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Home My WebLink About101 Main St - CofO (57)p ............ f/3�i1 APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT "UNTINGTON KAQi (PRWT OR TYPE ONLY) ATE I Address District � ' / Evsiness Name �C� fi 1.�i�,� y �/ Business Type —gg Ef:5— Tet` Occ. Group - �cst ' BUILDING OWNER BUSINESS OWNER/MANAGER Namer�/L�, _i/D Name w� Address � :,—` Home, Address city City Home Tel. ?6 —3Gjo THIS USE WOULD BE DESCRIBED AS: " NEWLY CONSTRUCTED BLDG, E CHANGE OF OWNER CHANGE OF OCCUPANT EXISTING BUILDING ❑ CHANGE OF USE C) ADDITIONAL OCCUPANT Indicateformer use, it any __Occupancy Gr. Div. - SQUARE FT. OF BUILDING TO BE OCCUPIED__U Sill, VOILEMENTAL , INFOR A'T!t 14. (Continued) Dees the operati-6,6' involves- any " of 'the f6flowing mate a'ls?: C! Yes Nc If - Yes'; 1n�f`leate q antEt` es. IViateri l'. Quantity 1. Flammable liquids Class I -A 4 ., . Class ! B- Class I-C 2. Combustible liquids, Class It Class III -A 3. Combination flammable , liquids; 4. 1=lammabie gases 8. 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. O ldizing material - liquids 13. Oxidizing materialt - solids 14. Organic peroxides - 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. Black sporting p-wder I .he.reby .. certify that t bove information. is. true and correct to the b st of m o e. Q S n ure Date i CERTIFICATE OF OCCUPANCY 6/22/994 „a CITY OF HUNTINGTON BEACH _ Date Address 1 G 1 NA I N P 3G District OCEANVIElk PRO EhADE Tel. 714-536-4516 Business Name Bic OFFICE USE. Occ. Group Business Type. BUILDING OWNER BUSINESS OWNER/MANAGER � AEsNAD ABDELMUTI SA1� E AZ: BUILDING tM NEi3 Name Name Home ! Address 18900 DAKOTA Address I FOUNTAIN VLY Tel. _ 714-963-39CO City Home y Tel. � City 1 1 {t Construction _ No. of Stories _ Occupant Load Sprinklers 1i CONDITIONS OF APPROVAL 1 comments: OFFICE USE ONLY 1, t I f DEPARTME14T OF COMMUNITY DEVELOPMENT' I ! f_ This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and shall not be removed except by the by t Building Official. COMMUNtry DEVELOPMENT —,.aur,a,+.rr..r.....:........—r..�.....guars..xr��;ra,�+,.....-...r...s—._...,... a .- . .... .. . ... i APPLICATION FOR CERTIFICATE OF OCCUPANCY / CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT ,� HUNMIcroN ff>� ATE (PRINT OR TYPE ONLY) r Address � � _( � *3 CY District ( Business Name y5al BusinessType- [�� Occ. Group BUILDING OWNER BUSINESS OWNERIMANAGER Name Name Address _ � T—iQ Home i E '�! �� Address Tel.— _L— City Home Tel, THIS USE WOULD BE DESCRIBED AS: I I NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER ❑ CHANGE OF OCCUPANT ❑ EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT t Indicate former use, if any Occurancy Gr.—Div. ; SQUARE FT. OF BUILDING TO BE OCCUPIED �J (FOR OFFICE USE ONLY) SUPPLEMENTAL INFORMATION ZONING _ OCCUPANCY GROUP _L ram. PLAN CHECK NO. NO PARKING SPACES OCCUPANTLOAD PERMIT NO. HEALTH DEPT APPROVAL NO. OFSTO ES ADMIN. ACTION 4��'t UTILITIES RELEASED p c CERTIFICATE OF OCCUPANCY FEE A ROVED DATE CHANGE OF USE OR OCCUPANCY FEE $ it TOTAL $ 75.039 Rev, 11190 COMMUNITY DEVELOPMENT � I I' i I E I � ` ' ' ' , ^ | ` , ' ^ ' ' SUPPLEMENTAL INFORMATION - - 1 . ' BUSINESS ` | | OL Person to contact in case of emne'gen ' Telephone number: 3' Does the building in question have electricity? ^ ` Yes , LJ No (a) If No, are you requesting that the sJeotrh:hy be [] Yes turned on? [] No ' | ' ' .' 