HomeMy WebLinkAbout15262 Pipeline Ln - CofOIN
r
i
i
�e APPLICATION FOR CERTIFICATE OF OCCUPANCY
CiTY OF HUNTINGTON BEACH
"t P/ � DEPARTMENT OF COMMUNITY DEVELOPMENT ��E
HU TON erAOi (PRINT OR ^'YPE ONLY)
address�v2`._� �s rev . (o [ District
i Business Name
Business Type _�" _ Occ. Group
J
yP — — j_ p
BUILDING OWNER ^ S-w BUSINESS OWNERIMANAGER
Name wru.I}l. 'Name
Address e _ �''!
y_ _
Cit ' Icity- Home Tel 4 D
` THIS USE WOULD BE_D£SCRitiED A7,1 1 G
❑ NCVLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER ❑ CHANGE OF OCCUPANT '.
Il
IKEXISTING BUILDING CHANGE OF USE ❑ ADDITIONAL OCCUPANT
` Indicate former use, it snyCA •_ _ fir Occupancy Gr Div;;
SOUA;RE FT. OF BUILDING TO BE OCCUPIED.���?
OWL,,-
------------
NOTICE: 1. Occupancy of any 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 he released fer any existing building until the service has been inspected and ;'
certified safe. Ail applicants for occupancy in an existing building are required to schedule an electrical U
'fuse up' inspection in the Department of Community Development at the time this application is filed. (t
3. Change of occupancy or use inspecti^- f^,. Whenever it is necessary to rirake inspection of a building or 4_ `
premises in order to determine if a change may be made in the character of occupancy or use of the building [; j
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 t
be paid to the city.
4. Huntington Beach Fire Code Section 10.208 requires that building numbers must be a minimum of four(4) t:
inches in height with one half (1/2) inch stroke, and of a contrasting color from the background. These j
numbers must be posted on your building in a location that is visible from the street.
5. Huntington Fteach Fire Code Section 10.301 requires fire exting i r selection and distribution per the
✓� National Fire Protection Association pamphlet 10 (see revers sl ).
1 `to
t / TRAFFIC IMPACT FEE 4*`t 017
t'
--- — —
DATE PAID� 'ilk
AMOUNT RECEIVE,
f`3PFvIc � _.. __� _._ _ �_ (FOR OFFICE. USE ONLY)
ZONING
OCCUPANCY GROUP S _ PLAN CHECK NO NO PARKING SPACES
OCCUPANT LOAD PERMIT NO HEALTH DEPT APPROVAL �F
NO, OF STORIES ADMIN- ACTION ' UTILITIES RELEASED r;
CI4 CERTIFICATE OF OCCUPANCY FEE g hl
APPROVED BY DATE CHANGE OF USE OR OCCUPANCY FEE g 6,
TOTAL $
75-039 Rev. vex COI~ MUMTY DEVE;..OPMu T,!T
�...
I
r
SUPPLEMEN 'AL INFORMATION
1.
BUSINESS ADDRESS zIyWws-,HNOO
2.
Person to contact in case of, emergency' 4 w
Telephone number:
3.
s so
Does the building in question have ,electricity? CN
(a) If No, are you requesting 'that the electricity be ❑ Yes
turned on? ❑ No
i
r
4.
The building is prink(ered? Yes
K
El -N o
l
5.
Operations will produce dust/wood shavings or similar
.
l
material? ❑ Yes
o
6.
Operations will involve the repair or replacement Lit Ej Ye_
'
automobile parts? _ o
If Yes:
{a
(a) Describe the components repaired or replaced.
(b) Does the operation involve the use of an open flame? Yes
s
7.
The business is drinking, dining or assembly use that will
result in an occupant load of more than 50 persons. ❑ Yes
i
8.
The f --best describes myoperation;
r
Office
Recai es
arehhouse��
a .�Distrlbution (describe process and end product)
i
Restaurant / Take Out Food
Medical / Dental
Other (describe)
-i
SUPPLEMENTAL INFORMAT ION
.
sS
SUPPLEMENTAL
INFORMATION (Continued)
Does
the operation involve any of the
Jollowing materials? O Yes
r
If
Yes; indicate quantities:
Material
Quantity @
—
1.
Flammable liquids
Class I -A
x
Class 1--B
Class I-C
2.
Combustible liquids
Class II
Class Ili -A
,
3.
Combination flammable liquids
4.
Flammable gases
5.
Liquefied flammable gases
i
r
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 naterial - solids
14.
Organic peroxides
1
15.
Nitromethane (unstable materials)
16.
Ammonium nitrate
17.
Ammonium nitrate compound mixtures
containing more than 60% nitrate
by weight
18.
Highly tnxic material and
poisonous gas
19.
Smokeless powder _
I
20.
Slack sporting powder
I hereby c-,rtify that the above information
best knowledge.
is true and correct to
the o my
sate
Signature
•
t
_ 7
South Coast 1
AIR QUALITY MANAGEMENT DISTRICT
21865 E, Copley D(ve, Diamond Bar,'CA 91765-417=is ;909) 396-2000 1=,
E' 1
AIR QUALITY PERMIT CHECKLIST
for nonresidential buildings only a
Company Name:_ fiP-l.r4rl��r� Tji.�t�il{r�{1.1�z
� T r
Location of Property:1" Z QJLr
I �1 _
j City:_4A (A t g�m W�Ll Zip Code:
[[ R 4
Contact Person: _' ff (G Iwl Title:"+
{
fTelephone Number: 4b �,2_j(ofl Fax Number:
` Type of IndustryBusiness` 41
,
To apply for a nonresidential building permit, you must complete this checklist. If you have any
questions about completing this checklist, please call (800) 388-2121. {
YES NO
1 Will the facility have a charbroiler? (�
2. Will an combustion engine with Y internal g greater than 50 horsepower
operate at the facility (excluding motor vehicles)? r�
3. 'Will operations at the facility involve mixing, blending, or processing of
solvents, adhesives, paints or coatings? ) E {
4. Will dust or smoke be generated at the facility? 1 ,�
` 5. Will refining of any liquius or solids be done at the facility?
6. Will any plating or coating of materials be done at the facility?
7. Will any combustion equipment rated greater than 2,000,000 $TU/hr be k
operated at the facility? E
i
8. Will any acids, solvents, or motor fuel be used or stored at the facility? E C T
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? I T
11. Will any C (Freon) recycling machines operate at the facility [)
Applicant: S o�y)
Signature:UV
(Print n -
)
>� If you have marked "NO" in _all the boxes, an air quality permit is not needed at this time,
F and this checklist is your written release.
If you marked "YES" in any of the boxes, you must contact the South Coast Air Quality
Management District (AQ?aM). Please read the requirements on the back ofthe checklist. 4;
(800) 388-21a #s
t'
ADDITIONAL SUPPLEMENTAL INFORMATION F
�`