HomeMy WebLinkAbout15222 Pipeline Ln - CofO (3)j. APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF 14UNTINGTON BENCH
? DEPARTMENT OF BUILDING 8 SAFETY'--�--
`°
'HtH:f9r(Ttk+. 9tK7S ;+ta'h Aq 0E. 1i+k w DATE
Address
BusinesstamtI
Business Type ���2 �CIiG �,� _..�1 �I`��+a�E�w.,�, .��.� Occ group
BUILDINGOYVNFR tBUSINE°a`SCaYdWt?IiANAGER�'
Name-� xwa �t..�i_.`�.a Named.-.`
Home
Address—,
City- Fume Tel :„J/ - %L .
THIS USE WOULD BE DESCRIBED AS.
NEWLY CONSTRUCTF0 81,013 0 CHANGE 01� OWNER ' OtiAht(� OF 04;CUPANIT
EXISTING BUILDING (-HANG+ Cif USE ADOITJONAk (XC UPANT
indicate loaner uSe` of any uk Sir} 1L x - Q(( Ijpancy 6r
SOUAPE FT OF BVILDIN(i TO BF C)CCxU1311I.7 , tT� �- � � �•�, g �b� 4 � � t
NOTICE; T ' Occupancyof any building is prohibited and business license will not be issued until the building has been `
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 sate All appfi^ants 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 i, a changct may be made in the character of occupancy or use of the buildings s
or premises which would place the building in a different division of the same group of occupancy or in a 4
different group of occupoincy, a change of occupancy arispeciton fee of S _ _w...-_shall
be paid to the city I
4.. Huntington Seach Fire Code Section 10208 requires that building numbers must be a minimum of four (4)
inches in height with one halt (iez) inch stroke, and of a contrasting color from the bacRground. 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 requites lire extinguisher selection and distribution, pet the
National Fire Protection Association pamphlet 10 (See reverse side).
�d
{1 1 € (FOR OFFICIE USE ONLY)
OCCUPANCY Gf34Ttif 7 u PLAN CHECK NO .d NO PARKING SPACCS
OCCUPd T LOAD PERMIT NO HEALTH DEPT APPROVALNO F S,0 ES AIDMIN ACTION UTILITIES RELEASED
kTIFICATE OF OCCUPANCY FEE; $
1,E'f'F3C Vi f DATE CHANCE € r USE OR OCCUPANCY t=>:F S
TOTAL $
fiE ?" ..x x: x ti .`Atit"s Z, «14ASA 714 t,d: 1 s ,�1t,
J� APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
DEPARTMENT OF BUILDING & SAFETY
rtClt.'ilydSi7rX+ NrtiCri' .:` :i t+IN1 : pit'1Yp1;. iVq Y; " DATE
' Address,;-w
Business N2ine` Tel id
Business Type _ 4 Orr.�rrJi7�r� Ja 3�,
...,....,.... ,.,,,,,
BUILDING OWNER iiC�SaNF,f�� O'C�Nf WtdAtrh �C�a "' ,,
Name k• .�, z ? � �_:� .,w. Namt ,._ ..w..
Address- m41 E Home
- - - ram_ . ,,o Address
City
,.. <.,._TO...,...�..:�,:....�r.°'•.�G:t}'...,,...�,..�.�„».�..�...,...:...w,�, tiort]@ Tit
THIS USE WOULD BE DESCRIBED AS; ti
n NEWLY C NSTRUCTED 131.013 CHANG V s T OVA-IER r>tt ititW OF i,UPANT
k, ,
EXISTING, BUILDiNt �y d hiANfaE +�� sfSF: 0 Atif.�t lG�idA! .it:GttAAfa�
Indicate former use. 4 any �.... � ""
W._.Oci uparmy CitU-v
SOVARE FT OF BUIt, 3JN Tr?) HE r:7CiWiFF
NOTICE* 4 Occupancy of any building is prohibited ands bu mess license will not be issued until the building ties been t ;
inspected and o cedifrcate of occupancy is issued `
2 No electrical service will be roleased for any existing building unfit the service has been inspected and
certified safe, Aff applicants for occupancy in at) existing building are required to schedule an electrical
`fuse up" inspection in file Department of Community Development at the time this appJfcation is fried: �
3 Change of occupancy or use inspection fee. Whenever it is necessary to make inspection of a building or
premises in order to determine rI a change may be made inthecharacter of occupancy or useof thebuitding
or preauses which would place the buildineq in a different division of the same group of occupancy or in a
different group of occupancy, a change of occupancy inspection fee of S ...___::. _ w shall
be paid to the crty.
4 Huntington ,Beach "Fire Code Section 10-20a requites that building numbers must be a minimum of four (4)
inches in height with one haft ('12) 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
5 Huntington' Beach Eire Cade Section 10.301 requires fire extinguisher Selection and distributio' n per the
National Fite Protection Associatio, amphiet 10 (see reverse side).
