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Home My WebLink About118 Main St - CofO (10)COMMUNITY DEVELOPMENT ,..`` Y i• LA 1� APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT DATE riUNTINGTON BEAQi (PRINT OR TYPE ONLY) l ddress —1/, ✓.i 'ST fipfAg-rWtr7&V District 4usiness Name ff!yJ� T✓��z7�✓rV v��r/�cj✓1TS �✓� a� Tei.�. .i ) a `Business Type C-2-611°/ I-V G� _ _— Occ.'Group BUILDING OWNER BUSINESS OWNERIMANAGER Name/ �xS}✓"�75�✓/Si✓Ylr•`,C�C"7ir5 e��fg�` og Address[ •� "�t� ,j j ,rTj�f�L1`/A*tet.1�'frir ress LIp �� Cit`>l�tl "/�� d�crtiC i� Te(_Y ! ` (r;�c?,1'� Home Tel. Y THIS USE WOULD BE DESCRIBED AS: ❑ NEWLY CONSTRUCTED BLDG.❑ CHANGE OF OWNER /, CHANGE OF OCCUPANT ® EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT Indicate former use, if anyOccupancy Gr__ Div SQUARE FT. OF BULDING TO BE OCCUPIED Q_0 ,k- 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 bu.rding until the service has been inspectedand 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 characterof Occupancy Or use of the building or premises which would place the building in a different division of the same group of occupancy Orin a different group of occupancy, a nhange of occupancy inspection fee of $ shall be paid to the city: 4. Huntington Beach Fire Code Section 10.208 requires that building numbers must be a minimum of four (4) Inches in height with one half (1/2) inch sitroke, 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. 5. Huntington 8each Fire Code Section 10.301 requires fire extinguisher selection and distribution per the National Fire Protection Association'pa,;7nphlet 10 (see reverse side). i (FOR OFFICE USE ONLY) �'�---� —- 1 I SUPPLEMENTAL INFORMATION ZONING OCCUPANCY GROUP ' PLAN CHECK NO NO. PARKING SPACES 4 OCCUPANT LOAD PERMIT NO. HEALTH DEPT APPROVAL NO, OF STORIES ADMIN. ACTION UTILITIES RELEASED .y CERTIFICATE OF OCCUPANCY FEE $ PROV BY DATE CHANGE OF USE OR OCCUPANCY FEE TOTAL $_ S� 75-039 Rev. 11/90 ("OMNlLrNITY LEVELORMEINT LJ -- . rn m SUPPLEMENTAL. INFORMATION 1• BUSINESS ADDRESS ' i,U S' r;' E ,r , ' 2. Person to contact in case of emergency- '-50&/V eM Telephone 0/r' number: Pzz pv,- Ciftf-j. 3. Does the building in question have electricity? .._ Yes (a) If No are You requesting that the electricity be turned on? ❑ No Yes ❑ No 4. The building in sprinklered? El Yes: 5. Operations will produce dust / wood shavings or similar No material? Yes 6. Operations will involve the repair or re placement p of �tio automobile parts? ❑ Yes ONo If Yes: (a) Describe the components ,repaired or replaced. (b) Does the operation involve the use of an open flame? ❑ Yes 7. The business is drinking, dining or assembly use that result in will No an occupant load of more than 50 persons. ❑ Yes 8. The following best describes my operation; ' C4 No Of Onl ' Retail Siales Warehouse Manufacturing / Distribution (describe process and end product) Restaurant / Take Out Food Medical / Dental Other (describe) Y� -- � SUPP{.IMEtiNTAL INFORMATION riJ SUPPLEMENTAL m INFORMATION (Continued) Does the operation involve any of the following materials? Cl Yes No If Yes, indicate quantities: Material Quantity 1. Flammable liquids V Class I -A a i Class I -g Classl -C 2. Combustible liquids Class It Class III. -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 13._ Oxidizing material - solids 14. Organic peroxides 15. Nitromethane (unstable materials) 16. Ammonium nitrate 17. Ammonium nitrate compound mixtures containing more than 60%o nitrate by weight 18. Highly toxic material and poisonous gas 19. Smokeless powder 20. Slack sporting powder .r i i l l hereby certify that ;the above information is true and correct to the bast of '` my knowledge. 