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CERTIFICATE OF OCCUPANCY
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CITY OF HUNTINGTON BEACH
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Date
Address 101 MAIN 42A
District
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Business NameHB' CONFERENCE AND VISITORS BUREAU 969--3492
Tel.
Business Type, —VISITOR INFORMATION cc, Group B2
BUILDING OWNER BUSINESS OWNER/MANAGER
ABDELMUTI DEVELOPMENT DIANE BAKER, PRESIDENT
Name Name
AddreA,,600 DOVE 140 Address 9 FIRENZE
CAP Tel. 536--6567 Ci4B Holme 497-4472Te
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Construction No. of Stories Occupant Load 13 Sprinklers
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CONDITIONS OF APPROVAL
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omreents: VISITOR USE (OFFICE)
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DEPARTMENT OF COMMUNITY DEVELOPMENT
3.
This Certificate of Occupancy
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SHALL BE posted in a conspicuous place on the
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premises and shall not be removed except by the by
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Building Official.
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a COMMUNITY DEVELOPMENT
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APPLICATION FOR CERTIFICATE OF OCCUPANCY c�
CITY OF HUNTINGTON BEACH _
DEPARTMENT OF COMMUNITY DEVELOPMENT
HUtlnNGTON KAOi (PRINT OR TYPE ONLY). DATE
Address 1 3 1 ma 1 N 57, IF District
Business Name U PN C�%`b /ll ("_UTU FFa2 /y c f !f- ty Ji Tel ZW-1-6 i `3 -ill Z
1il $ rT0lZS �L�agll
Business Type Y �SITO12 �/I�FUQ%n�7/O /U Occ. Group
BUILDING OWNER BUSINESS OWNERIMANAGER
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BDELMtkTi 1EV61-0100OUT C'v Name :tat�lt �, KE(L }�i2_✓sf� ry
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Add.acs / a e) �o ✓F S f S� �y U Address q F I AE N Z I 0C.
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City lye h/F6�e� JC A C JV e%Z/-6 0 Tel S� � City (V E W IPA Co F4 S e Home Tel. �1�
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THIS USE WOULD BE DESCRIBED AS; !°
NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER ❑ CHANGE OF OCCUPANT i
{_I EXISTING BUILDING ❑ CHANGE OF USE ADDITIONAL OCCUPANT
Indicate former use, if any Occupancy Gr Div.
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SQUARE FT. OF BUILDING TO BE OCCUPIED i
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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.
o electrical service will be released for any existing building until the service has been inspected and I
certified safe. All applicants for occupancy in an existing building are required to schedule an electrical
e up' inspection in the Department of Community Development at the time this application is filed.
Change of occupancy or use inspection fee. Whenever it is necessary to make inspection of`a building or
emises in order to determine if a change may be made in the character of occupancy cruse of the building
r 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
I be paid .to,the city:
_ requires that building numbers must be a minimum of four (4)
4. yuntington Beach Fire Code Section 10.208
�>nches in height with one half ('h) inch stroke and of a contrasting color from the background. These i
lllIIIJJJJJJ��.��. numbers must be posted on your building in a location that is visible from the street.
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). f
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fRAFFIG IMPACT FEE c
DATE PAID
AMOUNT RECEIVED
NAME (FOR OFFICE USE ONLY) I
I' SUPPLEMENTAL INFORMATION ZONING
OCCUPANCY GROUP 't'' h � NO. PARKING SPACES PLAN CHECK NO, a"
OCCUPANT LOAD Z PERMIT NO. HEALTH OEPT APPROVAL —
NO, OF STORIES ADMIN, ACTION UTILITIES RELEASED
C�—�DA��
CERTIFICATE OF OCCUPANCY FEE g
A�O CHANGE OF USE OR OCCUPANCY FEE $_ t
TOTAL $
75 039 Rev, 1 1y90 COMMUNITY DEVELC•r' e-NT
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SUPPLEMENTAL INFORMATION
1.
BUSINESS ADDRESS Z0Z AV19-1/?-) 57. a,4
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�S77-
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2.
Person to contact in case of emergency'
Telephone number: y9"�— �/q7Z
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3.
Does the buildingin question have electricity?
C`'J�Yes
c
No
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(a) If No, are you requesting that the electricity be
❑ Yes
y.,
turned on?
❑ No
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4.
The building is sprinklered?
Yes
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❑ No
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5.
Operations will produce dust/wood shavings or similar
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material?
