HomeMy WebLinkAbout15081 Edwards St - CofO (2)` OAF LIGATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH ^� f
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DEPARTMENT OF COMMUNITY DEVELOPMENT ,v2L/ ( CT"—r;
(PRINT OR TYPE ONLY) DATE
Address "6� Q_YI/kJ)2 (�S SE ,��cf.Lra District
Business Name
Business Type _
91
BUILDINGOWNER
Name "�f n e /
AddfeSS.i_�� 4ec1 Qin d, r�-P;//mrfl �5,l e 3_26,,_
Cit
THIS USE WOULD BE DESCRIBED AS:
Tel.
Occ. Group_
t7F USINESii OWNERIMANAGER 111 ��-
Name ? AA4 •�l. !�l^�'(1 �/£�%
HomeICI r7�! i
Address((- rr K__'-- VUL
City C �"Ckvt �T D� Horne Tel.-714.63.6.,�4ap
❑ NEWLY CONSTRUCTED BLDG lJ CHANGE OF OWNER (���c,C�) ❑ CHANGE OF OCCUPANT
EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT
Indicate former use, if any c Occupancy Gr Div
SQUARE FT. OF BUILDING TO BE OCCUPIED�v 4W
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
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 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
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 Beach Fire Code Section 10,208 requires that building numbers must be a minimum of four (4)
Inches in height with one half (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 10 (see reverse side).
TRAFFIC IMPACT FEE —
DATE F'AID
AMOUNT RECEIVED
N.' ME @@i
SUPPLEMENTAL INFORMTON (FOR OFFICE USE ONLY) ZONING_
OCCUPANCY GROUP_PLAN CHECK NO NO PARKING SPACES
OCCUPANT LOAD __ PERMIT NO _� _,._. _ _ HFAI TH DEPT APPROVAL
NO, OF STPRIES ADMIN ACTION_ _, _ _ UTILITIES RELEASED
_ ��-
Z' CERTIFICATE OF OCCUPANCY FEE $
AP RC ED b DATE CHANGE OF USE OR OCCUPANCY FEE $
TOTAL
75.039 Rev.1/97
COMMUNITY DEVELOPD..WNT
na
SUPPLEMENTAL INFORMATION
1. BUSINESS ADDRESS Z Si�v 4 A 0
2. Person to contact in case of emergency* `T'-BA-A -44-. �-JCTUYE6=1
Telephone number: ( -1(4 ) ~ 3�'7
3. Does the building in question have electricity? 12Yes
❑ No
(a) If No, are you requesting that the electricity be ❑ Yes
turned on? ❑ No
4. The building is sprinklered? u Yes
❑ No
5. Operations will produce dust/wood shavings or similar ❑ yes
material? ®No
6. Operations will involve the repair or replacement of ❑� �Yes
automobile parts? �d" Flo
IT Yes:
(a) Describe the components repaired or replaced.
(b) Does the operation involve the use of an open flame? ��
7. The business is drinking, dining or assembly use that will ❑ Yes
result in an oc.:upant load of more than 50 persons. ONO
8. The following best describes my operation;
Office Only
Retail Sales
Warehouse
Manufacturing / Distribution (describe process and end product)
Ragfnii ant / Take Out Food
SUPPLFMFNTAL INFOWATION
SUPPLEMENTAL INFORMATION (Continued)
Does the operation involve any of the following materials? ❑ Yes
❑ No
If Yes, indicate quantities:
Material _ Quantity
1. Flammable liquids
Class I -A
Class I-B
Class I-C -
2. Combustible liquids
Class II
Class III -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. Nitromethane (unstable materials)
16. Ammonium nitrate ~�
17. Ammonium nitrate compound mixtures
containing more than b0la nitrate
by weight
18. Highly toxic material and
poisonous gas
19. i Smokeless powder
20. Black sporting powder...__-...�__r._,�...._.m__,_..-,..__�v.,.,.v,.,_..,...,_._.,..�.�....�.._,
i hereby certify that the above information is true and correct to
the best of my knowledge.
c� Signature Date
7