HomeMy WebLinkAbout15081 Edwards St - CofO (9)Y'CA e' 1,"') y-,- 6- 0 nyino"",
No
Jj
APPLICATION FOR-C'Eff-fl-FIC
.A7j6F
4� CITY OF HUNTINGTON SEACH
j
►K1N1NVGrON KncrI DEPARTMENT OF COMMUNITY DEVELOPMENT -71CIZ
(PRINT OR TYPL ONLYj
Address
Business
Gusintiss
BUR DING OWNHI OUSINP 55 OWNr MMANALjr. 11
Name-4SH-Le
Homo
Ad(lrow;A! 1
0(ty Home Tal
THIS U,;E WOULD BE DESCRIBCD AS,
NEW0 CONSTRUCTfil) BLDO
0IANGr0r,0WNi]4 C1, IANGF 01, OCCUPANT
v�w ExisrfNG OUILDIN6 n. CHANOF OF U61, AOMT(ONAL OCCUPANT
Indicate fotmar use. if any 0e, uparit v (it
SQUARL FT Or BUILDING 10 BI, OGGUPILD,
NOTICE:
1. Occupancy of any building to prollibiled and a business license Will not be Issued Until the building has boon
Inspected and a cortI1,10ale Of Occupancy in j0SUod,
2. No electrical Service Will I)o roloaGed for any ,�Iolft building until the sorvIc3 has boon Inspected and
',
certified safe. All applic)nta for Occupancy in an oxislino building are roquired 10 Schodulo an olectrioal
'fuse up' inspection in the DOPOrtmont of Got'll"Ilu"IlY Devolopmont at the Ift'no thin application Is filed,
3- Change of Occupancy or use Illopeclilon toe. Whonever
changO may be wado who 0110MCIOrOtoccupancy or use of the building
PrPMISsts in order to doloonina it, 11 It 10 nocc!�'�*ful`Y 10 make (I'sPeCtion of a building cir
. wornines which would Placolho building in a different division or tho -1mo group of occupancy 01 In a
different group Of occupancy, a change Of Occupancy ingpoctioll too or $
be paid to tile city, 8hall
A. Huntington Beach Firo Code sectioij 10.208 raquIran that building numbers must ba a minimum ()I four (4)
Inches in holailt with One half (vs) inch stroke, and of a cwhaaling color from the background, These
numbors 1111191 b0 P0,91od on You,build!nq In a location that Is visible from 1110 stroot,
5, HunitinoWn Beach Fire code Section 10,301 rogulron fire extinguisher DIDIOGliorl and disl6bullor) per Ike
National Fire Protection Assoctiation pjmpjjjot 10 (800 rovorso side),
TRAFFIC IMPACT
A-11—
AMOUNT RrXC-IVr,.0
NAME
(FOR OFFICE USC ONLY)
SUPPLEMENTAL INFORMATION
OCCUPANCY C IOUP PI AN I'M CK Nf)
000WPANT LOAD
NO OP STOnlrG 14 Ilkli r No
ADMIN ACIIIIIN
(11itif KAlt, of (X 4AJPANOY I 11,
CHANUt Of Uott 014 UCCUPAN(=)' I L I
TOTAL
00kno"wr ' J)p%j ()P?'jr-f,4T
/()NINt',
Nil PAIiKIW,,NPA( I
III At III IJI Pt AM)NOVAL
III'll III[; fill LA,51 1)
w
SUPPLEMENTAL INFORMATION
1. BUSINESS ADDRESS 151021 E)WZVr-) s A. C ' 4
2. Person to contact in case of
emergency` 510-6h'-)
Telephone number:
_
—('714) S4.J
3. Does the building in question
have electricity?
Yes
❑ No
(a) If No, are you requesting
that the electricity be
❑ Yes
turned on?
❑ No
4. The building is sprinklered?
Yes
❑ No
5. Operations will produce dust/wood shavings or similar
material?
❑ Yes
❑ No
6. Operations will involve the repair
or replacement of
❑ Yes
automobile parts?
No
If Yes:
(a) Describe the components
repaired or replaced.
(b) Does the operation involve the use of an open flame? ❑ Yes
�r7 No
7. The business is drinking, dining or assembly use that will
result in an occupant load of more than 50 persons. ❑ Yes
No
S. The following best describes my operation;
Office Only
Retali Sales
Warehouse
Manufacturing / Distribution (describe process and end product)
_._i'=i T�_,�, � .� C, s M ► i (,ram � z i
Restaurant/Take Ou' Food
Medical / Dental
Other (describe)
suwnt.aWNTAL ►raMMIAMN
SUPPLEMENTAL INFORMATION (Continued)
Does the operation involve any of the following materials? ❑ Yes
WNo
If Yes, indicate quantities: _
Material Quantity
1. Flammable liquids
Class I -A
Class I-B
Class I-C
2. Combustible liquids
Class II
Class Ill -A
3. Combination flammable liquids
4. Flammable gases
5. Liquefied flammable gases
6. Flammable fibers - loose
7. Flammable fibers baled
8. Flammable solids
9. Unstable materials
10. Corrosive: liquids
11. Oxidizing material - gases
12. Oxidizing material - liquids
13. Oxidizing material - solids
14. Organic peroxides
15. Nitromethana (unstable materials) _
16. Ammonium nitrate
17. Ammowurn nitrate compound mixtures
containing more than 60% nitrate
by weight
'8. Highly toxic ma+erial and
poisonous gas
19. Smokeless powder__ _
20. Black sporting powder
I hereby certify that the above
the best of my knowledge.
Signature
information is true and correct to
Date
6iF:
South Coast
.. AIR QUALITY MANAGEMENT DISTRICT
21865 E. Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-2000
AIR QUALITY PERMIT CFZCI<LIST
for nonres;-Jential buildings only
Company Name: .1 120E r• , () k N a, Q x1 tl r L S
Location of Property:;?
City:_ H .
Zip Code:.
Contact Person: j±lk ) J �., a
Title: ,r.
Teloplione Number:) c» 1 _
Fax Number:
Type of IndustryBusiness: ► A� L S
—
To apply for a nonresideritial building permit, you must complete this checklist. If you have any
questions about completing this checklist, please call (800) 388-2121. I
4
1• Will the facility have a charbroiler? YES
NO
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 (�
solvents, adhesives, paints or coatings? P,'ocessing of
4. Will dust or smoke be generated at the facility?
5. Will refining of any liquids or solids be done at the facility?
6• Will
any plating or coating of materials be done at the facility?
?• Will any combustion equipment O
�'
rated greater than 2,000.000 B � u/hr be
operated at the facility?
8• Will any acids, solvents, or motor fuel be used or stored at the facility? O
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) ) rP cycling machines operate at the facility?
Applicant: -±1 Ajgr, r n -! 1/ Signature:
r
(.Print name clearly)
If you have marked "NO" in al( the boxes, an air quality permit is not needed at this time,
and this checklist il�, your WAtten
release.
If you marked "YES" us any of the boxes, you must contact the South Coast Air Quality
Management District (AQMD). Please read the re �'
qurEments on the back of the checklist.
(800) 388•,2121
`
i
ADDITIONAL SUPPLEMENTAL INPORMA'110N
j