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Home My WebLink About101 Main St - CofO (42)CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH Date Address 1- i i i r s District Business Name _ c t I L t t_ Tel. Occ. Group Business Type C F i BUILDING OWNER BUSINESS OWNER/MANAGER El;a�t. bi�IIw .L� I Name Name Home Address +. t, tr t t. {. "t .€` Address Home City E' Cth;`ir:If. 'V1iLLi', Tel. i i- 14C o— a City TeL Construction No. of Stories l Occupant Load Sprinklers CONDITIONS OF APPROVAL Cc:r;ia€ntz. iFI"F. 4'CE — I +C 1'1 !", DEPARTMENT OF COMMUNITY DEVELOPMENT This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and shall not be removed except by the by Building Official. COMMUNITY DEVELOPMENT J� APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH # DEPARTMENT OF COMMUNITY DEVELOPMENT HUNTINGTON anon DATE {PRINT OR TYPE ONLY) Andress o4 ::5 T t5y t District_ Business Name Tel C'14)S36 -ifs- / �o Business Type — Occ Group //�J / /BUILDING OWNER BUSINESS OWNER/MANAGER Namefl7? Name 0 d0� Home Address Address City Tel 9�'3 3%90 City Home Tel. THIS USE WOULD BE DESCRIBED AS: NEWLY CONSTRUCTED BLDG ❑ CHANGE OF OWNER ❑ CHANGE OF OCCUPANT 1? ❑ EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT t; Indicate former use, if any. f�+e:� Occupancy Gr Div SQUARE FT. OF BUILDING TO BE OCCUPIEDfa� S OD 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. 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 $ shall F be paid to the city. (� 4. Huntington Beach Fire Code Section 10.208 requires that building numbers must be a minimum of four (4) y inches in height with one half (1/2) 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. rV 5. Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection and distribution per the National Fire Protection Association pamphlet 10 (see reverse si ). (FOR OFFICE USE ONLY) �� — cam' t SUPPLEMENTAL INFORMATION ZONING — OCCUPANCY GROUP PLAN CHECK NO NO PARKING SPACES OCCUPANT LOAD PERMIT NO HEALTH DEPT APPROVAL NO OF STORIES ADMiN ACTIO UTI9_ITIES RELEASED s; r, dv , L CERTIFICATE OF OCCUPANCY FEE P D DATE CHANGE OF USE OR OCCUPANCY FE' a TOTAL S 75-039 Rev, 11/90 COMMUNITY DEVELOPMENT SUPPLEMENTAL INFORMATION 14. BUSINESS ADDRESS I U 2. Person to contact in case of emergency` q&5- 3eiRo - Telephone number: — 3. Does the building in question have electricity? Yes ❑ No (a) If No, are you requesting that the electricity be ❑ Yes C turned on? ❑ No 4. The building is sprinklered? Yes ❑ No ' 5. Operations will produce dust/wood shavings or similar material? El Yes ® No 6. Operations will involve the repair or replacement of ❑ Yes automobile parts? No `r If Yes: (a) Describe the components repaired or replaced. } flame? ❑ Yes No (b) Does the operation involve the use of an open ( 7. The business is drinking, dining or assembly use that will result in an occupant load of more than 50 persons. ❑Yes $ i No 8. The following best describes my operation; Office Only Retail S—a s� ;> Warehouse Manufacturing / Diptribution (describe process and end product) Restaurant /Take Out Food Medical / Dental Other (describe) SUPPLIMENTAL INFORMATION I , I SUPPLEMENTAL INFORMATION (Continued) Does the operation involve any of the following materials? ❑ Yes ❑ No If Yes, indicate quantities. _ Material Quantity 1, Flammable liquids Class I -A Class I-B Class I-C 2. Combustible liquids Class Il Glass 111-A 3. Combination flammable liquids 4. Flammable gases 5. 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. Oxidizing material - liquids t 13. Oxidizing material - solids p 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 i poisonous gas 19. Smokeless powder 20. Black sporting powder I hereby certify that the above information is true and correct to the best of my knowledge. Signature date r l , nGz$ [preparitig ihiz; foim i us! a 11-flu Same pf.r i! } ' li Cs a w+�i' atEscg e � [ , f.S.a1 "F;7 S ri <S ai$C)nC rF-atfA(':F� your ipro c 3ed `t.'cou': s i E ANSWER I O A OUES"{'IC, N, MARK 'N THE 'wlPf�, AGNID PER i',3 a h 6 &IC`, E63 NO 3 , Boss vouF facilihf +ase :any internal combustion engines gre�,t_r than 50€-iP? -__ l/----- 2, Does your fac: 'iit'y involve mixing, blending, or solvent;:, � adh Ives, pa ilts ,.A W--Aings? 3. Dorts your facility create any dusts or smoke? 4, [)ors i c,ur facility refine any liquids or solids or reclaim$ arry mete lc,? __ ✓..___ _ t t , Doss your facility plate or coat anything? _ __✓____.-_- R Does yourfacility have any combustion equipment (i.e. boile . furnavis 3ai inn ove;,st etc.) ratinrq greater than 2,000E € v C$`itr."/�� s eJ your f ,iiity handle nr store solvents or motor f,:nl? _. _.__.- �_. ✓__ __-- _- G g. ? ycr�[�: c r ,cEre an- os ids? 9. Do you use any 3hernical pi'ocoss! I)C '�i.i use any 5i:iiv'nts for t,l .:3rj 1." i I t . use ynu a cr$y cl eln r, restaurant with a charbroilaer, rood% shop, gig Olin ii St ,tit"st p r ntar, or part water? _ _ ____ ._.___ ,✓--__._ i Is time s,,ibiect ix lding i' Wed -uvithin tt"r$i;"•• tY1C$!a'tion !; 9,9 3 r s �; am r chool? F'POPF F( LINE TO PE�f PIE::R T Y Llo ' . F l: s ,"S : ; ''v'. V in the .i r.a 'z_i $;9 Istcontaclthi ' i_. t -0 ast`1P, � 9.3 fi 23,.i� s ty'e t loa,s? calf Picar Government Code Section 6585O.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 to 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. 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 AQMD engineer by calling (714) 396-2000to 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 from AQMD. 5. If air permits are required, the applicant must submit the necessary permit applications before the -elease 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. (1360D) ADDITIONAL SUPPLIMENTAL INFORMATION r i I