4~ ' The building |o aphnk|ered? yoa � ` [] No 5. Operations xvi|| produce dust/wood shavings or similar material? ' [] ymo ` - ��> `0` i t of �>pemdkzAo m4U involve the repair or replacement []�ee �� No automu)i|e parts? ~�_ ' ^ ' SUPPLEMENTAL INFORMATION (Continued) Dues the operationinvolve and ' of the following materials? ❑Yes JY\No If Yes, ' indicate quantities: s ' Material Quantity 1. Flammable liquids Class I -A Class 1-B ! -Class l-C i 2. Combustible liquids Class Il _ — ! -Class l l l-A 3�Combination flammable liquids 10 4. Flammable gases 5. Liquefied flammable gases 6. Flammable fibers - loose 7. Flammable fibers - baled i 8. Flammable solids r 9. Unstable materials - 10. Corrosive liquids ~ 11. Oxidizing material - gsse: { l 12. Oxidizing material - liquids 13. Oxidizing material - solids A 4 14. r Organic peroxides 15. Nitromethane (unstable materials) 16. Ammonium nitrate 17. a Ammonium nitrate compound mixtures - containing more than 60% nitrate by weight 1, 18. Highly toxic material and poisonous gas 19. Smokeless powder E20. Black sporting powder I hereby certify_ that tlm.14bove information is true and correct to M the b st of m o e. S na u r e Date SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT (Nonresidential Buildings Only) �3G Location of Subject Property:_ Property Owner Name: _ _--��'"``�_ Phone #:3� Name of the person preparing this form in print and signature: ' j Name; � 2? __46- / eaw"_ - . Signature. The person preparing this form must be the same person applying for buildin permits. Please answer the following questions regarding your proposed occupancy of the subject building. IF YOU DO'NOT KNOWN THE ANSWER TO A QUESTION, MARK IN THE "YES" COLIJtAN: AQMD PERMITTING CHECKLIST 6 YES NO 4 1. Does your facility use any internal combustion engines greater than 50HP? t/ t ` L, Does your facility involve mixing, blending, or processing any solvents, } adhesives, paints or coatings? 3. Does your facility create arV dusts or smoke? 4. Does your facility refine any liquids or solids or reclaim any metals? I 5. Does your facility platy , coat anything? � f 6. Does your facility have any combustion equipment (i.e. boiler, furnaces, 1 broiler, baking ovens, etc.) rating greater.than 2,000,000 BTU1HR? IR ; 7, Does your facility handle or store solvents or motor fuel? 8. Do you use or store any acids? - --- l 9. Do you use any chemical process? j 10. Do you use any solvents for clean-up? y E. 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 (1,000) feet of any ` school,? PROPERTY LINE TO PROPERTY LINE. GRADES K-12. t, 1f 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: 21865 E. Copley Drive } Diamond Bar, CA 91765-4182 1 Please call: Plan Check (909) 396-2000 i i i 9 1 Government Code Section 65850.2(b) requires that the City of Huntington Beach not issue the final i certificate of occupancy unless the applicant has met or is meeting the requirements of the South Coast Air Quality Management District (AQMD). The Department of Community Development must obtain a written release from AQMD to show the applicant has complied with this law. The check i list on the reverse side is designed to help the applicant and the buildin division to meet these 9 P PP� 9 requirements. 10 1. The applicant (the same person who applies for permits from the Department of Community Development) must complete the check list which can be obtained either from the Department of Community Development cr at AQMD. 2. If all boxes in the list are checked "no", the Building Division can accept the check list as the release. 3. If there are any "yes" answers in the list, the applicant must contact an i AQMD engineer by calling (714) 396-2000 to find out whether air permits are requiredfor the proposed construction project. i 4. If air permits are not required, the applicant will obtain a written release from AQMD. 5. If air permits are required, the applicant must submit the necessary permit applications before the release can be issued. Because of the time it may take for AQMD to go through the above procedures, the applicant is advised to contact AQMD immediately after applying for building permits, C ADDITIONAL SUPPLIMENTAL INFORMATION r _ i