HomeMy WebLinkAbout1207 Main St - CofOa
APPLICATION FOR CERTIFICATE OF OCCUPANT Y
CITY OF HUNTINGTON BEACH
HUNTIN ON lei DEPARTMENT OF DEVELOPMENT SERVICES /
DATE
ArJdres,7
Business Name -
I�fjL S � �".�, f.�'s S t�.+� C•= ,.�.....,�_-._ _.�,�...--.-.----_.. Qistriet...._,..._.,_,__-.-
Business Type �p • I - f✓?" --_ � --- 6& 9_
.� BuiLtStra� U Oy�d'�aEfi Ucr.: Graup_
Name-.'-/�;rc'af_. C�•�ls /5 'fn liJStA3tSSoWN4Rrnf NAGER
1.10 7 G7
fr ry ime �
Address___-_ ✓J." r«t/" c
+om�-------�.----.vim
City .+/rrr✓G,rC.ci __ __.�_�.��f..�`._,_."
THIS USE WOULD BE DESCRIBED AS:
THT NEWLY CONSTRUC , ED BLDG. j� ^ ��
Q�--1
EXISTING BUILDING CHANGE OF OCCUPANT
Indicate former use:. i; any 0 ADDITIONAL OCCJJPA NIT
SQUARE FT_ OF BUILDING TO BE 0CC`itrpiE G [3Cciapar3cy far, _
NOTICE: 1 Occupancy of anv bu,+ding i; Prohibited andVbus+ness I:r arise
been inspected anwill hot be issued
ti a certif+cC t4 r3f occupant., i5 tsuued, until the builainp has
No electrical seivice will Leto?ea for .
certified sate All ad env xiStitt I building until the ser•fiice has been inspected and
` applicants for Depart
cupancy in an existing building are required to schedule an electric,.,,
'fuse up' inspection in the Eiepartrrsent Of pe„otopmenf Service
S. Change of occupancy or use inspection fee. Whenever it is i+aces xar i
s at the time tills applipatian is filed I or premises in o°der to use
if a change may by Made in the character of Occupancy building or'nreln ;� � which A z Y o ,.rake inspection of ~�,bui'ding
g Would p ace the ttultding ina differentdtui i f cupancy or use of itie or in a different group of Occupancy, a ct;dr3 son o, the sarrre group ref occupancy
/ shall be Paid to the city. ge of occupancy inspection fee of S I
4. Huntington Beach Fire Cade Section 10,208 requires that building number.
() inches n height with arse half (r z) Incfl sfrp[�e and ofcontrasting s must be a .immune of four
from the
numbers must be hosted can your building in a iocation thatis vi ble tr�mrthe StreetbackprourEd.Thase !
5• Huntington Beach Fire Code Section 10.301 requires
the National Fire Praytection Associatfire exlirtrrrrsher selection on and distribution }.er
ion parnph;gt 10 ( gee revers,. side),
SUIPPLEMENTAL:INFORMATION (FOR OFFICE USE ONLY)
OCCUPANCY UROUP ZONING
OCCUPANT LOAD PLAN CHECK NO, NO. PARKING SPACES
No. OF STORIES -- PERMIT �_- �.. HEALTH DEFT. APPROVAL__,_, _: ----
AgMlN, ACC TIONPI UTILITIES RELEASED
APPROVED BY -` "CERTIFICATI OF OCCUPANCY FEE
1TE CHANGE OF USE OR JCCU$
PANCY fit)
TOTAL
753d9 RE:.
ti
1
CERTIFICATE 7F OCCUPANCY
CITY OF HUNTINGTON BEACH : {' I `i
Date
Address District
Business Name i Te1. r �r b
Business Type _ Occ. urou t
BUILDING OWNER BUSINESS OWNER/MANAGER
Name
Name I. 4
Home
Address Address r
Home f
City +, TeL City TeL'
Construction No. of Stories Occupant load ` Sprinklers
CONDITIONS OF APPROVAL
APPLICATION FOR CERTIFICATE OF OCCUPANCY ✓� '��
CITY OF HUNTINGTON BEAC" ,
rtuxn Grorsr DEPARTMENT OF COMMUNITY DEVELOPMENT s2
FI 'SPRINT OR TYPE Oh;;_r_. --
BATE
f/-e- sc,�<�
8usmes4 Nam^=_ _1��It/l1Ll�C'a%d/L�-G�t�/2./'STi4-in/ ��E/fd�f�
�-- _
Business T c., >�R1 V
tS . SI hIF r�Y'JNEH0.h,�,^u A:�EG?
Name_��ST1N.�Ag(,/¢ r• am /2�@�✓,C
Address-,%-r���2_ �%%/�/���,� Hnrn"
City- l7 uNT e2Af -
-- -- T A5S�
Home Tr,I8i 7-00/%
r THIS USE WOULD BE DESCRIBED AS:
❑ t` WLY CONSTRUC;TED BLt-iC;
❑ CHANGE CHANGE OF OCCUPANT
0EX(STItyG BUILi);N,
CHAP,'C [ ;c.,E ❑ AD7L!JIONAL OCCUPANT
tnd;cate former ase f any
SOUARE FT OF BUN -DING T;i BE
�N CTI C E:
1. Occupancy of any building is prohibited and a business license will not b f in a issued inspected ed un ed a i the. - p and certificate building a r" e trfica a of din has be
occupancy is issued. g been {�
2. No electrical service will be released for any existing building until the service has been inspecteO and
certified safe. All applicants for occupancy in an existing building are required to schedule an electrical
'fuse up' inspection in the Depa,tment of Community Development at the time this application is filed.