9 Signature Date P +f 1 . x a 4 " a k SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT (Nonresidential Buildings Only) j I Location of Subject Property: Property Owner name: C41j . SeR775 5' 1�C> c"�c<.x3T�5 Phone Name of the Person. Preparing this form in print and sj,.gn ure Name o k • Ca H /Di �9_ pc),k 01V 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: SCAQMD PERMITTING CHECKLIST YES NO 1. Does your facility use any internal combustion C ,angines greater than 50-HP? E6 2. Does your :facility involve mixing, blending, or C� processing any sol -nts, adhesives, paints or coatings? 3. Does your facility (.zeate any dusts or smoke?' 4e Does your facility refine any liquids or solids? Reclaim any metals? `--� 5. Does your facility plate or coat anything? 6. Does your facility have any combustion equipment i.e. boiler, furnaces, broiler, baking ovens, etc.) rated greater than 2,000,000 BTU/HR? 7. Does your :Facility handle or store solvents or motor El Pq fuel? 8, Do you use or store any acids? 9. Oo 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, or part coater? 12. 1:3 the subject building located within one thousand (1,000) feet of any school? 4 PROPERTY LINE TO PROPERTY LINE. GRADES K-12 i If you have narked "NO" in all columns, you do not need an Air Quality i 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: ( 9150 FIAIR DRIVE., EL MONTE, CA 91731 I Please za.11 these offices: Plan Check (818) 572-6406 - (818) 572-6111, (818) 572-626 D:AI,OnbO' f ,',...✓>Fri1k•+,wv.:F:iYftil�aka+4rf« �r'7 'Y APPLI ,,kTION FOP CERTIFICATE OF OCCUPANCY Department of Development Services Gi t of kiunt i n oz Beach_ �.�� DATE ' •` FOR PLICAt� T;) FILL IF kPrint or t/pe on1y� 4 ' Application is hereby rude for a Certificate of Occupancy for a; oc gan, C,�, r. r . DescR be Business Use r. f To be known as a Name of W159nUbb J Located at -r'-- -= 'Business Address � - -,, s ce4 ddress � a r.-:sty Lip *Name: BUSINESS OWNER Rest en Residence:.,=.°..,,' Phone No. Business; — _ ress ty Name: BUILUM - THIS USE WOULD BE DLSCRIBED AS; .-. �. � Change of Occupant f--] Newly Constructed Building � Change of Owner E Existing Building Change of Use � Additional Occupant Occupancy- Gr. Diu, Indicate formar use if any r 5� ?r ccupancy of any buy zng �s prohzi d dna Certificata us e ofe0ccupaXcynos �ssuedd un,.l the building has beer, inspected til the 2. No electrical service wll be released ford s afe. eAll tapplicantsnfornoccupancy service has beeninspected edule an electrical "fuse up" in an existing building are required to sch inspection in the Department of Building and Corpunity bevelopment at the time this application is filed. 3. CHANGE OF OCCUPANCY OR USE INSPECTION FEE. WhenevM-N it is necessary to make inspection of a building or premises in order to dchange may es which be made in the character of occupancy or use of thprefsac upancy would place the building in a different division ooup w..,, ,, ar in a different group of occupancy, a change of pect, n f e of aid to the City, .�$30.00 shall be p . (FOR OFFICE USE ONLY) SUPPLEMENTAL INFORMATION Sq. ft, of building Plan Che-,: No. r____�.ay LL Permit Occupancy Group�---- r Occupant Laad_ �'�° �'�` Admin. Action r.. No. Parking Spaces No. of Stories health Dept. Approval / Utz 1 i ti �s Released ppROVED BY , _ p� �T CERTIFICATE OF OCCUPANCY FEE $ 6.00 ��'� CHANGE Or OCCUPANCY OR USE INSPECTION FEE y> TOTAL (#75-039)