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HomeMy WebLinkAbout15001 GOLDEN WEST - CofO (6)APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH a NttHtwctcxv ucaO, DEPARTMENT OF COMMUNITY DEVELOPMENT PRINT OR 7"PE I-,NLY t3uSinesc, NerTir=_ �t YL1 a (( t RCN+ _ c`• �'/�/ 7�t *Cusrner F 5 t �Ll ii C S' NF v �F,rq r,A,t:Fi " Name---�J„`r � 40 t'i'(QSt'L F: (I�7T Qj c C - F r _- A1v•, , g _ I .-City-��_._"_. 4'�i-�,.._ �C'`���! • j�G� ,i „�r,1 � J� r<.'`.i' o HGmr �p1 "��1��j'� � THIS USE WOULD BE DESCRIBED AS: El NEWLY C iaST i'iir?Fl) h, ,'r"ti 1 n fm w�dnai�t";iE C4 x i Q EXISTING BUILDING 3 H.3. -i fi >FaAL it CJPRPd SQUARE FT r>r E' l r,^ . T t . NOTICE` 1. Occuoa,-icy of any buildmq is prohibited and a Lus!ness license will not be issued until the building has been I inspected and a certificate of occupancy iS'SSued. f r 2. No electrical service will be released for any existing building unti! the service ,-3s been inspected and certified safe All applicants for occupancy in an existing building are required to schedule an electrical 'fuse up' inspection in the Depa-tmentof Comrriun!ty Oeveloprrient at the time this application is filed. 3. Change of occupancy or use inspection fee. Whenever it is necessary to make msnecti©rt of a building or j premises in or der to determine if a change may li-e made in the character of occupancy at useof the building j or premises which would place the building in a d!tfereot division of the same croup of occupwncyor in a, x different group of occur;,ncy, 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 c. :> half f',>l inch stroke, and of a Contrasting color trom the background. These � numbers must be pasted on your building in a iodation that is visible from the street 5. Huntington Beach Fire Code Section 10 301 requires fire extinguisher selection and distribute,in per the National Fire Protection Association pamphlet 10 (see reveise side), i (FOR OFFICE USE ONLY) SUPPf ENfE,'vTAL ffQFORiNRT10N A>� '-, Cit,,_JP,*ANT t OAu t ! k -- — A, '. Jt, (FS f 1Q i F T At PRt Ef HY f 4 r s ,I i 1 I SUPPLEMENTAL INFORMATION(Continued) noes the operation involve any of the following materials? Oyes ONo I Yes, rn rca e quartities. Material Quantity 1. Flammable liquids Class I --A Class I-B Class I-C 2. Combustible liquids Class 11 Class Iri-A 3. Combination flammable liquids 4.- Flammable gases S. Li uefied flammable gases 5. Flammable fibers --loose 7. Flammable fibers baled #. Flammable solids 9. Unstable materials 10.: Corrosive liquids 11. Oxidizing material gases 12. Oxidizing material - liquids 13, Oxidizing material - solids 14. Organic 32proxides 15. Nitromethane (unstable materials 16. Ammonium nitrate 17. Ammonium nitrate compound mixtures containing more than 601 nitrate by weig t 18. Highly toxic material and poisonous gas 14.; Smokeless owder 20. Black sporting powder 1 hereby certify that the rbove informatior, is true and correct to the best of my knowledge. Signature pate (0562D) C12/$f$6 I� APPLICATION FOR CERTIFICATE_ OF OCCUPANCY CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT HUNTINGTON B£ACH PPI.PJT (,R TrP1- -'NLI Ado,.,,, ------- '-Business Name Sjom '5—.11h B�ineGs Type ,i V THIS USE WOULD BE DESCRIBED AS: 1'>e, 7 izl�R DAT_ D l� Sr9r,p _ H F c"Li�E� ---Horn3�r° ❑( NEWLY CONSTPUCTED B.D , (❑�� _11Ary �f � ,r �_ .:^:[ r, W EXISTING BUILDING CF OCCUPANT r� El A[1pJTIL)NAL OCCUPANT a - �/! _ Indica'� forms , —, a„Y L2 5- f .lL�11 .i ,., , , D SQUARE FT C_1F BU?t[)JN(; Til 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 en inspected and certified safe. All applicants for occupancy in an existing building are required to schedul 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 ,)f a building or premises in order to determine if a change maybe made in the character of occupancy or us(: 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 S __ _ ______— 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). 1 1-7. 