,-(FOR Or,
F1 E USE ONLY)ZONING
QCC UPA
NCY GROUP �.� PLAN CHfrk NO " " NO PARKING SllAoEs
QCC61PAINT t.OAi . � ` w � .. PERtvtlI' NO "fTEAi 7H `DEP' 4` APPROVAL
PACT pr STORIE$ ADMIN ACTION------ .UTILJTIt RELEA$ED s
IFI�"rATt<',0} ' itrrJ FANCY Fr
AP OVt i Y f, t ai' CHAfsf OF tlsr L)Fl OCCUPANCY FEE
,- -- .-....-� A� ,
TGTAt
1:.N�ib4 r ;NiY �.� ' R! 4,P41FA SAIN41)014-A
SUPPLEMENTAL INFORMATION
BUSINESS ADDRESS l_' a T,- g _J_tvt
3,
Person to contact In case of emergency 'i 7r,,O,
Telephone number:
3.
Does the building in question have electricity?
Yes
❑ No
(a) If No, are you requestingthat the electricity be
❑ Yes
turned on?
0 No
4.
The building is sprinklered?
❑ Yes
O�No
5.
Operations will produce dust/wood shavings or similar
material?
❑ Yes
3-No
E.
Operations will involve the repair or replacement of
❑ Yes
automobile- parts?
0,,No
If Yes:
(a) Describe the components repaired or replaced.
(b) Does' the operation Involve the use of an open ' flame?
❑ Yes
❑ No
7.
The business is drinking, dining or assembly use that will
result in an occupant load of more than 60 persons:
❑ Yes
❑ N,o
8.
The following best describes my operation:
Office Only
Retail. Sales
Warehouse
• Manufaoturinq f Distribution (describe process and end product)
Restaurant l Take Out Food
Medical / Dental,
Other' (describe)>„
SUPPLEMENTAL INFORMATION (ContinucA)
Dees
the operation involve are of the following materials? L,I
1� Y ? wrrn� CY3a to 'r`.s
1f
Y£3S, indicate quantities:
'
Material C��rarrttty
Flammable liquids
Glass I -A
Glass �"�
Glass I-C
2.
Comtrustible liquids
Glass 11
.»... ,d..i-r.-r-d-.a,... ,.,,...+-,.,.r: x. x. , ....,,_.-..:...r.,..w:.,........>....rn.<.w...a,.. ..u+w,.. wxros-w...:uw.,..d...,.a::.,..�.w.-w...... «>...
Glast* 111
3.
Combination flamma le, liquids:. ..... _......
4.
F3arr';r,°�able gases
l.rgrrr.frej€larr°trr abi.p.,.. gases ..
Flammable fibers - loose
a .
Flanrrna xle fibers - haled
Fl rnmable solids
,,r
-,,,,,ate .-..,.
llr^�sta1,bi rat fir�ria,is
xrdrzrrr material,, gasp'
t rxidizinq matt rl trr Sri s
1
~ n.
Oxidizing rr aterralr solids
14.
Organic �w. er oxides . M .
peroxides
l rtr; r r thane rrrsta R1R materials)
16,
. Ammonium m nitrale
17,
Ammonium compound mixtures
coplairong more than % nitrate
by wei0it
wind
18,
I^at hly tuxic material
poisonous ga-
'l
mokeless powder
f
wsporting
Siack powder
I 1"Ri�rfjb ertif t1 at the a r ve information ration is tare and correct to
r
the best of ray knowledge.
c r r aWrex Date
EY
t
South Coast
AIR QUALITY MANAGEMENT DISTRICT
21865 E Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-2000
,I
AM QUALITY PERMIT CHECILIST
for nonresidential buildings only
E
Company Name- k
+ f
Location of Property: t
City- ,.f 1.r�) 75-- Zip Cooe r `
Contact Person, _lK et u/iID V1 Title: � ���, l_ � r � �.. ��Jor o
Telephone Dumber: '7 -1 , (a Fax Number
Type of Industry/Business:
a r
To apply fora nonresidential building pe=n you must complete this checklist If you have any
questions about completing this checklist, please call (800) 388212 ;
YI;,S NO
1. Will the facility have a cbarbroiler? L I M
2,. Will n y � internal combustion engine with greater than 50 horsepower
g
operate at the facility (excluding motor vehicles)?
3, Will operations at the facility involve mixing, blending, or processing of
solvents, adhesives, paints or coatings? [ C`
4. Will dust or smoke be generated at the facility? ]
5, Will refining of any liquids or solids be done at the facility? [ ] M
f done at the facility?
e ials be o
6. Will. an platingor caata.rt o� rx�at r y
Y
7. Will any combustion equipment rated greater than 2,000,000 BTI.1thr be
operated at the facility?
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 products at the facility?
11, Will any G>?C (Freon) recycling machines operate at the facility?
Applicant: l Signature:
(P-rint name clearly)
If you have m;arked'.WO"`-in 1i the boxes, an air quality permit is 1p-tneeded at this time,
and, this checklist is your written release.
If you marked "Y '` in any of the boxes, you .must contact the. South Coast Air Quality
Management District (AUM ) Please read the requirements on the back of the checklist,
(800) ass-212x
4 x0VF:E. N'N- kFN A COAJE. g'1'3 'h. TION 475950.,2 (.'i.B.. 205,)
c api3°ndw ," tw " lAw 1&'. 4ma'a"ss a CCU VA"01 T Wi,a,r," Or,
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