HomeMy WebLinkAbout15272 Jason Cr - CofOAPPLICATION FOR CERTIFICATE OF OCCUPANCY
f , CITY OF HUNTINGTON BEACH
V' DEPARTMENT OF COMMUNITY DEVELOPMENT
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(PRINT OR TYPE ONLY) 1pV / DATE
13
Address /'5-Z 7 J.clS� G�i2ev//z District s
Business Name Z r ,01- o cv z"4, r S Tel.
Business Type r�ir ac��� i�5s rrr3�y� C? /GiL j Occ. Group 13
BUILDING' OWNER BUSINESS OWNER/MANAGER i
Narne���r� it��r.��rrvJ d�oo�ef� Name E
/ -Z 2. J e7.e1 Gf� G/!L Home 1
Address Address —
City /3, Tel City Home 1 el. 1
THIS USE WOULD BE DESCRIBED AS: i
❑��NE^WLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER ❑ CHANGE OF OCCUPANT
l EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT
Indicate former use, if anyOccupancy Gr. _Div,
SQUARE FT. OF BUILDING TO BE OCCUPIED
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1
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 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 its necessary to make inspection of a building or
prF;mises in order to determine if a change may be made in the character of occupancy or use 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'$ 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)
xi
inches in height with one half (Yz) 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.
S. Huntington Beach Fire Code Section 10,301 requires fire extinguisher selection and distribution per the
National fire Protection Association pamphlet 10 (see reve a side).
TRAVFtC: IMPACT FE eEONLYY)
�xpt� reDATEPAID
AMOUNT RECEINIRD
NAME -
(FOR OFFIGE l ZONING
�� � S
OCCUPANCY GROUP NO PARKING ,PACES r
OCCUPANT LOAD PERMIT NO 72 HEALTH DEPT APPROVAL
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NO. OF STO 1 --- ADMIN. FACTION.— UTILITIES RELEASED
CER i IFICATE OF OCCUPANCY FEE g
APPROVED BY DATE CHANGE OF USE OR OCCUPANCY FEE $
TOTAL-
7=-oti''a�i'�V'�.bi e
39Rev.1197 TYDIEVEs PIAENT
` fi"UM
SUPPLEMENTAL INFORMATION
J
1.
BUSINESS ADDRESS fs-Z?Z J%fsv/j
2.
Person to contact in case of emergency
Telephone number:71^ ss'y
3.
Does the buildingin question have electricity?Ves
❑ No
-'(a) If No, are you requesting that the electricity be
❑ Yes
turned on?
❑ No '
4.
The building is sprinklered' -
0--Yes
-
❑ No
5.
Operations will produce dust/wood shavings' or similar
material? _
❑ Yes
�A'IVo
6.
Operations will involve the repair or replacement of
❑Yes
automobile parts?
C3-bo
If Yes:
(a) Describe the -components rer a reil ' or replaced.
(b) Does- the operation involve the use of an open flame?
❑ Yes
o
7.
The business is drinking, dining or assernply use that will
result in an occupant load of n,ore than 50 persons.
❑ Yes
L�-Nro
8.
The fold g best describes my operation;
_office Only
Retail Sales
Warehouse
fianufacturing / D_istr buti (describe process anJ end product)
/.?�'.� stop% �s,s ��� L.•.1 , G� �,�i�/z !?.�� f..t�A/i�/fav�✓r.-
Restaurant/ TakQ Out Food
Medical / Dental
Other (describe)
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SUPPLEh4'MTAL INFORMATION
SUPPLEMENTAL INFORMATION (Continued)
Does the operation involve any of the fo!ilowing materials?
0 Y
"o
5 if
Yes, indicate quantities;
Material Quantity
1.
Flammable liquids
Class I -A
Class I-S
Class I-C
2.
Combustible liquids
..Class 11
Class > Ili -A
3.
Combinaf on flammable Iiquids
4.
Tlammabie gases
5>
Liquefied flammable gases
6.
Flammable fibers" - I60se
7
Flammable fliers - bales
8.
Flammable solids
9.
Unstable material.
10.
Corrosive liquids;
1.1:.<
C}xidi ir►q... material - vases
t 12.
Oxidizing material 'liquids
13,
Oxtdiz°rig raterial> solids
14.
'-Organic pwrixides
15>
Nitromethane ` '(unstable : materials)
16.
� Ammonium nitrate
17.
Ammonium nitrate compound mixtures
containing more than 60% nitrate
by weight
18.
Highly toxic material and
poisonous: gas
19,
Smokeless powder
20.
`' Slack sporting powder
l hereby certify ;!hat the above 'information is true andl, correct
to
the hest of y knowledge.
Signature gate
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South Coast
AIR QUALITY MANAGEMENT DISTRICT
21865 E. Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-2000
AM QUALITY PERNUT CHECKLIST ;
for nonresidential buildings only
,f'ornpany Name: r� rr r ch.u; ga l .-{ a r5
Location of Property: /sue
City: Zip Code:z<
Contact Person: z5�,1--w Title: cp' .�.z, I %%r�+ � sr 2-
Telephone Number: I .IX) f*W Fax Number:
Type of industry/Eusiness:xl�
To apply for a nonresidential building permit, you must complete this checkht If you have any
questions about completing this checklist, please call (800) 388-2121.
`DES NO
1 : Will the facility have a charbroiler?
2 Will any internal combustion engine wish greater than 50 horsepower
operate at the facility (excluding motor vehicles)?
3. Will operations at the facility involve mixing, blending, or processing of
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? [ ] [ L3
6. Will any plating or coating of materials be done at the faciliq -,? [ ] [
7. Will any combustion equipment rated greater than 2,000,000 BTU/h . 'be
operated at the facility?
8. Will any acids, solvents, or motor fuel be used or stored at the facility?
9. Will any organic liquids or gases be reacted or produced?
10. Willany ovens be used to dry or cure products at the facility?
11. Will any CFC (Freon) recycling machines operate at the facility? [
Applicant: C'r�r�� ,�r�.,� Signature:
(Print name clearly)
If you have marked "NO" in all the. boxes, an air quality permit is gt needed at this time,
and this checklist is your written release.
If you marked "YES" in any of the boxes, you bnust contact the South Coast Air Quality
Management District (AQAW). Please: read the requirements on the back of the checklist.
(800) 388-21.2I
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