i4L' all you ar+: advised to contai:t t QAN-1l1
hair►ic.diately after apply"irg for tluildiv:! pwrlits.
(800) 388-2121
favi"ed lt.rJ
