HomeMy WebLinkAbout10500 GARFIELD AV - CofO (2)d
'
�.�—_mow!'
t
CmwicATE or- OCCUPANCY
+
C(iY OF HUNTINGTON BEACH date
District
+ : e 3 —
---�--- --
e's-'-��
F
Tel: _
Occ. Group P,
,.�x:.l.;Lw a <..3, t.r.,� :.:�
BUSINESS0WNERftv1ANAGER
a
BUILDING OWNER
yy
_ Name
F•
_�
Home -
_
^__Address
Home
Tei.
_ t
Cit.'
City :_..
Construction _ No. of Stones _ ,___--
Occupant Load Sprinklers
CONDITIONS OF APPROVAL
OF COMMUNITY DEJELOPMENT
r!!'
DEPART
I.
This GertYricate of ot;cu'pancy
in a conspicuous place on the
f
SHALL BB posted
premises and Shall not be removed except by the
by
Building Official.
6
it
COMMUNITY DCVELoPMENT
+
s
s ,
-
ks
{
x+
Y
Pf
!•
r
3
a
a^r
i
xp
E
y
sa t
a
t
A
fi
G
. J
BUILDING PERMIT/CERTI ICAUTg OF OCCUPANICY SUPPLEMENT
"
SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT
PERMITTING CHECKLIST
COMMERCIAL BUILDINGS ONLY
Y
N f `"
1. DOES YOUR FACILITY USE ANY 'INTERNAL COMBUSTION
�• k
u
ENGINPS GREATER THAN 50 HP?
2. DOES YOUR FACILITY INVOLVE MIXING, BLENDING, OR
PROCESSING ANY SOLVENTS, ADHESIVES, PAINTS OR
COATINGS?
3. DOES YOUR FACILITY CREATE ANY DUSTS OR SMOKE?
4. DOES YOUR FACILITY REFINE ANY LIQUIDS OR
;
..
SOLIDS? RECLAIM ANY METALS?
5.DOES YOUR FACILITY PLATE OR COAT ANYTHING?
x
6. DOTS YOUR FACILITY HAVE ANY COMBUSTION
�
EQUIPMENT (I : E a , BOILE'RS , FURNACES, BROILERS,
AKING OVENS, ETC) .
7 ` DOES YOUR FACILITY HANDLE OR STORE SOLVENTS OR
MOTOR FUELS?
8. DO YOU USE OR STORE ANY ACIDS?
9. DO YOU USE ANY CHEMiI- PROCESSES?
u
10. DO YOU USE A.NY SOLVENTS FOR CLEAN UP?'
;
11. ARE YOU A DRY CLEANER, REST-kUR"T, BODY SHOP,
GASOLINE STATION, PRINTER, ' OR PART COAi'ER': i
y
IF YOU DO NOT KNOT THE ' ANSWER Tb A QUKB`�ION; HART IN THE "Y"
'COLUMN.
IF YOU RAVE MARKED A-N)E QUESTIONS xN THE COLUMN YOU MUST
CONTACT THE SOUTH COAST AIR QUALITY MANAGMENT DISTRICT LOCATED
i
AT 9150 FLAIR DPIVE, EL MONTE C.A., 917.31. :?LEASE CALL PUBLIC
;F
INFORMATION AT (818) 572--6283 OR CUSTOMER SERVICE AT (818), 572— x
6347.
}
JOB ADDRESS: �✓lf�`'GJr IL ��tills��z%� ��
DATE k`% SIGNATURE:
Y
i
i
s
1
{
i
SUPPL,EMMAL INFOPM.ATION (Continued)
involve,ary of the following
mate
�rials? Meg
t5a
Does the operation
............... - --
es, in ica e quantities:
Quantit'
Material
1. Flammable liquids
Class I -A
Class I�-B
Class I-C '>
2. Combustible liquids
Class II ---------------
s II -A
Clas I
3, Combaration flammable liquids
4. Flammable ' aseB _------;
S. Li ueried flammable ases
6. Flammable fibers --loose
r
.,
';. Flammable fibers - baled
�8. Flammable solids
P
9, Unstable materials �------�-�--
r
10. �orrosiVQ li alas
11. dxidixin material - ases
1_ a, pxidizirz material. - �.i aids
:
13. Oxidizin material - solids
14. Or anic eroxides
1S. Nitromethane (unstable materials)
15.
ry
+ r .
_
6. 'Ammonium nitrate
17.-Ammonium nitrate"compound mixtures'
containing more than 60% nitrate
b arei he"
Highly toxic material and
�
pois�JPli?lt� ids
Y;
}
�
19. smokeless awdr
2p„`81ack snortino`�owder
I hereby certify that the above informat3c�n
is true anci
c®r ct'to the
�.
9
best of ray knowledge,
:
Date
Signature
.
(0562D)
E
s`
i
E
SUPPLMENTA:LItdF(RIIATI02
1.
BUSINESS ADDRESS _ ClS-4-0
x.
Person to contact in Casa of emerges : -1%O,G i�l,�'lO�T
Telephone number:
3.
Does the building in question have electricity?
M/Yes
a. If No, are you requesting that the electricity be
No
Yes
turned; oar?
4.
The building is sprinklered?
c3Yes
5.
operations will produce dust/wood shavings or smiler
amo 1
material?
Cites
NtNo j
o.
Operations will involve the repair or replacement of
0Yes
automobile parts?
if yes:
w
E
(a) Describe the components repaired or replaced.
`
®Yes
(b) toes the operation involve the use of an " flame?
7.
The business is drinking, dining of assembly use that well
in
f,
result are occupant load of more than 50 persons,
bites
j
B.
The following best. describes my operation;
�
;
cztrfi ce Onl�r
Retail Sales
Warehouse
i
ManufaQtvring/DistZ'ibuti€. (aezCCibe �rt3CE3�ffi $flC� �11t�
product)
n
_
estwauran Ta e out ao
iMediC4 /Dental
1j
other (desr„„vibe)
(12/8 86)
i
i
i
t
st
s
s'
5
y[y�
uY $ .