HomeMy WebLinkAbout101 Main St - CofO (75)I
APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT
"UNONGTON KA at DATE
(PRINT OR TYPE ONLY)
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Address f ®/ h9/.l_6j Sy',a< akc- District
Business Nameog t l�O�d N6c�3: iyC; TeI.91Sr -1foQ'Z 3�F2
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BusinessType-A�,120��RV1CQ �� C' Occ. Group
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-BUILDING OWNER BUSINESS OWNERlMANAGER
Name 65VIEL^*-n Lb. eLmL ww&o Name
Home Sl��
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Address ooV Address— 7
City l veAAftilt.1- 44-4r",CAft 0Tel. City �LLJ/JS7��Td1 Home T t,
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THIS USE WOULD BE DESCRIBED AS:
❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER CHANGE OF OCCUI`-j1T
❑CHANGE OF USE ❑ADDITIONAL OCCUPANT
EXISTINGBUILDING
Indicate foriner use, if any �/ !OA J %d Occupancy Gr. Div. Z-�+
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SQUARE FT. OF BUILDING TO BE OCCUPIED
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NOTICE: 1. Occupancyof 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
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certified safe. All applicants for occupancy in an existing building are required to schedule an electrical
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'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
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premises in order to determine if a change maybe 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 ,t ire .;ode Section 10.208_requires that building numbers must be a minimum of four (4)
inches in height with one half ('h) 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.,
5. Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection and distribution per the
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National Fire Protection Association pamphlet 10 (see reverse side).
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TRAFFIC � �ACTFEE
DATE PAID
c ED
YAIIOUNT
(FOR OFFICE USE ONLY) ZONINGSpS
ry NO, SPACES
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OCCUPANCY GROUP PLAN CHECK N0. PARKING
OCCUPANT LOAD PERMIT NO. HEALTH DEPT. APPROVAL
NO. OF STORIES _ ADMIN. ACTION
UTILITIES RELEASED
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t,D .Cif CERTIFICATE OF OCCUPANCY FEE
APPROVED BY LDAT CHANGE OF USE OR OCCUPANCY FEE
TOTAL $
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75-039 Rev.1/91' COMMUNITY DEVELOPMMNT 1 7 `t
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SUPPLEMENTAL .INFORMATION
1.
BUSINESS ADDRESS for 64AItu Sv- S'tc a—C
2.
Person to contact in case of emergency- CA6 , ` �1.0 ', <<a
Telephone number: -7 y 96q -23 `f2-
3.
Does the building > in question have electricity?
No
(a) If No, are you requesting that the electricity be
❑ Yes
turned on?
0 No
4.
The building is sprinklered?
13 No
5.
Operations will produce dust/wood shavings or similar
materiaf?
❑ Yes
6.
Operations will involve the repair or replacement of
C7 Yes
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automobile 'parts?
If Yes:
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(a). Describe the components repaired or replaced.
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,
(b)r Does the operation involve the use of an open flame?
1 Yes `
7.•
The business is drinking, dining_ or assembly use that will
_resuit :in an occupant load of more than, 50 persons.
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,Yes>
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8.
The foil t describes my ; operation„
`
ffice Only
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Retail Sales
Warehouse
Manufacturing ! pistribution (describe process and end proL'Uct)
,
x
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Restaurant / Take Out Food
Medical / Dental
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Other ;(describe),
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..,... SUF'PLEMEhlT AL INFORMATION
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SUPPLEMENTAL JNFORMATION (Continued)
South Coast
AIR EQUALITY MANAGEMENT DISTRICT
21865 E. Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-2000
AIR QVA LITY PERMIT CHECKLIST
for nonresidential buildings only
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Company Name: Cok& RoLdftiers T',ve
Location of Property: _71 %1-e, -C
City: 4a rJ To N G T-QN1 , C A Zip Code: SC'V
Contact Person: U 2-AGr Lc o Q4i�t 0
_Title:Co ol�rrce/L
Telephone Number: `7 /! 1t6S=et 3 52 Fax Number: `?/ y'` 169- 316 0
Type of Industry/Business: OFFt. DA-,rtio a— �'u c e
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To apply for a nonresidential building permit, you must complete this checklist. If you have any
questions about completing this checklist, please call (800) 388-2121:
YES NO,
1. Will the facility have a charbroiler? [ ]'
-'2. Will any internal :combustion engine with. 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? [ ] pq
4. Will dust or smoke be generated at the facility? ( ]]
5. Will refining of any liquids or solids be done. at the facility? [ ] Pq
6. Will any plating or coating of materials be done at the facility? [ ] PIS
7. Will any combustion equipment rated greater than 2,000,000 BTU/hr be
operated at the facility?
8. Will any acids, solvents, or motor fuel be,. used or. stored at the facility? ] j
9. Will any organic liquids or gases be reacted or produced?
10. Will any ovens be u ,ed to dry or cure products at the facility? [ ] [
11. Will any CFC (Freon) recycling machines. operate at the facili ]
Applicant: i L.1 o Signature:
(Print name clearly)
if you have marked "NO in g1l, the boxes, an air quality permit is nQt needed at this time,
and this checklist is your written release.
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If you marked "YES" in any of the boxes, you must contact the South Coast Air Quality
Management Disti icf (AQAM). Please r-^-d the requirements on the back of the checklist.
(801:1.:88-2I.21
ADDITIONAL SUPPLEMENTAL INFORMATION