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Home My WebLink About101 Main St - CofO (59)CERTIFICAYE OF OCCUPANCY CITY OF HUNTINGTON BEACH 1r, 1 `' p' :`` Date Address a C_1 �, ". 1 .` 1 District Business Name i:CF LL IiI''L,t � d£ Tel. Business Type i' i' L Occ. Group PUILDING OWNER BUSINESS OWNER/MANAGER Name / Name Address 3 i cj i, t tl 1 .t i� C. .4 { .. Home Address _ City £� UN1'taIh VALLJ." Tel. 7 1y.4ri:-.- <;t'. Home City Tel. Construction No. of Stories t` Occupant Load Sprinklers CONDITIONS OF APPROVAL Ccr3iaents; This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and shall not be removed except by the Building Official. DEPARTMENT OF COMMUNITY DEVELOPMENT by A'd APPLICATION FOR CE RTIFICATE OF OCCUPANCY • CITY OF HUNTINGTON BEACH ,n,nr Ta,l , DEPARTMENT OF COMMUNITY DEVELOPMENT (PRINT OR TYPE ONL) DATE Address __ /J / ��-� l 'moo V 1'1'�7► L Q �--- Business Name District �S �,r-� l�s • Tel. Business. Type � -- _ Occ. Group.____ BUILDING OWNER BUSINESS OWNER/MANAGER Name C&/ / Name Isa Address Ap90 d kr1 � Home Address City Tel. �0('3990 City Home Tel.______ THIS USE WOULD BE DESCRIBED AS: NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER ❑ CHANGE OF OCG EXISTING BUILDING UPANT 1-1�j I ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT Indicate former use, if any_ c.1-«k Occupancy Gr. Div SQUARE FT. OF BUILDING TO BE OCCUPIED-E00 NOTICE: 1, Occupancy of any building is prohibited and a husiness license will not be issued until the buildin has I inspected and a certificate of occupancy is issued. 9 been 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 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 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 $ — be paid to the city. shall 4. Huntington Beach Fire Code Section 10.208 requires that building numbers must be a minimum of four (4) b inches in height with one half (1/2) inch strike, and of a contrasting color from the background. These V 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 reverses' SUPPLEMENTAL INFORMATION (FOR.OFFICE USE ONLY)' ZONIN(; 1- ��„_ OCCUPANCY GROUP PLAN CHECK NO. _. OCCUPANT I nAn _ _ - NO. PARKING SPAr.PP SUPPLEMENTAL INFORMATION 1. BUSINESS ADDRESS I U 2. Person to contact in case of emergency, I T1 kA A le- Telephone number: fv 3 - 3°z4 D 3. Does the buildingin question have electricity? 1z Yes (a) If No, are you requesting that the electricity be No ❑ Yes turned on? ❑ No f 4. The building is sprinklered? Yes 5. Operations will produce dust / wood shavings or similar El No material? ® Yes No G. Operations will involve the repair or replacement of ❑ Yes automobile parts? No If Yes: (a) Describe the components repaired or replaced ❑ Yes (b) Does the operation involve the use of an open flame? No 7. The lousiness is drinking, dining or assembly use that will result in an occupant load of more than 50 persons. ❑ Yes No 8. The following best describes my operation ' Office Only F�etail a Warehouse Manufacturing ./ Distribution (describe process and end product) Restaurant / Take Out Food Medical / Dental Other (describe) SUPPLI UIENTAL INFORMATION SUPPLEMENTAL" INFORMATIf"I (Continueu) Does the operation involve an ' any. Qf l the allowing materials? C7 Yes. 'lf EI No -indicate, Yes, tlti+rs, Material Quantity A 1. Flammable liquids Class I-,4 Class I-B V Class I-C - 2. Combustible liquids - Class !l Class 111-A -- 3. (Combination fla `- mimabier,. liquids_ , 4. _ >"lammaale gases, 5. Liquefied flammable gases 6. Flammable fibers - loose:. 7. ° `Flammable ;fibers - bared 8. i=lammable solids 9 Unstable materials 10. Corrosive liquids - .. 11 Oxidizing material - gases _ --- 12. Oxidizing --material -- liquids 13, ..Oxidizing mateerial —solids 14. , ,,,Organic peroxides 15. Nitromethane (unstable materials) 1G. a..aArnmonium nitrate _ 17. Ammonium nitrate po n mixtures containing more than 60% nitrate by weight 18. Highly toxic material and poisonous gas 19.; Smokeless_ , powder 20. Black spotting powder 7 r E Government Code Section 65850.2(b) requires that the City of Huntington Beach not issue the final 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 list on the reverse side is designed tn help the applicant and the building division to meet these requirements. 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 or at AQMD. . 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 AQMD engineer by calling (71 4) 396-2000 to find out whether air permits are required for the proposed construction prniect. 4. If air permits are not required, the applicant will obtain a written release from AQMD. 5. If air permits are required, the applicant irrust 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. {13fOD) 1 A13DITIONAL SUFrLIMENTAL INFORMATION SOUTH COAST AIR QUALITY MANAGEMENT D ISTRICT (Nonresidential Buildings Only) Location cif Subject Property: I ._c _m Property Owner Name: �__L A_ea . �. , _ Phone ir._9_�O_i _13.' 1 Cy Name of the person preparing t1its form in print and signature: 10, Name:! __A j E 1 3 yICg. nature: -- �-- - - - e person applying for.b.uj n er, s. Ploase answer the The pei stit� preparing- this €arm must lac #h� same p . . _ , � P following questions regarding your proposed occupancy of the subject budding. IF YOU DO N.0T KNOW THE ANSWER TO A OUESTION, MARK INIHE ``YES" 'GOLUMN: AGMD PERMITTING CHECKLIST" YES NO 1. Does your facility use any internal combustion engines greater khan 50I-1P? 2. Does your facility involve mixing, blending, or processing any solvents adhesives, paints or coatings? S. Does yol ' . facility create any dusts-nr srnokel-y 4. Does your �cility refine any liquids or solids or reclaim any metals?- 5. Does your facifty plate or coat anything? 6. Does your facility have any combustion equi me,it (j.� boiler, furnac s, broiler, baking ovens, etc.) rating greater than 2,O00,000 STUfNR? — -- -- 7. Does your facility hanel'r or stage solvents or motor fuel? �-- --'l S. De you use or store any acids? - - --- __ ✓_ l 9. Do you use any cheirical process? _> y ,, 4'' f 10. Do you use arty solvents for clean-up? 11. Are you a dry cleaner, restaurant with a charbroiier, body shop, +gas�pline 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 -12. If you have marked "NO" in all columns, you do not need an Air Quality permit at thls time. i1 you have marked "YES" e Management Dlstr6ct located at., any questions in the YES column , ou must contact the South Coast Air Quality 21905 E. Copley Drive Diamond Bar, CA 91765-4182 Please call: flan Check (909) 096-2000 �,�2)