HomeMy WebLinkAbout15021 GOLDEN WEST - CofO (3)CERTIFICATE OF OCCUPANCY 0 / 2 L '
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CITY OF HUNTINGTON BEACH
Date
Address 15021 GULB i,' EST District
LA i VEGAE L`� G rdP CuLt� a TL'' '� INC.
Tel.
Flusirn.ssName _
RETAIL Si LES E. UIP?.EV'r. +�t LFIxEFa.i i^rs-1
Occ. Group
Business Type _
BUILDING OWNER BUSINESS OWNER/MANF.GER
BUSINESi PRGnFTi'.. :7 ivC. IL`i' BRUE'HY
Name _ Name• —
a
R Home 22 G GhIO I
"- 1 F3 T, fi Address
Addressl
TRVIi L, G`, 1#,�. 4- ,,C.;'a Lol;G 4-FACii Home
TeL
Tel. City
Cr,y Y
Construction No. of Stories _ Occupant Load Sprinklers
CONDITIONS OF APPROVAL
Comments: LOO S ,.FT. aUFERUU
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This Certificate of Occupancy
SHALL BE posted in a conspicuous place on the
premises and shell not be .removed exLapt 4y the
Building Official.
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DEPARTMENT OF COMMUNITY DEVELOPMENT
by'�' '
j
COMMUNITY DEVELOPMENT
BUST BE FIT.ED IN PERSON �C
•
eP NATION FOR CERTIFICATE OF OCCUPANCY
"I
UP
CITY OF HUNTINGTON BEACHDEPARTMENT OF COMMUNITY DEVELOPMENT ATE
(PRINT OR TYPE ONLY)
Address'� ^1'(n�J jJlil � —I�j ` •
_e, isiness Name lZll.,! ND L ErY. G�
Business Type. 1� _ � � i 0
BUILDING OWNER
Name S.4 Tav
Name
�% Home
Address ! ; \ Address
pity -ay-yt 0 , C n O0 jL 1 Tel City.
District
TeL:2 /y-!?n — '-
^-- KA
4HIs USE WOULD BE DESCRIBED AS:
�E] NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER .lit CHANGE OF OCCUPANT
EXISTING BUILDING ❑ CHANGE OF USE ElADDITIONAL OCCUPANT
eicate former use, if anv 11 Occupancy Gr Div.
SQUARE FT. OF BUILDING TO BE GCCUPIED 5 �G6 STiRerw►1
NOTICE: 1. Occupancy of any building is prohibited and business license will net be issued until the building has been
inc.•pectea 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 detsrmine if a change may be made in the character of occupancy or use of the building
or premises which vijould place the building in a different division of the same group of occupancy or in a
diff^rent 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 (1,12) inch stroke, and of a contrasting color from the background. These
numbers roust 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
DATE PAID
�•��•q�
AMOUNT _
t
NAM
FOR OFFICE USE ONLY)
SUPPLEMENTAL INFORMATION
ZONING-•
OCCUPANCY GROUP {� - 5�
PLAN CHECK NO. —
NO. PARKING SPACES
OCCUPANT LOAD "let
-- PERMIT NO
HEALTH DEPT APFH_)VAI_
NO. OF STORIES
ADMIN ACTION
UTILITIES RELEASED
%� /j CERTIFICATE OF OCCUPANCY FEE
$
?PROV'ED Bye
DATE CHANGE OF USE OR OCCUPANCY FEE _
TOTAL
$
75-039 Rev.1/97
COMMUNITY DEVELOPMENT
_
SUPPLEUIENTAL INFORMATION
1.
BUSINESr ADDRESS
2.
Person to contact in case of emergency ���� ��f 0-60Z
Telephone number: -_qg-,Sc�
3.
Does the buildingin ?
question have electricity?
Yes
n P, O
(a) If No, are you requesting that the electricity be
❑ Yes
turned on"?
❑ No
4.
The building is sprinklered?
EKYes
CI 'd o
5.
Operations will produce dust/wood shavings or similar
material?
❑ Yes
f'
6.
Operations will involve the
No
KYes
repair replacement of
automobile parts?
f5I No
`
S
If Ye
(a) Descri';e t: ie components repaired or replaced.
,=
IY
(b) Does the operation involve the use of an open flame?
❑ Yes
,*
qrNo
".
The business is drinking, dining or assembly use that will
result in an occupant Load of more than 5G persons.
❑ Yes'
Ktio
1,
8.
The following best describes my operation;
Offi niy'
r
P.(-tail Sales
r
re u
E$
Manufacturing / Distribt!tion (describe process and end product)
{
Restaurant/Take Out Food
Medical / Dental
Other (describe)
x
F
SUPPLEMENTAL 1NFORMAMON
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SUPPLEMENTAL INFORMATION (Continued)
Does the operation involve any of the following materials?
If Yes, indicate quantities:
_ Material _ Quantity
1. Flammable liquids
Class I -A
❑ Yes
XNo
Class I-B
Class I-C
2. Combustible liquids
Class 11
Class III -A
fr
3. Combination flammable liquias
4. Flammable gases
5. Liquefied flammable gases f'
6. Flammable fib•-rs - loose
7. Flammable fibe-s - baled
8. Flammable solids
9. Unstable materials
10. Corrosive liquids -
1 I Oxidizing material - gases
12. Oxidizing material - liquids �-
13. Oxidizing material - solids
14. Organic peroxides
15. Nitromethann (unstab le materials)
16. !Ammonium nitrate —
17. Ammonium nitrate compound mixtures
containing more than 6011,u nitrate
!)y weight
18. Highly topic material and
poisonous gas
19. Smokeless powder
20. Black sporting powder
— l
I hereby certify that the above information is true and correct to\ �
thlel best of my knowledge. t:
Signature Date 1.
South Coast
AIR QUALITY MANAGEMENT DISTRICT
21865 E. Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-2000
AIR QUALITY PERMIT CHECKLIST
for nonresidential buildings only
Company Name:
Location of • • •/ �` v �. ltiV 1 .�
City: Y� Zip Code:
Contact Perso Title: _ IAVJ
T�G u
Telephon um �I Fax Number:
Type of IndustryBusiness:
To apply for a nonresidential building permit, you must complete the c' .ecklist. If you have any
questions about completing this checklist, please call (800) 388-2i21.
YES
NO
1. Will the facility have a charbroiler?
4 2. Will any internal combustion engine with greater than 50 horsepower
operate at the facility (excluding motor vehicles)? [ ]
[\A
' 3. Will operations at the facility involve mixing, blending, or processing of
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solvents, adhesives, paints or coatings?
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? [ ]
[
s
7. Will any combustion equipment rated greater than 2,000,C 00 BTIJ/hr be
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operated at the facility?
8. Will any acids, solvents, or motor fuel be used or stored at the facility? [ ]
[
s
9. Will any organic liquids or gases be reacted or produced?
r10. Will any ovens be used to dry or cure products at the facility? [ ]
LAC]
11. Will Ry CFC (Freon) recycling machines operate at the facility? [ ]
Applicant: �� _ Signature:
l
(Print name c arly
If you bave marked "1-;0" in all the boxes, an air quality permit is not needed at this time,
and this checklist is your written release.
If you marked "YES" in any of the boxes, you must contact the South Coast Air Quaut3
Management Dlstrilt (AQMD). Please read the requirements on the back of the checklist.
(800) 388-2121
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AnDMONAL SUPPLEMENTAL INFORMATION
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