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HomeMy WebLinkAbout116 Main St - CofO (9)�A APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HVNTINGTON BEAC14 DEPARTMENT OF DEVELOPMENT SERVICES r WNTINGTtN ;T , • . r < <;Pi. ; , - DATE 4 Address ! �lG21 '- � �._ _ District-___ Auriness Name,.L_�! L" ", C?{r ? _C�c a'_ �/7 / Tet+ {cam / .. - Bu.>Fne:>S Typri ._ 1!t�Z•Fy? _e n. r ` BUILDING OWNER BUStNES3'3'llNkHWANAGi R Name— Home Address, CityLLc e_ Lt3 _;� tyf r Home Tet 7'e��' 1 D THIS USE WOULD BE DESCRIBED AS.---; NEWLY CONSTRUCTFE7 E~t.DG. l f t' fAhf' a CHANGE OF OCCUPANT ' EXISTING BUILDING`, ID CH{ NNE: .I USE � ADDITIONAL OCCUPAN Indicate forme, use: ,f SOUARF FT. OF BUIL€iIN15 TO 13 010G tl'' D. . r �, NOTICE: 1Occupancy ctf any rui:di q p r,+ , ,+,r>""no, a lutis r � r_ r.k; will not be, ,,suoc a,ntli the Luitding has been to p cled and d ceri €ic eats of ix.Cl r i r`y is P te'd 2 No electrical service k ? Cr fe3 r>d for sn fi , ici t wilding, until th st rise ha ; bt=en inspecfr c and { ce,, i€ied safe Aft appfi arils fUr 5:rrr;tip snCy :n an exi,.!, y 00 ing a.� required to schedule an eter_,t—.1 ft.se up insp rtinn in the Dop,,,jrirmi w of Dpwiiopnient cf rdtr o5 t +t a ftmt titis application is tiled Change of occupancy iar use inspection fee. W t riev ee it iy near sry to ttaake in .pection of a budding or I?rC'rTliai?4 Ira t+rdFrr to 3cterc;i;r�e if ,� cfi�,nge r?Zrsp E;c� rr,a�e ar± th_ i nnaractcr of occupancy r r use of the rs0ding or vit i h vroujd ( t rVic rtUilidwl,, i 1 a d {t >tonl di >inn of he ;,, rrir group of occupancv or in ,a diff �rer t arouo c' oc.cup ari y a c hangfe o o r+uparcy m,, rwiicrt lee of '4, shalt by paid to the city Huntington Beach Fire Code Section I() € r ,i nr =,; that building roan br rs mist t a a rn4nirrlum ei four � + P (4) mcner , �n height with ono hl(e tncl c troko, ranid of a conivasling collar from the background. These n:mt ers must be posl?d or; mir building as a io a,ion that is wtble from the streel b. Huntington Beach Fire Code Section 10 3031 =r raL F; fitr. rlxtinquishei selection and dip,ribution per the Natrona, Fire Prr,tec,t,on As..c:;ta:;ori par�r{:Ni f 1r7,sMc: rrvrr de).' i (FOR OFFICE USE ONLY) SUPPLEMENTAL INFORMATION° CtNIP�t "_ OCCUPANCY ORC3UP .. _ ._ Pt.AN CHECK fi( ^T _ NO PARKING SPACES Of"CVPANT LOAD ___ �s�—� - PERMIT NO ....... _ __-. _ .._ HEALT[i DEPT APPROVAL. - NO O?TORIE6 _. _� _ AI' MIN A.t,TiCQ _ _ - U tLITlr:; RrLC=ASE D /_ t ERPFIGATE OF {)'ti{;lrl'E1rJt:Y' f 41_ AVwovED EsY DATC CHANGE Ot' LICE" CR e ;t'LE xf.6 Y FEE TOTAL c SLt1PLEMENTAL INFORMA?ION a 1. BUSINESS ADDRESS I L�;t j f _5 2. Person to contact in case of emergency; Telephone numbers 3. Does the buildingin question have electricity r ta'Yes a. If No, are you requesting that the electricity be L3 No MYes turned on? GNo 4. The building is sprinklered? Dyes :< 5. Operations wijj ;produce dust/good shavings or similar material?: 0790 O Yes r EWO 6. Operationswill involve the repair or replacement of automobile parts? Dyes 6�tYo If yes: M (a) Describe the components repaired or replaced. Does the operation involve the use of an open flame? OYes EIR-0. 7. The business is drinking, dining or assembly use that will result in r an occupant load of more ;than 50 persons. ©�'es 8. the following best describes my operation: tt '�`h ware o use. M4nu.facturing/Distribution (describe process product) p and end t F�estaurant Ta e out Pon Medical/Den 1 �—' other (describe) r (0562D) (12/if6y e SUPPLIat4SN2AL INFORMATION (Continued) I Does the operation involve any of the following materials? ❑Y'es r - AN f,if Yes, i icate quantities �. Material Quantity 1. Flammable liquids f Class I- A Class I-H e Class I-C ' 2. Combustible liquids Class II - Class III --A 3. Combination flammable liquids 4. Flammable gases 5. Liquefied flammable gases 6. Flammable fibers --loose ?. Flammable fibers baled k 8. Flammable solids 9. Unstable materials 10. Corrosive liquids 11. Oxidizing material - gases 12. Oxidizin2 material - liquids 13. Oxidizing material - solids 14. Organic peroxides 15."Nitromethane (unstable materials) 16. Ammonirzm nitrate 17. Ammonium nitrate compound mixtures - - containing more than 60% nitrate by Weight 15. Highly toxic material and �.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. Sig natut Dat e (0552D) (12/8/86) h I �I