The URL can be used to link to this page

Home My WebLink About1120 Pacific Coast Hwy - CofO (4)m teen APPLICATION FO C�RTI II" OF OCCUPA�C (��,ATECITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT s0 HUNTWICTON'eFw01 DATE (PRINT OR TYPE ONLY) ,,--Address�) ac, �45� t 114E iJ4V � �'i Q -A 126(4i�- Distract Business Name J rr 14 C' n ^^ / Business Type 4 J b e- 1,iU 77 r n I f l, b Occ. Group 13 .� _— BUILDING OWNER BUSINESS OwNERA',ANAGER Name^L�tJ{ cvI Ct �L JSh��ame �%r4GV 411Qv, Address I D /. C /1/ - /nddres ,, // /n� �7/� nn� -City i4 ►J C' G3 Tel �y T) 17 C/� Home Tel. THIS USE WOULD BE DESCRIBED AS: ❑ NEWLY CONSTRUCTED BLDG. CHANGE OF OWNER W1C(HANG?0F OCGuPANT EXISTING BUILDING CHANGE OF USE El ADDITIONAL OCCUPANT Indicate former use, if any 'gd �Grj t- f-1 C Occupancy Gr. ES ✓u Div. SQUARE FT. OF BUILDING TO BE OCCUPIED 3� s` god li i N OTICE: 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. G 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 D3velopment 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 character of occupancy or use of the building i or premises which would place the building in a different division of the same group of occupancy or in a E I different group of occupancy, a change of occupancy inspection fee of $ shall k be paid to the city. 4. Huntington Beach Fire Code Section 10.208 requires that building numbers must be a minimum of four(4) r 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. s 5. Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection z -1d distribution per the r National Fire Protection Association pamphlet 10 (see reverse side). TRAFFIC IMPACT FEE DATE PAID _ AMOUNT RECEIVED NAME (FOR OFFICE USE ONLY) Z _ SUPPLEMENTAL INFORMATION ZONING _ OCCUPANCY GROUP t Z'` PLAN CHECK NO. NO PARKING SPACES OCCUPANT LOAD 4r PERMIT NO. HEALTH DEPT, APPROVAL NO. OF STORIES ADMIN, ACTION UTILITIES RELEASED �Q G _'. fj < CERTIFICATE OF OCCUPANCY FEE $ \PPROVED D E CHANGE FUSE OR CCUPANCY FEE $ ✓ TOTAL 1 /, 'J� $ 75.039 Rev, 11/90 COMM Y DEVELOPMENT . r SUPPLEME.:�TAL INFORMATION 1. BUSINESS ADDRESS 120 � '� �oGs� i h�Xy }`�� i� R 26 Ct� 2. Person to contact in case of emergency l l'�cy ��n �r 014rfor;e.4llQn Telephone number: tC(!,i Sq00 3. Does the building in question have elec�ric ty? Yes ❑ No - (a) If No, are you requesting that the electricity be ❑ Yes turned on? 0 No 4. The building is sprinklered? ❑ Yes E No 5. Operations will produce dust / wood shavings or similar material? ❑ Yes No 6. Operations will involve the repair or replacement of ❑ Yes automobile parts? VNo If Yes: (a) Describe the components repaired or replaced. s ❑ Yes (b) Does the operation involve the use of an open flarne? ,iRr-No 7. The business is drinking, dining or assembly use that will result in an occupant load of more than 50 persons. ❑ Yes 0--No 8. The following best describes my operation; F Only uW Sales Warehouse Manufacturing / Distribution (describe process and end product) 1 t Restaurant / Take Out Food Medical / Dental Other (describe) } 4 i t �i a SUPPLEMENTAL INFORMATIO, SUPPLEMENTAL INFORMATION (Continued) Does the operation involve any of the following materials? ❑ Yes No If Yes, indicate quantities: Material Quantity — 1_. Flammable liquids Class I -A r Class I-B Class I-C 2. Combustible liquids Class !I ` Class Ill -A ` 3. Combination flammable liquids ` 4. Flammable gases s" 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 i 9 14. Organic peroxides 15. Nitromethane (unstable materials) i 16. Ammonium nitrate 17. Ammonium nitrate compound mixtures containing more than 60% nitrate by 'weight 18. Highly toxic material and 1 p. gas as � 9. Smokeless powder i 20. Bleck sporting powder I hereby certif at the above information is true and correct to j the Uest ledge. � rkw S- ignature Date 3 u Government Code Section 65850.2(b) requires that the City , f Hur .n,jton Beach not issue the final P. certificate of occupancy unless the applicant ha." imet or is mee;rc , ,ne requirements of the South , G Coast Air Quality Management District (AQMD). The Department Community Development must 1' 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 s ► requirements. 