9Z- �� — ----� (FOR OFFICE USE ONLY) Cam--- SUPPLEMENTALINFORMAT4ON 1 IJ' _ OCCUPANCY GROUP PLAN i tit CK NV? — N 1 aPK ^JT PA( t --- OCCUPANT LOAD — ---- PE Pt, iT di _ a Tri il( PT :.,PM40VAI --- NO OF 5Tt RIES —-- A[� 11N H,_Tii Sri- �t f F; rT --- ,� -y) CJ, E�iTiGu'ATf. rif �i t iiPAI PROVE `� DATE gfdt�t i it Li f L R ,rt '.r, rf -- —-------- TOTAL 75-039 Rev. 11/90 COMMUNITY CEVEL?1tfyT SUPPLEMENTAL INFORMATION 1. BUSINESS ADDRESS /UGC / Y. JL'�r �C �.,°', �>l� � y1 2. Person to contact in case of emergency' Telephone number: ZZO 2 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 ,S�N o 5. Operations will produce dust/wood shavings or similar material? ❑ Yes 'No 6. Operations will involve the repair or replacement of ❑Yes automobile parts? ;KNo If Yes: (a) Describe the components repaired or replaced. (b) Does the operation invo:ve the use of an open flame? ❑ Yes ❑ 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 Retail Sales Warehouse Manufacturing / Distribution (describe process and end product) Restaurant/Take Out Food Medical / Dental Other (describe) l }s S-6A« N }ti1► tom- AeK L SUPPLIMENTAL INFORMATION SUPPLEMENTAL INFORMATION (Continued) Doi.:s th(, operati,—,1 invr.dve, any Df the fo!lf-wing ;iaeriafs'? Mat 0,jantity Flarnmable EOLi!U�� Class A r�jrjss i-C: 2. Cornbii^tibie li-11J&-1 .;lass it Class lil-A 3- Co,-nbina'on -!!amrnab,e liquids 4. Flammable ciases Liquefied flamrriabe gases fi. F!amrnable fioers i Fiamrnab�—u fiters balec, 9 Unstat)le rraterials 10. Cc)rrcs).o liquids 11 0 x i d;. z i ng maleri.al - q—of; 12. Cxidizing materill; - lsu� its 13. Oxidizing material solids 14 Organic, peroxid,.c, 15. Nitromethane (unstab;e materials" !& `Ammonium nitrate 17. Ammonium nitrate compound mixtures containing more than 6Va nitrate by weight i B. Highly toxic material and poisonous gas 19. Smokeless powder 20. Black sporting powder Yes E No I hereby -certify that the above information is true and correct to the besy/of my kn?,Wlarjge Signature - ---- ---- ate SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT (Nonresidential Buildings Only) Location of Subject Property: j(SC(�l Property Owner name: I'lCIjtl _Phone # Name of the Person Preparing this form in print end signa ;re Name3!!`` AWz,P_ Ku % `1101 t mature The person preparing this form must be the same person applying for building permits. Please answer the following questions regarding your proposed occupancy o` the subject building. IF YOU DO NOT KNOW THE ANSWER TO A QUESTION MARK IN THE "YES" COLUMN: SCAQMD PERMITTING CHECKLIST YES NO 1. Does your facility use any internal combustion �f engines greater than 50-HP? 0 I 2. Does your facility involve mixing, blending, or I processing any solvents, adhesives, paints cb or coatings? 3. Does your facility create any dusts or smoke? 4. Does your facility refine any liquids or solids? Reclaim any metals? S. Does your facility plate or coat anything? O^� 6. Does your facility have any combustion equipment Eft i.e. boiler, furnaces, broiler, baking ovens, etc.) rated greater than 2,000,000 BTU/HR? 7. Does your facility handle or store solvents or motor fuel? L�J 8. Do you use or store any acids? 9. Do you use any chemical process? 10. Do you use any solvents for clean-up? 11. Are you a dry cleaner, restaurant with a charbroiler, body shop, gasoline station, printer, or part coater? 12. Is the subject building located within one thousand f�I (1,000) feet of any school? L__J PROPERTY LINE TO PROPERTY LINE. GRADES K-12. If you have marked "NO" in all columns, you do not need an Air Quality permit at this time. If you have marked any questions in the "YES" column You must contact the South Coast Air Quality Management District located at: 9150 FLAIR DRIVE, EL MONTE, CA 91731 Please call these offices: Plan Check (818) 572-6406 D:AL00603 (818) 572-6111, (818) 572-6261 South Coast Alit QUALITY MANAGEMENT DISTRICT 1865 E Copley Drive, Diamond Bar, CA 91765-4182 (714) 596-2000 DATE: January 14, 1992 TO: n Huntington Beach Building Department FROM: // Arthur Lawler, Air Quality Engineer SUBJECT: BUILDING PERMITTING UNDER AB3205, WATERS BILL Regarding PLAN CHECK-#' LOCATION: Sam's Mobil / 15001 Goldenwest Street Huntington Beach, CA. 92647 This site has met or is meeting the requirements of Section 42303 of the Health and Safety Code and the requirements for a permit to construct and operate for the South Coast Air Quality Management District . APPLICANT HAS ALL REQUIRED PERMITS FROM THE SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT FOR THIS SITE AND/OR PLAN CHECK ONLY. APPLICANT HAS FILED FOR PERMITS TO CONSTRUCT EQUIPMENT WITH THE SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT. — Change of Owner APPLICANT IS EXEMPT FROM PERMIT REQUIREMENTS AT THIS SITE AND/OR PLAN CHECK ONLY. REVISED 7/13/89