HomeMy WebLinkAbout101 Main St - CofO (79)I, CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH 1 7 f
Date
Address 101 kitTti District
j Business Name ELACI:CCLD IN,IEhMAIIu It'iC'. Tel.
Business Type khGLE:ALELEXPC;51' Occ. Group —C {
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BUILDING OWNER BUSINESS OWNER/MANAGER
IF
Name AEIELMUTZ DE1rELtP1•`+k:1dT COName TAE IL ke_TM
Address 101 iAIN ST Address 421 FURLTNGTCN CT
E Home
City HF, GA Tel. 714-5^6-6567 City LGk.G FLACH Tel. i1E ��ctt3�zF�.1
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Construction No. of Stories Occupant Load 7t Sprinklers
I CONDITIONS OF APPROVAL
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DEPARTMENT OF COMMUNITY DEVELOPMENT
} This Certificate of Occupancy i
" SHALL BE posted in a conspicuous place on the
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premises and shall not be removed except by the by
Building Official.
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APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
nunrnrcron erwor
DEPARTMENT OF COMMUNITY DEVELOPMENT �-
(PRINT OR TYPE ONLY) DATE
✓Address 12Ll 5w t � � aP \ 01n 7 ` L2-6
/ 1 DISIfIC1
J Business NameIII L1)Z- z%r Tel
I Business Type � e— > F
l Gcc Group
4 BUILDING OWNER BUSINESS OWNER/MANAGER
V Name 's/ 1�/� ,('tn v V Name 7AE a- Lc H
Home �—
Address5T ?f
I Address ' fY7l:
l V City T,14! �ity G /'�_7GG�=- Home Tel
T�I{S USE WOULD BE DESCRIBED AS:
L�1 NEWLY CONSTRUCTED BLDG n
� I- 1 CHANGE OF OWNER ❑ .CHANGE GF OCCUPANT I
EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT
dicate former use, if any j
.�- Occupancy G� Div
S UARE FT. OF BUILDING TO BE OCCUPIED Cj e ��.
NOTICE: 1. Occupancy of an building is prohibited
R Y g p ted and a business license will not be issued until the buildi4been'
certified safe. All e Y Y 9 .9 p {
inspected and a certificate of Occupancy Is Issued.
2. No electrical service will be Ieleased for an existing buildin until the service has been inspected and
I 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 determine if a change may be made in the character of occupancy or use of the building
M/ / 1 or premises which would place the building in a different division of the same group of occupancy or in a
" - U`��tQ e�- different group of occupancy, a change of occupancy inspection fee of $ shall
W be paid to the city.
u 4. Huntington Beach Fire Code Section 10,208 requires that building numbers must be a minimum of four (4)
I i fi( inches in height with one half (1,12) 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.
;I 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).
SUPPLEMENTAL INFORMATION ^� (FOR OFFICE USE ONLY)
ZONINGTSf !P'n51- Cj
OCCUPANCY GROUP —.PLAN CHECK NO. NO P
i OCCUPANT LOAD PERMIT EC PARKING SPACES
�40.FT RIES HEALTH DEPT; APPROVAL
ADMIN. ACTION �ii - L UTILITIES RELEASED
�� CERTIFICATE OF OCCUPANCY FEE
A ROVE Y y
DA E CHANGE OF USE OR OCCUPANCY FEE S i TOTAL
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75-039Rev 11/90 COMMUNITY DEVELOPMENT
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SUPPLEMENTAL INFORMATION
1.
BUSINESS ADDRESS %3
2.
Person to contact in case of emernency,
Telephone number:
3.
Does the building in question have electricity?
'EYes
❑ No
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(a) If No, are you requesting that the electricity be
-❑ Yes
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turned on?
❑ No
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Yes
4.
The building is sprinklered?
CI No
5.
Operations will produce dust/wood shavings or ` similar
material?
❑ Yes
ID'No
6.
Operations will involve the repair or replacement of
Ores -
automobile parts?
No
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
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The business is drinking, dining or assembly use that
will
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result in an occupant load of more than 50 persons.:'
❑ Yes
JVNo
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8.
