HomeMy WebLinkAbout116 1/2 Main St - CofO (5)APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT Ft3ltvrirsG7Gn BEACH
(PRINT OR TYPE ONLY) SATE
Address DiSillCt' ..
Business Name Tet_
��_
Business Type �+' r' Occ, Group
BUILDING OWNER BUSINESS OWNERWANAGM
Name — i YA, _616 & Name —
f. Home
Address 2.3 f P WtZ "(._ 2—c+5 S., rsst% Ul} �{t�2>�f �c' .
City I ar►�£�1i'-t Te) 'y`T? HomeTeL51U1Z6_?/_
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I' THIS USE WOULD BE DESCRIBED AS
L 1 NEWLY CONSTRUCTED BL DG ❑ CHANGE OF OWNERCHANGE OF OCCUPANT
EXISTING BUILDING ❑ CHAN E OF USE )❑ ADDITIONAL, OCCUPANT
cloal
Indicate former use, if any-" Occupancy ,r Div.
SQUARE,FT. OF BUILDING TO BE OCCUPIED 1
NOTICE: 1. Occupancy ofiany building (s prohibited and a business license will nat be issued untilthe building has been
inspected. and a certificate'of occupancy is issued.
2: No +electrical service Will be released for any existing building ;jnul, the service has been, inspected and
certified safe. All applicants for occupancy in on axisting building are required to schedule an electrical
'fuseup' inspection in the Department of Community Development of 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 bo made in the characterof occupancy or use of the building
or premises Which would Mace the building in a different division of the same group of occupancy or in a
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different group of occupancy, a change of occupancy inspection fee of $ shall
be paid to the city.
4. Huntington Beach fire Cade Section 10.208 requires that building numbers must be a minimum of four(A)
Inch os in height E:�ith one halF f'fz} inch stroke, arld of a contrasting color from the bay kground. These J£'
numbers must Ue posted on you, :building in a location that is visible from the street.
5. Huntington Beach Fire Corte Section lO SkQ1 requires firs extinguisher selection and distribution per the
Narywonal Fire Protection Association pamphlet tG (sec reverse (side).
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TRAFF11'6.0I. 3-4 u ;
OATS PA0
AMOUNT RCiCEtVC (FOR OFFICE USE ONLY)
ZONING `---
5=
OCCUPANGY GROUP PLAN CHECK NO NO PARKING SPACESOCCUPANT
LOAD PERMIT NO _ ^. HEALTH DEPT APPROVAL
OFSTOS ADMIN ACTION._ UTILITIES RELEASED
NO.
;tC RTIFtCATI Ol`'CUPANCY FEE r t T
`r
OF
"
APPROVED 3`i�' DATE_ CHANGE OF USE OR OCCUPANCY FEE g
TOTAL $
w
ZS d3$ ReY. t/ 7 C0v1!'0i; Ni Y DE EI.CPl'?r_ vT
SLOP PLEMIENTAL INFORMATION
1.
BUSINESS ADDRESS __• Ll t ST
2.
Person to contact in case of emergency ��ty�wt�a �, ivy 3
Telephone number:l�t'-!®�I2-"]2
3.
Does . the building in question hr,p e
Yes
❑T N o
(a} If No, are you requesti n' ;hat the electricity be
,Yes .
turned on?❑`
No
4.
The building is sprinkled-ed,
❑
ies
5.
Operations: will produce dust/wood shavings or similar.
{.;
nlateriai? ;
❑ Yes
nr
--- ---
No
6.
Operations will involve the repair or replacement of
❑ Yes
automobile parts?
If Yes:
(a) Describe the components repaired or replaced,
❑ Yes
(b} Does the operation involve the use of an , open flame?
No
7.
The business is drinking;, diming or assembly use that will
result in an occupant load of more than 50 persons,
❑ Yes
i
l
No
$.
'The following best describes my operation;
Offl c_,g,,-0.01y
ai( Se#es'--e.
