HomeMy WebLinkAbout15071 GOLDEN WEST - CofO (6)' CERTIFICATE OF OCCUPANCY
12/23/15
, CITY OF HUNTINGTON BEACH
Date
f Address 15071 GOLDENWES4' District
' STEVE SPRY KARATE INSTITUTE !
i Business Name Tel.
KARATE STUDIO B
Business Type Occ. Group
I BUILDING OWNER BUSINESS OWNER/MANAGER
BUSINESS PROPERTIES INC STEVE SPRY
Name Name
Address
P.O. BOX 19586 ' Home 12292 ST. MARKS
Address
{
IRVINE 714-474--8900 GARDEN GROVE Home city Tel. _ City Tel.
Construction 714--$92--5175
1 8
I ! No. of Stories Occupant Load Sprinkler _
CONDITIONS OF APPROVAL t
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{
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DEPARTMENT OF COMMUNITY DEVELOPMENT
} This Certificate of Occupancy
SHALL BE posted in a conspicuous place on the
premises. and shall not be removed except by the b
Building Official. I
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COMMUNITY �VELOPMENT'
`I
AP P (CATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH !
DEPARTMENT OF COMMUNITY DEVELOPMENT I I •�•�(p
"UN iWLTON*
(Pr INT OR TYPE ONLY) DATE
Address ' 60LD&J1, 1Z} District
Business Name �J �Y�Ll l i� Tel.
Business Type Occ. Group EP
F BUILDING OWNER BUSINESS OWNERIMANAGER
Name &1621Arz� [s�I�ji�G. Name�� �� •`
Home
Address P. � �q'JDCCJ Address'Z— -• !+ ,• _ _
City,941de. 64, �tnf3 TAX-20 City Home'Tel._ _
�A gr'0.45 • ate. �c7s
THIS USE WOULD BE DESCRIBED AS:
I �Q(
❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER -I/Ni CHANGE OF OCCUPANT
❑ EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT •
Indicate former use, if any Occupancy Gr. Div.
SOUARE FT. OF BUILDING TO BE OCCUPIED
TRAFFIC IMPACT FEE
OATS PAID
AMOUNT RECEIV ��
pp
CIO• F�
NAME
(FOR OFFICE USE ONLY)
(`
SUPPLEMENTAL. INFORMATION
ZONING, `,�
OCCUPANCY GROUP
PLAN CHECK NO.
NO. PARKING SPACES
OCCUPANT LOAD g
PERMIT NO. o8y
HEALTH DEPT- APPROVAL
NO. 0 TORIES
ADMIN. ACTION �.id��P -�
UTILITIES RELEASED
/ 2 — CERTIFICATE OF OCCUPANCY FEE
$
APPIROVED BY
DATE CHANGE OF USE OR OCCUPANCY FEE
$
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TOTAL
75.039 Rev. 1'11/90
COMMUNITY DEVELOPMENT
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SUPPLEMENTAL. INFORMATION
1.
BUSINESS ADDRESS )50`11 CceE,pi�l �i
2.
Person to contact in case of emergency -
Telephone number: 01-� '5-17
3.
Does the building in question have electricity?
Yes
`
!❑ Noi
(a) If No, are you requesting that the electricity be
❑ Yes
turned orgy?
No
I
�
4.
The building is sprinklered?
❑ Yes
No
I 5.
Operations will produce dust/wood shavings or similar
material?
❑ Yes
No
6.
Operations will involve the repair or replacement of
❑ Yes
automobile parts?
No
If Yes:
(a.) Describe the components repaired or replaced.
(b) Does the operation involve the use of an open flame?
❑ Yes
No
7.
The business is drinking, dining or assembly use that will
result in a,� occupant load of more than 50 persons.
❑ Yes
No
f 8.
The following best describes my operation;
Office Only
Retail Sales
Warehouse
Manufacturing / Distribution (describe process and end product)
r
Restaurant/Take Out Food
Medical i Dental
Other (describe)
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SUPPLEMENTAL INFORMATION
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SUPPLEMENTAL INFORMATION (Continued)
Does
the operation involve any of the following materials?
Q Yes
No
If
Yes, indicate quantities:
Material _ Quantity
1.
Flammable liquids
Class I -A
j
Class I-B
Class I-C
i 2.
Combustible liquids
Class If
Ciass 111-A
' 3.
Combination flammable liquids
` 4.
Flammable gases
l 5.
Liquefied flammable gases
6.
Flammable fibers - loose
+
7.
Flammable fibers - baled
8.
Flammable solids
9.
Unstable materials
10.
Corrosive liquids
11.
Oxidizing material - gases
12.
Oxidizing material - liquids
13.
Oxidizing material - solids
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14.
Organic- peroxides
15.
Nitromethane (unstable materials)
16.
Ammonium nitrate
i
17.
Ammonium nitrate compound mixtures
containing more than 60% nitrate
by weight
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18.
Highly toxic material and
'
poisonous gas
�
19,
Si--,okeless powder
20.
Back sporting powder
�
hereby certify that the :above information is true and correct
to
the best of my knowledge.
Signature 6ate
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SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT
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(Nonresidential Buildings Only)
Location of Subject Property:_
Property Owner iVarr�e:�1/f��(�_.j�._ Phone #:I
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Name of the person preparing this form in print and signature:
�,
Name: %�c��Ti2��p _ - Signature:..r_`/
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The person preparing this form must be the saute person applying We building perm;ts. 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
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1. Does your facility use any internal combustion engines greater than 50HP?
2. Does your facility involve mixing, blending, or processing any solvents, -
adhesives, paints or coatings?
I 3. Does your facility create an} dusts or smoke?
4. Does your facility refine any liquids or solids or reclaim any metals? x
5. Does your facility plate or coat anything
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6. Does your facility have any combustion equipment /i.e. boiler, furnaces,
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broiler, baking ovens, etc.) rating greater than 2,000,000 BTUIHR?
7. Does your faclity handle or store solvents or motor fuel?
8. Do you use or store any acids?
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9. Do you use any chemical process?�
10. Do you use an solvents for clean-up?
P?
11. Are you a dry cleaner, restaurant with a charbroiler, body shop, gasoline
x
station, printer, br part coater? _
12. Is the subject building located within one thousand (1,000) feet of any
,I
school? PROPERTY LINE TO PROPERTY LINE. GRADES K-12. x 4
j
If you have marked "NO" in all columns, you do not need an Air Quality permit at this time. If you have marked
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any questions in the "YES" column you must contact the South Coast Air Quality Management District located at: `
21865 E. Copley Drive
Diamond Bar, CA 91765.4182
Please call: Plan Check (909) 396-2000
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