HomeMy WebLinkAbout15081 Edwards St - CofO (25)WIM
*/, APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
` DEPARTMENT OF BUILDING & SAFETY 0
11UNT1NGtON BEACH (PRINT On TYPE. ONt.Y) DA .E
1tNVW, r� ,yc-A- 7 Z f (41
Address District -
Business Name— rti c4, C/ Pf S '1�'f - Tetj1j
11 w
Business Type ► s% c ^� Occ. Group`
BUILDING OWNER BUSINESS OvINER/MANAGER
Name- ice. � C.,v •r-�Gl�1�.S� Name _ �"-�� � At�,°Yr .
Home �'
(� ) 6& c.. (� �}ltt j� 2�d
Address _. Address '
City Gt N ijo (r T' '� 'C"71rc, l ( �... Tel )-'$-Qlp d City r5 A-WTA AWA- 4je ._.. Kome Tel .-!7'y" %mil r 1
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THIS USE WOULD BE DE$CRIDED AS:
El NEWLY CONSTRUCTED BLDG, ❑ CHANGE OF OWNER � CHANGE OF OCCUPANT
R EXISTING BUILDING ❑ CHANGE OF USE ADDITIONAL OCCUPANT
Indicate former use, if any � ., �^ N_..k_,-,_,..Occupancy Gr �Div.��
SQUARE FT, CF BUILDING TO BE OCCUPIED_ ~� 17-!
u—,�--
NOTICE, 1.
2.
3.
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.
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.
Change of occupancy or use inspection fee. Whenever it is necessary to make inspection of a building or
premises in order to deter mine if a change may be made in the chara .ter 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 at occupancy inspection fee of g sh:-ii
be paid to the city.
Huntington Beach Fir 'ode Section 10.208 requires that building numbers must be a minimum of four(4)
Inches in height with c e 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.
Huntington Beach fire Code Section 10.301 requires fire extinguisher selection and distribution per the
Pfational mire Protection Association pamphlet 10 (see reverse sl, •9). �
.4Jats�' (FOR flFFICG 1USF CNLY)
$
OCCUPANCY GROUP
_�.. - --- PLAN HECK NO
OCCUPANTLOAD _
_ - i
my PER14"T NO
NO. OF S'rr,i1ES
ADMIN ACTION.,.....,-
CERTIFICATE OF OCCUPANCY F FF
PP O D by
DATE CHANCE OF USE OR OCCUPANCY I'LL
, $J
TOTA�
140 PARKING, SPACES ---
HEALTH HEALTH DEPT APPROVAL--. -
LITILITIFS RELEASED --- -
FUnM 76-039 REV 2102 TO ORDO" f ANU 00I I AR 714 842 1141
SUPPLEMENTAL INFORMATION
1. BUSINESS ADDRESS ( 5. U OF i � 4111 102_�( SI' , U,r�6'5�
2. Person to contact in case of emergency:_ _ A'-C' G, /J- mv
Telephone number;' .=
3. Does the building in question have electricity? VYes
C] No
(a) If No, are you requesting that the electricity be C' Yes
turned on? Cl No
4. The building is „prinklered? 0 Yes
Ll No
5. Oporations will produce dust / wood shavings or similar
material? 0 Yes
,9 No
6. Operations will involve the repair or replacement of 0 Yes
automobile parts? No
If Yes:
(a) Describe the components repaired or replaced.
(b) Does the operation involve the use of an open f6ame? 11 Yes
%-No
7. The business is drinking, dining or assembly use that will
result in an occupant load of more than 50 persons. 0 Yes
A.No
8. The following best describes my operation;
Office Only
Detail Sales
Warehouse
Manufacturing / Distribution (describe process and end product)
Restaurant/Take Out Food
Medical / Dental
Other (descr)` ) _ �
SUPPLEMENTAL INFORMATION (Continued)
Doc-.s the operation irvolvo any of iho loll- ClY (- s
?
El No
I hulrf!tty tivat tho ,q.[-)-,)vo is, trou ancl, wmxt to
tho best of vvy toiewledge.
South Coast
A►IR. QUALITY MANAGEMENT DISTRICT
21865 E. Copley Drive, Diamond Bar, CA 91765- 4182 (909) 396.2000
AM QUALITY PJE12.t2MIT CiECKLIST
:for nonresidential buildings only
Company Name:
Location of Property;
City: " h A � Zip Code: o) 2,
Contact Person. f1,. ;n o Title
Telephone Nurnber: �'l ("" Fax Number:
Type of Industry/Business.
