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HomeMy WebLinkAbout121 Main St - CofO (3)y I P' { J ( APPLIC►'4T ION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH ^ DEPARTMENT OF COMMUNITY DEVELOPMENT ` Hu Y[INGTON ecna{ DATE (PRINT OR TYPE ONLY) i T 1 Address � District Business Name Tel ss t r' Business Type _ i ihN i� c 1 4�� r / /-dC_` �.� Occ Group ( c t( BUILDING OWNER BUSINESS OWNNEERIIMrANN�AGER 1 Name i^�.Q. - Name ����— N Home `I c* I Address Address -� { l t G City 00 ` Tell c�6 Cny.GY+►r�—$cam ✓ Home Tel I — 0� 1 THIS USE WOULD BE DESCRIBED AS: NEWLY CONSTRUCTED BLDG ❑ CHANGE OF OWNER R1 CHANGE OF OCCUPANT EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT r Indicate former use, it anv(&Occupancy Gr Div r SOUARE FT. OF BUILDING TO BE OC.CUPIED�5 i 1 � � P i p ng u any Occupancy o 1. NOTICE: Of building is prohibited and a business license will not be issued until the building has been I � . 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 j j 'fuse up' inspection in the Department of Community Development at the time this application is filed, 1 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 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 rr 22 be paid to the city. 4. Huntington Beach Fire Cooe Section 10.208 requires that building numbers must be a minimum of four (4) 111 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. , [ q g j 00K5. Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection and distribution per the oc National Fire Protection Association pamphlet 10 (see reverse side). i }�ETa L `Tc� L. i kr— FoYL 1.1 Y_£ U" & G k Ci t'��a� (FOR OFFICE USE ONLY) i SUPPLEMENTAL, INFORMATION ZONING OCCUPANCY GROUP PLAN CHECK NC. NO PARKING SPACES OCCUPANT LC/AD PERMIT NO. HEALTH DEPT APPROVAL NO OF ST E ADMIN ACTION UTILITIES RELEASED — d I :;ERTIFICATE OF OCCUPANCY FEE g A ROVED D TE CHANGE OF USE OR OCCUPANCY FEE TOTAL S 75.039 Rev. 11/90 COMMUNITY rEVELOPMENT i 1 h f 1 SUPPLEMENTAL INFORMA71ON It 1. BUSINESS ADDRESS ZL CLl 2. Person to contact in case of emergency' El- Telephone number: i i. Does the building in question have electricity? Yes No (a) If No, are you requesting that the electricity be ❑ Yes turned on? NO C j 4. L The building is sprinklered? ❑ Yes ZNo 5. Operations will produce dust/wood shavings or similar material? ❑Yes No � 6. Operations will involve the repair or replacement. of ❑ Yes No automobile parts? If Yes: 4 (a) Describe the components repaired or replaced. k (b) €does the operation involve the use of an open flame? ❑ Yes; ` No I 7. The business is drinking, dining or assembly use that will ❑ Yes result in an occupant load of more than 50 persons. No C 8. The following best describes my operation; { t Office Only ,f F3/ -etail �;al re ase --�a` Manufacturing /Distribution (describe process and end product) Restaurant/Take Out Food {Medical / Dental ! i i Other (describe) C SUPPLIMENTAL INFORMATION I _ r r I I ' SUPPLEMENTAL 1NIFORMATI©N (Continued) Does the operation involve any of the following materials-? f Yes if Yes, indicate. quantities: I Material-_-- 1. Flammable liquids Class [-A Class I-B ' Class [-C 2. Combustible liquids - Class If Class Ili -A 3. Combination flammable liquids 10 4. Flammable gases 5. Liquefied flammable gases 6. Flammable fibers - loose 7. Flammable fibers - baled 8. Flammable solids Unstable materials 10. Corrosive liquids 11. Oxldizing material gases 12. Oxidizing material liquids 13. Oxidizing material - solids 14. Organic peroxides F 15. Nitromethane (unstable materials) -16. Ammonium nitrate 17. Ammonium nitrate compound mixtures I� containing more than 60% nitrate by weight i 18. Highly toxic material and poisonous gas - 19. Smokeless powder 20. Black sporting r)owder i f l here y certify that e above information is true and correct to t e b t of my kno edge. Signatur Date r ; I P s i City of Huntington Beach 2000 MAIN STREET CALIFORNIA92648 ` DEPARTMENT OF COMMUNITY DEVELOPMENT Building 536-5241 A Planning 536-5271 p Housing 536-5271 i b' Government Code Section 65850.2(b) requires the City of Huntington Beach Building Division not to issue the final certificate of occupancy unless the applicant has met or is meeting the requirements of the South Coast Air Quality Management District (AQMD). The Building Division must obtain a written release from AQMD to show the applicant has complied with this law. The check list on the reverse side is designed to help the applicant and the building division to meet these requirements. 1. The applicant (the same person who applies for permits from the Building Division) must complete the check list which can be obtained either at the Building Division or at AQMD. 2. If all boxes in the list are checked "no", the Building I Division can accept the check list az the release. l 3. If there are any "yes" answers in the list, the applicant must contact an AQMD engineer by calling (714) 396-2000 to find out whether air permits are required for the proposed construction project. 4. If air permits are not required, the applicant will obtain a written release from AQMD. 5. If air permits are required, the applicant must submit the necessary permit applications before the release can be issued. Because of the time it may take for AQMD to go through the above procedures, the applicant is advised to contact AQMD immediately after applying for Building permits. (1360D) u s f: r 44 II I. i 1 f SOUTH COAST AIR +QUALITY MANAGEMENT DISTRICT (Nonresidential Buildings Only) Location of Subject Property: Property Owner Name: 2( S ._ Phone # S3 6-UV,>,,-- rName of the Person Preparing this form in prin n signature jName; �� > % Signature: The person preparing this form must be the same person applying for F 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 4 1. Does your facility use any internal combustion X engines greater than 50-HP? 2. Does your facility involve mixing, blending, or processing any solvents, adhesives, paints or coatings? 3. Does your facility create any dusts or smoke? 4. Does your facility refine any liquids or solids or 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, _ r etc.) rated greater than 2,000,000 BTU/HR? 7. Does your facility handle or store solvents or motor fuel? 8. Do you use or store any acids? 9. Do you use any chemical process? 1, 10. Do you use any solvents for clean-up? _ 11. Are you a dry cleaner., restaurantwith a charbroiler, body shop, gasoline station, ` printer, or part coater? X 12. Is the subject building located within, one thousand (1,000) feet of any school? x PROPERTY LINE TO PROPERTY LINE. GRADES K-12. " l 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 Please call: Plan Check (714) 396-2000 i (1360D-2) t r. E b I J i I I