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CERTIFICATE OF OCCUPANCYf7/90
CITY OF HUNTINGTON BEACH
Date
Address
11 LLt
District
Name
!a r S L„E LTI! bAR &
DELI
Tel.
IBusiness
Business Type
CUD uANDV ZCh US
Occ. Group P" 2
BUILDING OWNER
BUSINESS OWNER/MANAGER
CASTOR
VILLALBA
Name
Name
Address
Home
Address ?018
CEO " EL,L.A PL
City
Tel.
City NEly FCRT
PCij Tome
7 111-642—IC5,
Construction Z
No. of Stories Occupant Load � ! Sprinklers
CONDITIONS OF APPROVAL
® a
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 f(.
Building Official.
COMMUNITY DEVELOPMENT
p o t
mie APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT
HUNMGroN eEAoj DATE
(PRINT OR TYPE ONLY)
Address 1 ZI Mx/�'>/l/? District
Business Name ') 4'-� Tel.
Type - 1.L7 %a �y�i l �` L'� Occ. Group
BUILDING OWNER BUSINESS OWNERIMANAGEiA
Name Name
Home
r
Address Address
City Tel City2c s/F'c�'^ ,�� Home TeL
THIS USE WOULD BE DESCRIBED AS:
NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER ❑ CHANGE OF OCCUPANT
XEXISTING BUILDING ❑ CHANGE OF USE y CDDITIONAL OCCUPANT'
Indicate former use, if any Occupancy G,.'_ / Div.
SQUARE FT. OF BUILDING TO BE OCCUPIED
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 occupan y 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 maybe road; 1rw 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.
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 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.
b. Huntington Beach fire Code Eection 10.301 requires fire extinguisher selection and distribution per the
® National Fire Protection Associationpamphlet10 (see reverse side).
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(FOR OFFICE USE ONLY)
SUPPLEMENTAL INFORMATION ZONI Gam`;?
OCCUPANCY GROUP d. PLAN CHECK NCB, NO. PARK -&PAGE-B
OCCUPANT LOAD t PERMIT NO. _ H� H DEPT APPROVAL - NO. OF STORIES f ADMIN. ACTION UTILITIES RELEASED
,
0
CERTIFICATE OF OCCUPArANCY
ES
P ROVE DA CHANGE OF USE OR OCCFEE -$ 1
TOTAL $
�s,ossRe�.siee COMMUNITYDEVEl..P.
SUPPLEMENTAL INFORMATION (Continued)
Does
the operation involve any of the following
materials? Oyes
.Wo
est indicate quant ties:
material
Quantity
1.
Flammable liquids
Class I -A:
--
Class I-,H
Class I-C
2
Combustible liquid
Class II
Class III -A
3.
Combination flammable liquids
4.
Flammable gases
5. _Liguefied
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
j 15.
Nitromethane (unstable materials)
16.
Ammonium nitrate
17.
Ammonium nitrate compound mixtures
i
containing more than 60% nitrate
by weight
18.
Highly toxic material and
poisonous gas
a
19.
smokeless powder
E
20.
Black sporting odder
P g P
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I hereby
certify that the above information is
true and correct to the
best
of . my knowledge.
Signat a
Date
(0362D)
-
�
r
!
1
` SUPP EMENTAy INFORMATION
1, BUSINESS ADDRESS .577�
2, Person to contact in case of emergency;
Telephone number:
3. Does the building in question have electricity 9'Yes
a ONO
a. If No, are you requesting that the electricity be 13Yes
turned on? MNo
s
4. The building is sprink.lered7 Oyes
�fiTa
S. operations will produce dust/wood shavings or similar
material? OYes
Mtn
6. operations will involve the repair or replacement of Oyes
automobile parts? 0140
If yes;
(a) Describe the components repaired or replaced.
(b) Does the operation involve the use of an own flame? Oyes
' 'o
7. The business is drinking, dining or assembly use that will
result in are occupant load of more than 50_persons. Oyes
PRO
8. The following best describes my operation:
Office Only
ware use
Manufacturing/Distribution (describe process and end
product)
{
sta,uran a e ut Pood
ffiI
e a-1/Dental
Other (describe)
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(0562D)