To apply for a nonresidential building permit, you must complete this checklist. If have any
questions about completing this checklist, please call (800) 388-2121.
'CBS
NO
1, Will the facility have a charbroiler? ]
)
2. Will any internal combwition engine with greater �dian 50 horsepower
operate at the fati.ility (excluding motor vehicles)?
3. Will operations at ;facility involve mixing, blending, or processing of
snlveuts, adhesives, paints, or coatings?
4. Will dust or smoke be gernorated at the facility?
S. Will refining ofwy liquids or solido be done at -the facility?
[x�
C. Will any plating nr coating of materials be done at the facility? ]
�
7. Will any combustion equipment rated greater than 2,000,000 BTLT/hr b
operated at the facility?
8. Will any acids, solvea,4, or motor fuel be used or stored at the facility?
9. Will any organic liquids or gases be reacted or produced? L ]
L I
10, Will any ovens be used to dry or cure products at the facility?
I'll
11. Will any CFC (Freon.`) recycling machines operate at the facility?
Applicant; , .. ! �+ o Signature: �.�..
(Print mane rl arly)
If you have marked "NO" in 1 1'the boxes, an air quality permit is mineeded at this time,
and this checiist is your written relcase.
If you marked "'YES" in any of the boxes, you must contact the South Coast Air Quality
Management Distriet (AQMD, )., Please read the rwquirements on the back ofthe checklist.
(800) 388v:2121
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++'Nv, 9.e\. m,,, M ����,r,����fe\ 0 1{,�k 0.2 (h���4'd2i'1, S)
:!lift omit st;at'' l'aw time tr.f'ow j'h")iw the HuMm, IkpartI Tents froi r
Ia"allip; as Anal ut, hisuc of t1mupatr* wilcy'sti tiill o"' the local air tlualite
Inet '�%Il are bvquitcd tt, C"pq;♦f�rplety tf}� air ��r*tf. sty }��pvrtlifityiJ4+[it�•Aliin't' `{ty'111E= CFrQCklyi4,t is3
deAgned to aid tho all plivallt 1 i a ���i4I1 �`F1�4{�}1�t65t� ICY IrI �AtGQ� pt.jvilt ,irjl `. If till mils o". 4o ,tny rif,
tllk tijiat' ;ti )111, i"i "YI'S! In lu dm t1i4,Y,:1tp'll`iallw.n" lv'u-�t t4biilll"1 a Irol a Cau local ait
t`lrltalit 4' tipt'lat y b"em'.'1n", th'it t"stv of 4pli': illt i ; ills t;twlphxjv'e'
All vc4tarobMcnati„' l dsto Ia. ° gt ��`.siw ,t01+111C 'Mlk' 1"ltl�, 111TIOW flits
2. If the "wr"4'v`:'a , t(+ val� t1 34'yk4tar: a31v ,,,,pit ),` tiw l§"t114t.1113iY fit t ac. 1' i.''CMiQ
,3 the N" vittela n2ivav't,'
if, wloY iillt" ttl`ri t Z'i" 'ZrWi'4'ro4nt:i � "I'i.S." ',a: .1is1411 i$4rt tal3.i`4 Ilu" 'nth'. ID by k°ebillt.11x
(8001 1880121 to 04;rClllliliv :Ajttr1v"1 it "quality pannit., are required f6r any equipiuout
avhkh xra,.ty be s"t„_`rastmi al die sne If ill.' A")All) deterta iuosa that Pair quality l pouts are
not ruquiled or flue all 11'"r e beery llact, as "NTiucti releaabr Mll be NstMtl.
4, If aii Flay 1+unniti ure ioquirurl Al ap1alicatiow leave not becrt subillitted, tlde applicaaut
tillist S;llbrili4t thelde.". ' :.. °�, l!�`l+`lit ar} lrllc:tatit,alr'�, and ap;,! kopriato ices', b'40 le .a "'�Ihterl
Maw W;R
AQMD is c t,rlarllined to expeclitin,'? all clf�aar wvv letter request, However it tllay tal• e " :"Ver;al
1it"eks tti1 voxii,w �'ltlll�la<.Yjs,"1' ttiltl; all reiiill'ww1t�"wI '4. Ii lieu -for . ^�'ou a�l'�' t'�il'�'3°.E": to contGtd AQN11)
irl lessen. after aplalyitllr for builciiva peralits.
(800) 88-2121
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