3. Change of occupancy or us? inspection fee. Whenever it is necessary to make inspection of a buiiding or
Premises in order to determine if a change maybe made in the character Of occupancy rr use of the building
rrt or premises which would place the building in a different division of the same group of occupancy or in a
different group of occupancy,
"ta change of occupancy inspection fee of $ ____-_ _
be paid to the city. - - shall
1, Q 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 i
R f;'r) inch stroke, and of a rontrasting color from the background. These
numbers must be posted on your building in a location that is visibie from the street.
5. Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection and distribution per the
National Fire Protection Association pamphlet 10 (see reverse side).
I
SUPPLEMENTAL INFORMATION (FOR OFFICE USE ONLY)]
OCCUPANCY GROUP_:.. ----
OGCUPANT LOAD __ PLAN tCHEc < N"7 __----- -._ NO t'Aftr IN(i gpA(sE s
�` ------ PERMIT NO'
NO OF STORIES At>hQ - - - - rrf Ai 1'f {'E PT APPRI)VAL_-- -.-.
IN hCTt �N
00
APPROV_ ny 'u CFIi it -!CATS Fi CCIr'AN r FF:E
DATE ..HANGS or USE : R ,,
)�:C:�JE HFJ �' FEE
TOTAL
75.039 Rev, 11/90
COMMLI`aI Y DEVELOPtit: PIT
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SUPPLEMENTAL INFORMATION
1. BUSINESS ADDRESS -7,
2. Person to contact in case of emergency -
Telephone number:
3.
Does the building in question have electricity?0
Yes
(a) If No, are you requesting that the electricity be
''
El No
Yes
turned on?
❑ No
1.
The building is sprinklered?
❑ Yes
5.
Operations will produce dust/wood shavings or similar
N o
material?
❑ Yes
i
I& No
6.
Operations will involve ?pie repair or replacement of
❑ Yes
I:
automobile parts?
IR No
If Yes:
(a) Describe the components repaired or replaced.
r
❑ Yes �
(b) Does the operation involve the use of an open flame?
EL Na
7.
The business is drinking, dining or assembly use that will
result in an occupant load of more than 50 persons.
El Yes
r1
No
8.
The following best describes my operation;
1
Office Only
Retail Sales
Warehouse
I
Manufacturing / Distribution (describe process and end product)_
Restaurant /Take Out Food
Medical / Dental
Other (describe)LL 5'O-oDe- l,Qi4�JS' -/Lid
SUPPLIMENTAL INFORMATION
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4
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SUPPLEMENTAL INFORMATION (Continued)
D{ es
rl',: ullerat+r�;s nvci'. ,. any 3t �u ; piice�/sl miterials? i 'saes
a No "
ti I'ies, indicaw au antitles:
Matariw Quantity
.__.._.._.___..�.. _ _.._._....
.q_
_ p ,n
liquids
,lass t-A
Class l..6
Mass t - ;
1
2.
le -
i,.., 4e mbeast i:,i!kt} k ids
Class it
:
Class A
I
C"ombinatlor' flammable liquids
f 4..
Flammable gases
Liquefied flammable ga; as
;.
Flammable fibers ' foo&e
,
Raminable fibers ba aiw,l
B.
Plamm;ahle son ds
Unstable nlaae-ials
10.
Corrosive liqu ds
Oxidizing material ga e
R o °
i xfU121ikf? rya aerial iigUi B
6xidizing material - so-iidS
1
Cirganic peroxides
15.
Nitromei acne (unstabl= r .aterr l r
16,
Ammonium nitrate
q
a7.
A# iralotlr+arn nitrate compound mixtures
containing more than 6a111, nitrate
by
"8.
Highly toxic material and
poisonois gas
fig.
Smokeless powder
k 20,
Slack sporting powder
k hereby certify that the above information is true and correct to
the best of my knowledge.
01g tore bate
I
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SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT
(Nonresidential Buildings only)
Location cr Subject Property:®� //�i{,}//�% �uwT• �'
rProperty Owner name: %/Q�i �f�e�sr,t�.✓ ('N.L Phone #57
Name of the Person Preparing this form in print and signature
Name ,
(C
Signature
The person preparing this form must be s e person applying for
building permits. Please answer the followiig 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 NO1. Does your facility use any internal combustion C� �J
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? B
4. Does your facility refine any liquids or solids? FX
Reclaim any metals? 3
5. Does your facility plate or coat anything? C�
6. Does your facility have any combustion equipment
i.e. boiler, furnaces, broiler, baking ovens, etc.)
rated greater than 2,000,000 BTU/HR? X
7. Does your facility handle or store solvents or motor
fuel?
8. Do you use or store any acids? X
9. Do you use any chemical process? X
10. Do you use any solvents for clean-up?
11. Are you a dry cleaner, restaurant with a charbroiler,
body shop, gasoline agitation, printer, or part coater? pi �
12. Is the subject building located within one thousand
(1,000) feet of any school?
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:
9150 FLAIR DRIVE, EL MONTE, CA 91731
Please call these offices: Plan Check (818) 572-6406
(818) 572--6111, (818) 572-6261
D:AL00603
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