HomeMy WebLinkAbout101 Main St - CofO (40)t'_
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CERTIFICATE OF OCCUPANCY
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CITY OF HUNTINGTON BEACH
Date
Address 1 O 1 MAIN District _
Business Name JAMBA JUICE Tel, �74-y166
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Business Type TAKE—OUT RESTAURANT Occ. Group B
BUILDING OWNER BUSINESS OWNER/MANAGER
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MIKE ABDELMUTI Name 1''1EKA AQUIRRE
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Name "—
Home
Address 1 G 1 MA I N 1 u 1 Address 12 3 5 1 2 T H 15
Home
City HB Tel. 5?5^(i5v! City HB 965 -7O5tf
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Construction _ No. of Stories Occupant Load 1 Sprinklers,
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CONDITIONS OF APPROVAL
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Comments: MAXIMUM 12 SEAT:
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DEPARTMENT OF COMMUNITY DEVELOPMENT
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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 '•i
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Building Official
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COMMUNITY DEVELOPMENT
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APPLICATION LORC ICAIE OP OCCUPANCY
ClTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT
HUNMIGTON euai DATE
(PRINT OR TYPE ONLY)
Address (s� ` # / O ! District
Business Name �� y�- J " f Ce rr Tel. 3 %
Business Type :1-.` 0'�- F_-esTL%/6i.% T Occ. Group
BUILDING OWNER BUSINESS OWNER/MANAGER
Name ft k1 cQe rho %, Name Mekh 14 y✓irenc
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Address Home mil_ _ '^ S S Address IZ 3S i S {
City l�Lh - -1� �„ �t k 6 Tel Ss6 - 656� City.(-6ft)n� {t- �. ^Rsra c Lam_ —Home Tel. u 6 4-�
THIS USE WOULD BE DESCROBED AS:
❑ NEWLY CONSTRUCTED BLDG ❑ CHANGE OF OWNER 1k CHANGE OF OCCUPANT
F�EXISTING BUILDING i[-t1A_&e w �GE OF US; El ADDITIONAL OCCUPANT
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Indicate former use, if any Ta%tt-a--I T� Occupancy Gr. Div _
SQUARE FT. OF BUILDING TO BE OCCUPIED_ 16 / t/
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
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
ADO 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
be paid to the city.
4re, Huntington Beach Fire Code Section 10.208 requires that building numbers roust be a minimum of four (4)
inches in height with one half (1/z) inch stroke, and of a contrasting color from the background. These
xnumbers must be posted on your building in a location that is visible from the Street.
Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection and distribution per the
National Fire Protection Association pamphlet 10 (see reverse side).
TRAFFIC IMPACT FEE
DATE PAID
AMOUNT RECEI�jF,� _
NAME C'/ {�-
(FOR OFFICE USE ONLY) ZONING �✓ t ,,. � (��
SUPPLEMENTAL. INFORMATION
OCCUPANCY GROUP PLAN CHECK NO. NO. PARKING SPACES
OCCUPANT LOAD PERMIT NO HEALTH DEPT APPROVAL
NO, OF STORIES ADMIN. ACTION UTILITIES RELEASED
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CERTIFICATE OF OCCUPANCY FEE $
A V D BY DATE CHANGE OF USE. OR OCCUPANCY FEE $
TOTAL $
75-039 Rev. 11190 COMMUNITY DEVELOPMENT
SUPPLEMENTAL INFORMATION
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1.
BUSINESS ADDRESS
2.
Person to contact in case of emergency -
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Telephone number:
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3.
Does the building in question have electricity?
Ye
0 No
(a) If No, are you requesting that the electricity be
❑ Yes
❑ s
turned on?
No
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4.
The building is sprinklered?
Yes
❑ No
5.
Operations will produce dust/wood shavings or similar
❑Yes
material?
CKNo i
6,
Operations will involve the repair or replacement of
❑ Yes r,
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automobiie parts?
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If Yes:
(7) Describe the components repaired or replaced.
(b) Does the operation involve the use of an open
flume? ❑ Yes
-No
7.
The business is drinking, dining or assembly use that
will ❑Yes ti
result in an occupant load of more than 50 persons.
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8.
The following best describes my operation;
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Office Only
Retail Sales
Warehouse
Manufacturing / Distribution (describe process and end product)
0y'I 2 6=5TA�,z�N'j—
estaurant / lake_ Out Food
Medical / Dental
Other (describe)
SUPPLEMENTAL INFORMA110M
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SUPPLEMENTAL INFORMATION (Continued)
Does the operation involve any of the following materials? ❑ Yes
No
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If
Yes, indicate quantities:
Material Quantity
1.
Flammable liquids
Class I -A
Class I-B _
Class I-C
2.
Combustible liquids
Class 11
Class III -A
3.
Combination flammable liquids
4.
Flammable gases
5.
Liquefied flammable gases
6.
Flammable fibers - loose
7.
Flammable fibers - baled
B.
Flammable solids
9.
Unstable materials
10.
Corrosive liquids
11.
Oxidizing material - gases
12.
Oxidizing material - liquids
13.
Oxidizing material - solids
14.
15.
Organic peroxides}"
Nitromethane (unstable materials)
16.
Ammonium nitrate
17.
Ammonium nitrate compound mixtures
containing more than 60% nitrate
by weight
18.
Highly toxic material and
poisonous gas
19.
Smokeless powder
20.
Black sporting powder
I hereby certify at the above information is true and correct to
t �est of M.no dge.
z-z3-'Izz
Signature date
SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT
(Nonresidential Buildings Only)
Location of Subject Property:_ _/�). -�!i _ S (0 ._
Property Owner Name:._ ' A-4k I M� %: 3 `�— .3 f � C
_..______ ____,� __-.---------__--- Phone:_____
Name of the person preparing this form in print and signature:
Name:— Signature:-
The person preparing this form must be the same person applying for building permits. Please 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 "YES" COLUMN:
AQMD PERMITTING CHECKLIST
YES
NO
1.
Does your facility use any internal combustion engines greater than 50HP?
2.
Does your facility involve mixing, blending, or processing any solvents,
adhesives, paints or coatings?
3.
Does your facility create ang dusts or smoke?
_
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?
6.
Does your facility have any combustion equipment (i.e. boiler, furnaces,
broiler, baking ovens, etc.) rating greater than 2,000,000 BTU/HR?�—
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7.
Does your facility handle or store solvents or motor fuel?
El.
Do you use or store any acids?
9.
Do you use any chemical process?
10.
Do you use any solvents for clean-up?
11,
Are you a dry cleaner, restaurant with a charbroiler, body shop, gasoline
station, printer, br part coater?
12.
Is the subject building located within one thousand (1,000) feet of any
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school? 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
Diamond Bar, CA 91765-4182
Piers s call: Plan Check (909) 396-2000