❑ Yes
2-No
6.
Operations will involve the repair or replacement of
❑Yes
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automobile parts?
12'No
If Yes:
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(a) Describe the components repaired or replaced.
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(b) Does the operation involve the use of an open flame?
❑ Yes
O-No
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7.
The business is drinking, dining or assembly use that
will
result in an occupant, load of more than 50 persons.
i] Yes
21No
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8.
The best describes my operation;
Office Only
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etas ales
Warehouse
Manufacturing / Distribu 'Dn (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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SUPPLEMENTAL INFORMA1,16N
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SUPPLEMENTAL INFORMATION (Continued)
Does the operation involve any of the following materials?
❑ Yes
2-No
If
Yes, indicate quantities:
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Material Quantity
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1.
Flammable liquids
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Class I -A
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Class 1-8
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Class I-C
2.
Combustible liquids
Class I1
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Class ill -A
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3.
Combination flammable liquids
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4.
Flammable gases
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5.
Liquefied flammable gases
6.
Flammable fibers - loose
7.
Flammable fibers - baled
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B.
Flammable solids
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9.
Unstable materials
10,
Corrosive liquids
11.
Oxidizingmaterial - gases
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12.
Oxidizing material - liquids
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13.
Oxidizing material - solids
1,
14.
Organic peroxides
15.
Nitromethane (unstablematerials)i
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16.
Ammonium nitrate
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Ammonium nitrate compound mixtures
containing more than 60% nitrate
by weigh
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18.
Highly toxic material and
poisonous -gas
19.
Smokeless powder
20.
Black ,sporting powder
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I hereby certify that the above information is true and
correct
to
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the best of my knowledge.
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ignature
Date^
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Government Code Section 65850.2(b) requires that thQ City of Huntington Beach not issue the final
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certificate of occupancy unless the applicant has met or is meeting the requirements of the South
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Coast Air Quality Management District (AQMD). The Department of Community Development must`
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obtain a written release from AQMD to show the applicant has compiled with this law. The check
list on the reverse side is designed to help the applicant and the building division to meet these
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requirements.
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1. The applicant (the same person who applies for permits from the
Department of Community Development) must complete the checklist
which can be obtained either from the Department of Community
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Development or at AQMD.
2. If all boxes in the list are checked "no", the Building Division can accept the
check list as the release.
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3. If there are any "yes" answers in the list, the applicant must contact an
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AQMD engineer by calling (714) 396-2000 to find out whether air permits are
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required for the proposed construction project.
4. If air permits are not required, the applicant will obtain a written release from
AQMD.
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5. If air permits are required, the applicant must submit the necessary permit
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applications before the release can be issued:
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Because of the time it may take for AQMD to go through the above procedures, the applicant is
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advised to contact AQMD immediately after applying for building permits.
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ADDITIONAL SUPPLEMENTAL INFORMATION
SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT
(Nonresidential Buildings Only)
Location of Subject Property:___.- 7`F1
Owner Lf?�uT/ Phone #:
Property tame:._ /4�_��
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Name of the person preparing this form in print and signature:
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Name: /U_l�' _.. Signature:--��
The person preparing this form must be the same person applying for building permits. Please answer the 1-
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following questions regarding your proposed occupancy of the subject building. IF YOU DO NOT KNOW s
THE ANSWER TO A QUESTION, MARK IN THE "YES" COLUMN;
AQMD PERM!TTING CHECKLIST
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YES
NO
1. - Does your facility use any internal combustion engines greater than 50HP?—
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2. Does your facility involve mixing, blending, or processing any solvents,
adhesives, paints or coatings? ----
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3. Does your facility create any dusts or smoke? ---
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4. Does your facility refine any liquids or solids or reclaim any metals?
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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 BTU/HR? --_
7. Does your facrlityhandle or store solvents or motor fuel?
8. Do you use or store any acids?
9. Do you use any chemical process?
10. Do youuse any solvents for clean-up?
11. Are you a dry cleaner, restaurant with a charbroiler, body shop, gasoline
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station, printer, br part coater?' —
12. Is the subject building located within one thousand (1,000) feet of any
scheok?PROPERTY LINE TO PROPERTY LINE. 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
any questions in the "YES" column you must contact the South Coast Air Quality Management District located at:
21865 E. Copley Drive
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Diamond Bar, CA 91765-4182
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?lease call: Plan Check (909) 396-2000
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