HomeMy WebLinkAbout15031 GOLDEN WEST - CofO (3)CERTIFICATE OF OCCUPANCY
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CITY OF HUNTINGTON BEACH
Date
Address G Q L. D) I1, I: T
District
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Business Name CL+)TH i,�ORLD ; 1 15P
_._ _ Tel. ;;98-2519
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cusinessType ni;TAIL — ;FABRICS
UOTTONS Occ. Group B -2
BUILDING OWNEiz,
BUSINESS OWNER/MANAGER
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BUSINESS PROPERTIES
Name PLA Or OHIO, INC.
Name
Home.
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Address 5555 DARROW A
Address
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HUDSOTJ, OH Te Home 216--656-2600
City ' R V I NE TeL
City
D ,(ruction No. of Stories
Occupant Load 00 S rinklsrs
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CONDITIONS OF APPROVAL
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DEPARTMENT OF COMMW1`Y DEVELOPMENT
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This Certificate of occupancy
SHALL BE posted in a conspicuous place on the
II not be removed except by the
.premises and shall
by
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Building Official;
COMMUNITY DEVELOPMENT
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APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT V97A�
NUNTPCTON KACH (PRINT OR TYPE ONLY) DATE
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' Business Name Gtt�i �i/ �G� j/< 5Tel
Business Type _�elkIl `dLSfri�J /%Of70�i �%'LLfiGf,GC4 �J Occ. Group
BUILDING OWNER BUSINESS P&NE"tJ ANAGER
Name!%l/LLJ T���i{�: _ Name -
Home
Address �y lv O,- f Address
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City —Tel City Home Home Tel Ga( r
THIS USE WOULD BE DESCRIBED AS:
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❑ P� CNEWLY CONSTRUCTED BLDG HANGE OF OWNER ❑ CHANGE OF OCCUPANT
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❑ EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT
Indicate former use. if an
Y Occupancy Gr. Div
SQUARE FT. OF BUILDING TO BE OCCUPIED /-'? .U�d
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(FOR OFFICE USE ONLY)
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SUPPLEMENTAL INFORMATION y?
ZONE
OCCUPANCY GROUP -
PLAN CHECK NO.
NO. PARKING SPACES
OCCUPANT LOADZlig&
PERMIT NO.
HEALTH DEPT APPROVAL_ -
NO. OF STORIES
ADMIN. ACTION
UTILITIES RELEASED
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- 1 9
I�Z !
CERTIFICATE OF OCCUPANCY FEE
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APPROVE ATV
CHANGE OF USE OR OCCUPANCY FEE
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TOTAL
$
75-039 Rev, 11/90
COMMUNITY DEVELOPMENT
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SUPPLEMENTAL INFORMATION
1.
BUSINESS ADDRESS /5���% ��rr,C� t���� Cr %.rn1zi fiy!I&
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2.
Person to contact in case of emergency -
Telephone number:
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3.
Does the building in question have electricity?
L3-Yes
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F-1 No
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(a) If No, are you requesting that the electricity be
-0 Yes
turned on?
❑ No
4.
The building - is sprinklered?
C'Yes
❑ No
5.
Operations will produce dust/wood shavings or similar
material?
❑ Yes
Fa' No.
6.
Operations will involve the repair or replacement of
C Yes
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automobile parts?
P-No
;x
If Yes:
(a) Describe the components repaired or replaced.
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(b) Does the operation involve the use of an open flame?
❑ Yes
❑ No
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The business is drinking, dining or assembly use that will,
result in an occupant Icad of more than 50 persons.
❑ Yes[
91- No
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8.
The following best describes my operation;
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OnIY
fRtalT Sales)
Ware o se
Manufacturing / Distribution (describe process and end product)
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Restaurant / Take Out Food
Medical / Dental
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Other (describe) _
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_,.'PLIMENTAL INFORMATION
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SUPPLEMENTAL INFORMATION (Contlnued) ,
Does the operation involve any of the foil wing materials? Q 'fie;
No
if
1'es, indicate. quantities:
Material Quantity
1.