1. The applicant (the same person who applies for permits from the Department of Community Development) must complete the check list which can be obtained either from the Department of Community Development or at AQMD. 2. If all boxes in the list are checked "no", the Building Division can accept the check list as the release. 3. If there are any "yes" answers in She 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 protect. � i 4. If air permits are not required, the applicant will obtain a written release from l AQMD. i 5. If air permits are requited 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 ad.'visdd to contact AQMD immediately after applying for building permits. 4 { r f ADDITIONAL SUPPI-15EM NTAL INFORMATION SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT I (Nonresidential Buildings Only) Location of Subject Properly:-LIZC _ ::`rL � Property Owner Name:__! CCU^ C C p y __ _m .__ �� _G_�/_.__ __-- _-___ __ Phone #:. Name of the person preparing this form in print and signature: Name:— ra - I �g_►'� _ Signature: ' The person preparing this form must be the same person applying for building permits. Please answer the k r 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 i 1. Does your facility use any internal combustion engines greater than 50HP? .—T s 2. Does your facility involve mixing, blending, or processing any solvents, adhesives, paints or coatings? 3. Does your facility create ang dusts or smoke? 4. Does your facillity refire any liquids or solids or reclaim any metals? 5. Does your facility plate or colt anything? » h t 6. Does your facility have ar Umbustion equipment (i.e. boiler, furnaces, s broiler, baking ovens, etc.) rating greater than 2.000,000 BTU/HR? _— ( 7. Does your facitity handle or store solvents c tor fuel? r 8. Do you use or store any acids? 9. Do you use any chemical process? 10. Do you use any solvents for clean-up? t �k 11, Are vl'u a dry cleaner, restaurant with a charbroiler, body shop, gasoline station, printer, br pan coater? 12. Is the subject building located within one thousand (1,000) feet of any school? PROPERTY LINE TO PROPERTY LINE. GRADES K-12. ✓ 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 i Diamond Bar, CA 91765-4182 j Please call: Plan Check (909) 396.2000 k s � I k 4 ' r l _r r _ -ice A_ APPLICATION FOR CERTIFICATE , TE OF OCCUPANCY CITY OF HUNTINGTON BEACH - DEPARTMENT OF BUILDING & SAFETY P" Floor — Afust Apply Irt-persot: j Business License # ZA C ISM _ Date Address / H f off r � Business Name {ilfii t G f� C Gt f i�t Cyr � --:. -� � Telephone i Busness Type F � Information Business; Owner } Name r rr r" /& Name �-�r Address _I C� f Rome Address City city T)E€IS USE: WOULD BE DESCRIBED AS: ❑Newly Constructed Building or AEXisting Building CRECK ALL THAT APPLY: ❑Change of Owner ha.nge of Occupant , ❑Chang -. of Use C]Additional Occupant Indicate former use, if anyµ Does the butil ding have electricit '? YesZt NoQ If No, :;ire you requesting that the electricity be turned on? Yes ❑ No The buildizig is sprinklered? Yes ❑ NoO Operations will product dustl wood shavings or similar material? Yes ❑ No-❑ I Operations will involve the repair or r--place.nent of automobile parts Yes ❑ Igo �4 If yes: Describe the components repaired or replaced. Does the operation involve the use of welding or, open 'flame? Yes ❑ No Qa The business is drinking, dining or assembly use that will result in an occupant load of more than 50 persons. Yes Q No ;U i The following best describes my operation: ,❑Office Only LJRetail Sales ❑iviedicallDental ❑RestaurantlTakc.- Out Food ❑Warelouse ❑Mar ufacturing)Distribution (describe process and end product) ❑ Other (describe) Office Use 011ly: oni'',g. Sq Ft Occupied: SOD Occ Group: Occ Load: # Stories. Parking Spares: _ Tip' Review. YI Amt. Paid$.- Paid BEfOFinal r ` P:B F�nai ins�,ecf�on Building Permit # Entitlem,ent 11: Ir Comments: Planner initials �,,,- i3l��gtl?lan Checker initials: CafQ w_ .