The ewin' - describes my operation;
Office Onl
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Re Il_ Sales
Warehouse;
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Manufacturing / Distribution (describe process and end
product)
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Restaurant/Take Out Food
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Medical / Dental
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Other (describe)
F
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SUPPLIMENTAL INFORMATION
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SUPPLEMENTAL. INFORMAL ION Cont-nued}
0 %Yes !
involve arty of the following matdrir.ls` 1'10
Does the operation
it Ye to quantities: Qua�nt�iy:_ _ --
Material
j, Flammable liquids -
Class I -A
-
Class l
Class t_ .. _. .
C
2. Combustible liquids
Class
Class lil-A
---_`..___ _ flarr:.nable liquids
3. Combination -
„
- Flammable gases---- _ _____ _
_.._
^ gLiqu�efied minable gases
lammab ee ibe s - goose
__ --- b
fibers led
7. Flammable -
Flammable
maturials
Unstable --
— -
Corrosive liquids -
__--- - --- materal
11. �xidiz�ng�- i-
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liquids
Oxidizing rn�teriai -"
mat<!i�al - solids
13_ oxidizing
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14 Organic es —
pe d...^_.
..� .,
`unstable materials)
ethane ( l-- -
18, Ammonium nitrate
17. Ammoniumnitrate compound mixturas
6Q% nitrate
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co.i wining more than
by weight -__�
18. Highly toxirf material and
poisonous gas __---� ---~
19. Smokeless powder -
20. Slack sporting powder
that the above information is true and correct io l
ereb certify
1 h y 0 led' -
the best ()f my kn
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signature
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SOUTH CO AST AIKQUALITY MANAGEME k
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DISTRICT J
(Nonresidential Buildings Only)
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! Location of Subject Property: /p/
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Property Owner Name:
! Phone #:
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Name of the person preparing this form in print and signature:
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Name Signature:
The person preparing this form must be the same person apply g for building permits. Please
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' 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'YET COLUMN:
AQMD PERIVIITT'ING CHECKLIST
YES NO
1. Does your facilit) use any internal combustion engines greater than 50-HP?
2. Does your facility involve the mixing, blending, or processing of any /
solvents, adhesives, paints or coatings?
3. Does your facility create any dusts or smoke?
4.. Does your facility refine any liquids or solids or reclaim any metals? ✓
5. Does your facility plate or coat anything? V
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6. Does your facility have any combustion equipment i.e. 'boiler, furnaces,
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broiler, baking ovens, etc.) rated greater than 2,000,000 BTTUIHR?
i 7. Does your facility handle or store solvents or motor fuel?
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8. Do ,you use or store any acids?
9. Do you use any chemical process? V
10. Do you use 'iy solvents for clean-up?
! 11., Are you a diy cleaner, restaurant with a charbroiler, body shop, gasoline
station, printer, or part Boater?
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 marred "NO" in all columns, yc a do not need an AIR Quality permit at this time. If
you have marked any questions in the "YES" column you mum contact the South Coast Air
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;y Quality Management District before submission for City review. The Air Quality Management
District may be contacted at:a
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21865 Copley Drive,..
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Diamond Bar, CA 91765-41825
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Or call: Plan Check (909) 396-2009
(scagmd)
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Government Code Section 65850.2(b). requires the City of Huntington $each Building Division
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 (AQ.MD)• The Building
Division must obtain_a written 1 re uSg 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
I' meet these requirements.
1. The applicant (Mile
e e t the Building ivisln ,)
must complete the checklist which can be obtained either at the Building Division or
r•, at AQMD.
� 1 2. If alLboxes in the list are checked"no", the Building Division can accept the check
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list as the release. J
3. If there are an `!
y "yes" answers in the list, the applicant must contact an AQMD
engineer by calling (909) 396-2000 to find out whether air permits are required for the
proposed construction project.
4. If air permits are not required, the applicant will obtain a written release form AQMD.
5. If air permits are required, the applicant must submit the necessary
applications before the release can be issued. permit
Because of the time it may take for A: '') to go through the above procedures, the applicant is
advised to contact AQMD immediately after applying for Building permits.
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