Faammabie liquids
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Class i- _
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Class 1-13
Class I-C
2.
Combustible liquids
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Class 11
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Gass Iff-A
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3.
Combination Flammable liquids
4.
Flammable gases
5.
Liquefied flammable gases
6.
Flammable fibers - loose
7.
Fiammabie fibers - baled
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1esolids
9.
— �s�n able materials
1o,
Corrosive liquids
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Oxidizing material - gases
12.
Oxidizing material - liquids
1s.
_Oxidizing material solids
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Organic peroxides
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15.
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Nitromethane unstable materials;'
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16.
Ammonium nitrate
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17.
Ammonium nitrate compound r., tL,-es
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containing more than 60% nit, _ to
by w fight
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Hig`.iy toxic material and
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poisonous gas
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SmoKeless powder
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20.
Black sporting powder
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I hereby certify that the above information is ' kre and correct to
the St of my Knowledge.
Signature Date
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SOUTH COAS% AIR QUALITY MANAGE
DISTRICT:
(Nonresidential Buildings Only)
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Location of Subject Property: / '3/ di?1-----_4 ILA-J:�4 J': vn/in /► d`eA- h, D/f' 3?Z4W-2
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Property Owner Name: —
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Phone #: �71 %i)
Name of the person preparing this form in print and signature -
Name: rSignature:
The person preparing this form must be the same person applying, building permits. Please
answer the following questions regarding your proposed occupancy of the subject building. IF
YOU DO NOT KNOW THE ANSWER TO A QUESTION MARK IN THE'YES' COLUMN:
AQMD PERMITTING CHECKLIST
YES NO
1. Does ycur facility use any internal combustion engines greater than 50-1iP?
2. Does your facility involve the mixing, blending, or processing of any
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solvents, adhesives, paint:, or coatings?
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3. Doesyourfacility create any dusts or smoke?�—
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4. Does your facility refine any liquids or solids or reclaim any metals? -?
5. Does your . acility plate or coat anything? ��
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6. Does your facility have any combustion equipment i.e. boiler, furnaces,
broiler, baking ovens, etc.) rated greater than 2,000,000 BTU/HR?
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7. Does your facility handle or store solvents or motor fuel? ✓,
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?
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12. Is the subject building located within one thousand (1,000) feet (property
line to property line) of any school (Grades K-12)?
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If you have marked "NO" in all columns, you do not need an AIR Quality permit at this time. If
you have marked%ny questions in the "YES" column you must contact the South Coast Air
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Quality Management District before submission for City review. The Air Quality Management
District may be contacted at;
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21865 Copley Drive
Diamond Bar, CA 91765-4182
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Gar call: Plan Check (909) 396-2000
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Government Code Section 65850.2(b} requires the City of Huntington Beach Building Division
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not to issue the final certificate of occupancy unless the applicant has met or is meeting the
requirements of the South Coast Air Quality Management District (AQMD). The Building
Division must obtain a written releas from AQMD to show the applicant has complied with this
law. The check list on the reverse side is designed to help the, applicant and the building division
meet *hese requirements.
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1. The applicant (the same Uercnn who applies for permits from the Building Division)
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must complete the check list which can be obtained either at the iwilding. Division or
at AQMD.
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2. If all boxes in the list are checked "no", the Building Division can accept the check
list as she release.
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3. If there are any "yes" answers in the list, the applicant must contact an AQMD
engineer by calling (909) 396-2000 to find out whether ai: permits are required for the
proposed construction project.
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4. If air permits are not required, the applicant will obtain a written .rc;ase form AQMD.
5 If air permits are required, the applicant must submit the necessary perrnit
applications 10efore the release can be;sued.
Because of the time it may take for AQMD to go through the above prozedures, the applicant is
advised to contact AQMD immediately after applying for Building pennits,
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