�'a
S
� Dose.
x
Manufacturing I bistribution (describe' process and end product)
f
Restaurant! Take Out Food
i
Medical 1 Dental
Other (describe)
SUPPLEMENTAL INFORMATION
SUPPLEMENTAL INFORMATION (Continued)
Does
the operation involve any of the followln ,, materials?
If
'des, indicate quantrtiesFa -
'
Material Quantity
4
1.
1~lamma.ole liquids
Class l-A
Class I -B
'.�
Class 1-C
j
2.
-
Combustible liquids
7
Class 11
ter+....,. +-....,v r--,..-.-...,.:.r.+n.......
Glass Ill -A
j
3.
Combination flami-noble i1quids
4. ''
Ma€ mable uses
v
Liquefied ' flammable uses
-la€np�able fibers - 1oose
Flammable firers - bard
Flammable solids'
9.
Unstable materials
757.
Corrosive liquids ,
11.
Oxidizing material - gases
12b
kidizing material- liquids
13
Oxidizing material solids
1,.
Organic peroxides
,j
1&
Nit or motl�(unsta,ble rxaaterials) �».r...-._._,...�..�..,-....,b...._..
16.
Ammonium nitrate
17.
Ammonfurn nitrate oornpound mixtures`
containing more than ti% nkrate
by eight
f
18.
_
Hligbly toxic material and
{
pol"sonous gas
W
Smokeless powder
Errww+
i
E
20,
.: +..,�..+.,
'. vaa H.we. w w..r•.-.,.+.w.......w +.«r - .n+++-w....r.w.w.y..
134(,Ick sporting poA4Vder •�
+u,.r..+...x.:+i wnue�wa.n++a..a. -.ram
w.i.�........ Ti.....a..
i
I hereby certify that the above information is true and correct to
the best of m knov le qe,-
,nature late
t
Bose. Coast
AIR �ALITY S E T DISTRICT"
'
21865 E. Copley Drive, Diamond Bar, CA 91765.41 a2 (909) 396-2090
AM QUALITY PERYffT4r-1MCXLIST
for nonresidential buildings only
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CompanyName, �' 3. ,
Location ofProperty:.__
City: # Zip Code:
`
..� [ f 7
Contact Person. ¢�cK,.� Title: �' �`__�r__
(7
Telephone Numb 1 �-J- S'� � � .2 1 Fax Number:
Type of Industry/Business: _ (,k-))s'P.10 s,
To apply for a nonresidential building permit, you must complete this checklist. If you have any
r -
questions about completing this checklist, please call (800) 3 88-2121.
r.
YES NO
1. Will the facility have a charbroiler? [ i'
2. Will any internal combustion engine with greater than 50 horsepower
operate at the facility (excluding motor vehicles)? [
]
Si* Will operations at the facility involve mixing, Mending, orprocessing of
solvents, adhesives, paints or coatings? [
]
4 Will dust or smoke be generated at the facility? [
]
5. Will refining of any liquids or solids be done at the facility'? [
]
& Will any plating or coating of materials be done at the facility? [
] [
7. Will, any combustion equipment rated greater than 2,000,000 P'f U/hr be
operated at the facility? [
]
8. Will any acids, solvents, or motor fuel be used or stored at the facility: [
]
9. Will any organic Lquids or gases be reacted or produced? [
],
10: Will any ovens be used to dry or cure products at the facility? [
]
IL Will any CPC (Freon) recycling machines operate at the facility? [
]
Applica&--it: �QYv�,..at, Signature~
T��-----
(Print name clearly)
If you have marked "NO" in all, the boxes, an air quality permit is mt needed at this time,
5
and this checUst is your written release.
;
If you marked "YES" in any of the boxes, you musk contact the South Coat Air Quali
Management Dis ct (AQt ). Please read the requirements on the back of the checklist.
(800) 3882121
A001TIONALSUPPLEMENTAE_Mi~t3RMATtON
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