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HomeMy WebLinkAbout15302 Pipeline Ln - CofOl J` APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH 5_6Z_dO DEPARTMENT OF COMMUNITY DEVELOPMENT euHrM+crON REACH DATE (PRINT OR TYPE ONLY) Address f� ja��/��� District i�lG//b 5 -" S �'� s lli�G .• Tel: (¢ 88 9 Z o a o Business Name , l Business Type lire/ crG�IGE6rf Cara of--.' S -5 Occ. Groups 4 BUILDING OWNER BUSINESS OWNER/MANAGER ! Name zy� G/'C Ural Name LZIzgP %J'l�7yIG�Gt S r %5-41Z ���' �dr>lr Gs7 . Home / ,� Address - Address City 6 �q Tel. 8`�'s City �Ol9G/ BBC h Home Tel. SE72- r 3 966 614 4_ THIS USE WOULD BE DESCRIBED AS: s, ❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER 161 CHANGE OF OCCUPANT EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT Indicate former use, if any Occupancy Gr. Div. j. 1, SQUARE FT. QQBUILDING TO BE OCCUPIED A-2) 2 Azw • I, I; NOTICE: )' t. 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. 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 Development at the time this application is filed. P` 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 different group of occupancy, a change of occupancy inspection fee of $ shalt be paid to the city: �. 4. Huntington Beach Fire Code Section 10208 requires that building numbers must be minimum of four (4)# 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. j 5. Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection and distribution per the 1i National Fire Protection Association pamphlet 10 (see reverse side). l� �N TRAFFIC IMPACT FEE DATE PAID ?` AMOUNT RECEIVED (FOR OFFICE USE ONLY) NAME ZONING OCCUPANCY GROUP- PLAN CHECK NO, NO PARKING SPACES OCCUPANT LOAD PERMIT NO. HEALTH DEPT. APPROVAL NO. OF STORIES ADMIN. ACTION UTILITIES RELEASED CERTIFICATE OF OCCUPANCY FEE $ APPROVED BY / DAfE CHANGE OF USE OR OCCUPANCY FEE g TOTAL $ v5-039Rev. 1/97 COMMUN,TYDEVELOPMENT 3 Y 7 SUPPLEMENTAL INFORMATION 1. BUSINESS ADDRESS 2. Person to contact in case of emergency - Telephone number: 3. Does the building in question have electricity? s-B—Yes No (a) if No, area- you requesting that the electricity be ❑ Yes turned on? ❑ No _ 4. The building is sprinklered? ❑ Yes 5. Operations will produce dust/wood shavings or similar material? ❑ -Yes 6. Operations will involve the repair or replacement of ❑ Yes automobile parts? If Yes: (a) Describe the components repaired or replaced. I,. i (b) Does the operation involve the use of an open flame? ❑ Yes "8"No r 7. The business is drinking, dining - or assembly use that will (: result in an occupant load of more than 50 persons. ❑ Yes' '.©_moo } 8. The following best describes my operation; i. Office Only .i 3: Retail Sales arehous (r Manufacturing / Distribution (& scribe process and end product) { i. Restaurant/Take Out Food Medical / Dental Other (describe) SUPPLEMENTAL INFORMATION SUPPLEMENTAL INFOWA'TiON (Continued) 4 Does the 'operation involve any of the following materials? 1:1 Yeses ❑ No If Yes, indicate quantities: Material Quantity 1. Flammable liquids Cass I -A Class I-B Class I-C 2. Combustible liquids Class 11 Class 111-A 3. Combination flammable, liquids 4. " ` 'Flammable gases r 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... 6 Oxidizing material - solids 14. Organic peroxides 15. Nitromethane (unstable materials) 16. Ammonium nitrate 17. Ammonium nitrate compound mixtures containing more than 60% nitrate by weight 18. Highly toxic material and poisonous gas 19. Smokeless powder, 20. Black sporting ,powder I - I hereby -: certify. that the -above-- information is -true and correct to the best of, my knowledge. Signature 9 bate r y i r South Coast :. Air Quality Management District t 21865 E. Copley Drive, Diamond Bar, CA 91765-4182 http://ww%v.agznd.gov (909)_396-3529 • Air Quality Permit Checklist California State Law Code 65850.2 prohibits cities from issuing an occupancy permit without clearance from the local air quality agency. This checklist will determine if you need to obtain clearance from the South Coast Air Quality Management District (AQMD). Company Name: S . Z,-A1 Property Address: 15 3 o z pzp� %/ire r City:, . �. Zip Code: Contact PersonTitle: G�i7C/ //41z2s Type of Business: IS1//6y1/0n �.5 LAIGe- Telephone: ' Applicant (print name) �/T? ,IfA/aalf,* s Signature: • Will the facility have any of the following equipment? YES[ ] NO Charbrozler Dry g Cleanin Machine. at i [ Spray Booth. Printing Press (screen/lithographic/flexographic) Internal Combustion Engine (greater than 50 HP (excluding motor vehicles) Boiler/Combustion Equipment (greater than 2MVI BTU/hr. maximum input) r Abrasive Blasting Cabinets/Rooms Baghouse/Cartridge- ,q e Dust Filter/Scrubber Motor Fuel Storage & Dispensing Equipment • Will any of the following operations be performed? YES[ J NQ-[. Application of Paints and Adhesives Etching, Plating, Casting or Melting of Metals Plastic Molding, Extruding or Curing Mixing and Blending of Liquids and/or Powders Storage of Acids, Solvents, Organic Liquids or Fuels Production of Fumes, Dust, Smoke or Strong Odors I If you answered"NO" to both questions, this checklist is your clearance from AQ.MD. If you answered "YES" to either question, you must contact the AQMD to determine if air quality permits are required. If permits are needed, AQMD will assist you in submitting permit application(s) and then provide you with a clearance letter. If you have any questions, please call AQIviD's Small Business Assistance office at (800)-CUT-SMOG, and press 41. I, l{ I F