HomeMy WebLinkAbout1502 PALM AV - CofOAj
aTy or- HUN�i INGTON $?EACH
DEPARTMEN7 OF COMMUNITY DEVELOPMENTAP?LICATION FOR CERTIFICATE OF OCCUPANCY
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huzaw DA ;=
(PRINT OR TYPE ONL,1 I
y
Address `�--E'aL District z
Business,Name t-rs__''�� rely:
Business Type G-u U V,- r- L Occ Group .,r__-_____
BUILDING OWNER BUSINESS OWNFRII,A.ANAGER z;
A /y
Name Au �` �j c _. �C?a c i1 k �� -Sts 4' Name ti . 'tL es slo,-- kHome
{y
Address2.0Is ,r2VINO -OA� Address
__7e7JJrW#s`% city_ �r t ��e �,-. c tt• m____HomeTel.
THJS U E WOULD BE DESCRIBED AS:
IVLY CONSTRUCTED BLDG CHANGE OF OWNER � CHANGE OF OCCUPANT f'
:�TiN" BUILDING Q CHANGE OF USE ❑ ADOITIONAL OCCUPANT
Indicate former use, if any _�`r Occupancy Gr_ _ Div.
I
SQUARE FT. OF BUILDING TO BE OCCUPIED,���
sQ7i E� 1. Occupancy of ari;. building is prohibited and a business license will not be issued untiithe building has been
Inspected and a certificate of occupancy is issued.
2. lea eiecfrical service will ire 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 tiled:
1 Change of occupancy or use inspection.fee. Whenever it is necessary to make inspection of a building or
premises,,in order to determine if achange may be made in the character of occupancy drusa ofthe buitd rg
or premises which would place the building in a different division of the same group of occupancy Orin a
different group of occupancy, a change of occupancy inspection fee of $ - shall
be,'pald to the city.
4. Huriongton Seactl Fire Code Section 10.208 requires thatbuild'og numbers must be a minimum of tour(r4) y
inches in height 'with one baif (fV2) inch stroke, and of a contrasting color from th oackgreurid. these
numbers must be posted on your building in a'location that is visible from the street.
5. Huntington Beach Fire Code Section 10,301 requires fire extinguisher selection and distribution per the
National Fire Protection Association pamphlet iD (see reverse side).
.ray c ems.
D.CkTE PAID —- _
.z At OUNT R C
(FOR OFFICE USE r0fitt.Y)
NAM ZONiNC
OC tlPRtvuY GROUP �4 - e PLAN CHt CK NO NO PARKING SPACES
OCCUPANT LOAi3 - - PERMIT N3, _ HEAt TH UEPT'APPRO'VAL a
STOFI €S - -� -. ADMiN ACTION . LI'i iLiT(l S RELEASED
k' �• , t
•�,+�i CERTIFICATE OF OC' InANCY I'EE
` APP Eli BY DATE CHANGE OF USE OR UCCIII?ANCY FEE $
TOTAL g
nss fzeti. tfs. C0M14 !-1Ni f `t DEV EL11M,, iN T
..
t71 Pli+ a=tFi NTALT INFOS'i.. A S. ION
'..'
BUSINESS ADDRESS SG i ty►� „ J-j ,
2.
Verson to r.,ontadt irf case of emergency- )Af' R key.. J_C a �A ck
Telephone numbs
3.
Dees the buildingin .question have electricity?
( ,fes
(a)` If No, are you requesting that
'� 9 he electricity be
i] N o
Q Yes
turnery on?
C No
;.
4._
The builciing is sprit- lewed?
vet
'
5.
Operations will produce dust/wood shavings or similar _
material?-
� No
�
Yes
i No
5.
Operations will invoive the repair or replacement of
[l Yes
automobile parts?
Ne
if ; Yes:
(a) Describe the Components repaired or replaced.
® Yes
{b) Does the operation involve the use of an open flame?
7.
The business is drinking, dining or assembly use that will
19 No
j
result in ` an occupant ' load of Gore than 55 persons.
14 'Yes
8.
The following best ` describes my operation,
71 No
Office Only
Retail Sales
`
Warehouse
Manufacturing / Distribution (describe process and end product)
Restaurant) Takc Out Food
;Jledical / Dental
x
Other (describe) f_� titre
r
I°x
I.:
SUPPLEMENTAL INFORMATION
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5
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South Coast
t
AIR QUALITYM. AG ' E T DISTRICT
I
21865 E. Copley Drive. Diamor d Bar, CA91765.4182 (909) 393-2000
I
AM QUALI PERMIT CHECKLIST
%r nonresidential buildings only
Company Name: _ E 4'N4U,9S
Location of Property:
a s 11y; 4L'3 P4;1 (11, G' Zip Codes t
Contact Person: l "/[ k. G• Qb5GtG Title: 5 0 1
7-11
Telephone 11iumter, .5 3 & T G� Fax Number:_ 3 —
Type oflndustrylBusiness:
r
To apply for a nonresidential building permit, you mast complete this the*list. If you have any
F
questions about completing this checklist, please call (800) 388-2121.
=`
YES
4y
NO
1.V1111`the facility have a charbroi'er?
2,- Will -any internal combustion ..?ire with greater than 50 horsepower
operate at the facility (e� luding raotor vehicles)?
( �
I Will operations at the facility involve mixing, blending, or processing of
solvents, adhesives, paints or coatings? rr
';li
4. Will dust or smoke be generate l at the facility?
5. Will refining of any liquids or solids be done at the facility? f ]
6. Will any plating or coating of materials be done at the facility?
7. - Will any combustion equipment rated greater than 2,000,000 BTI7/hr be
operated at the facility? j
8; Will any acids, solvents, or motor fuel be used or stored at the facility]
9.' 'Will any organic liquids or gases be reacted or produced?
10. Will any ovens be used to dry or cure pro ducts at tc,n facility? ]
[K]
11. ` Will any CFC (Freon) recycling machines operate at `tie facility?
Applicant: Q` , _]_�,Av� K t. f. S-5ACk Signature: )
-�—
(Printnarne clearly)
If you .have markee "_NO" in a%( the boxes, an air quality permit i; not needed at &Is time,
and this cheeldist is your written release.
Ifyou. nxar. d "YES" in any of the boxes, you must contact the South Coast Quality
,ear
Mana genreut District ( Q1NID). Please read the requirements on the back of the checklist.
(800) 3 8-2121
AODNITIONAL SUPPLEMENTAL INFORM91 ON
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Permit Issued status
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