HomeMy WebLinkAbout15329 Pipeline Ln - CofO (8)APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH DEPARTMENT OF BUILDING & SAFETY
(3r` Floor-11_ust Apply ., n-Person)
Iusiness License r A t `70 %-40 Date
Address 1 ma's S9 Pi Pat_l ► s
Business Name .—Telephonet4�4�-'5
Business Type cg r_6.jze,aa.. Goxa-r9Aevrrr-15.
Sus . -. gip.
�e�� .; a#t Inforrnati ' Owner
Name G-t LSE *40 04"L Epi as
Address eP33I A-Tt xOA, '� - Home Address .S70 �JeoPer+ t1 . 4� Ir20
City } 1- Tel. e 4b -S *q 7City t-leuk Tel. OL05 -1 oz3
THIS USE 'WOULD BE DESCRIBED AS:
❑Newly Constructed Building or OExisting Building
CHECK ALL THAT APPLY:
❑Change of Owner Z£hange of Occupant ❑Change of Use ❑Additional Occupant
Indicate former use, if any A1,XtC ! LEPAC1
Does the building have electricity? YeF 0 N o CI
If No, are you regi,aesting that the electricity be turned on? Yes ❑ Nu 1❑
The building is sprini;lered? Ye A No❑
Operations will product dust/wood shavings or similar material? Yes ❑ No
Operations will involve the repair or replacement of automobile parts Yes ❑ No
If yes: Describe the components repaired or replaced.
Does the operation Lnvolve the use of welding or open flame? Yes ❑ No ;d•
The business is drinking, dining or assembly use that will result in an occupant load t u S
of more than 50 persons. Yes ❑ No,, Ott,
ThF following best describes my operation:
❑Offi.ce Only ❑Retail Sales QMedical/Dental ❑Restaurant/Take Out Food Warehouse
❑Manufacturing/Distribution (describe process and end product)
❑ Other (describe)
M.
Q�- Ft Occu ied. Occ Group:
office Use only: S Li
Zoning: _ q p � cc Load:
Stories: Parking Sp7Ps: TTFRe`riew: YlN AmtPaidS:
�
Paid BEFQREFinal Inspection i
Building Permit T Entitlement r.
Comments: 0 ,
Planner Initials 5 �( -� Bldg/Plan Checker Initi s v CofO
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HAZARDOUS MATE'_'�ALS DISCILOSURE INFORMATION
Huntington Beach Fire Department
California Health and Safely Code requires the Fire Department to regulate businesses that handle hazardous
materials. Motor oil, hydraulic fluids, gasoline, dry cleaning fluid, etc., a; ; considered hazardous materials and
must be disclosed. If you use, handle or store hazardous materials or waste materials equal to or in excess of
the following basic quantities, your are required to disclose:
• 55 gallons of liquid
s 500 pounds of solid
•' 200 cubic feet of compre _d gas
• Any amount of radioactive materials
e Any amount of Class A explosive
• Any amount of chemicals known to cause cancer
• Any amount of commercial pesticides
• Reportablequantity of any chemical on EPA Extremely Hazardous Materials Substance List
Disclosure is not required for the following:
1 hazardous substances contained in food, drug, cosmetic or tobacco products.
2. Upon ; approval of the Tire Chief, hazardous materials contained solely in consumer products packaged
for use by and distributed to the general public. However, pesticides, herbicides, and ammonium
nitrate fertilizers over the required disclosure amounts are not exempt from disclosure.'`
3.' The transportation of hazardous materials accompanied by shipping papers prepared in accordance with
the provisions of 49 Code of Federal Regulations.
4. Infectious waste generated by health care facilities that are regulated under Title 22 of the California
Administrative Code.
Check one of the following:
—X No chemicals are used, handled or stored at this business.
Chemicals are used, handled or stored at this business, but do not meet the requirements for disclosure
Chemicals are used, handled or stored at this business. Disclosure fours will be sent to you.
Amounts will be verified by the Fire Department during annual inspections. It is unlawful for any person to
knowingly violate any provision of this ordinance.
I certify, under the pe of perjury, that the above information is true and correct to the best of my`
knowledge. `
Signature Date i&�A
Home Phone t/��8--b�+'�7
Please call 714-536=5676witic questions regarding ricehazardous Materials Program.
t
South Coast
Air Quality Management District
21865 E. Copley Drive
Diamond Bar, CA 91765-4182
(909) 396-3529 htpp://www.agmd.gov
.Air Quality Permit Checklist
California Government Code 65850.2 prohibits cities from issuing a Certificate of Occupancy to a business
without clearance from the local air quality agency. This checklist will determine if you need to obtain f
clearance from the South Coast Air Quality Management District (AQMD)
Company Name: }-�owt EST 1�Ju u s
Property Address: 15 3 2 FPE L., _
City: N• v3 Zip Code:
Contact Person: c-F N 13,&p42 Title: --
Type of Business: Telephone: (�ji g `F 2 - oc->G
Applicant:'(print name) (5r.Z�-xr, Signature:
• Will the facility have any of the following equipment? Yes ❑ Noy,
Charbroiler
Dry cleaning machine
Spray Booth
Printing Press(screen/lithographic/flexographic)
Internal combustion engine (greater than 50HP) (excluding motor vehicles)
Boiler/combustion equipment .(greater than 2 millionBTU/hr. maximum input)
Abrasive blasting cabinet/room
Baghouse/cartridge type dust filter/scrubber
Motor fuel storage and dispensing equipment ,,,,��
• Will any of the following operations be performed? _ Yes ❑ No 2i
Application of paints or adhesives
Etching, plating, casting, or melting of metals
Molding and blending of liquids and/or powders
Storage of acids, solvents, organic liquids or fuels
Production of acids, solvents, organic liquids, or fuels
Pn >dc.ction of fumes, dust, smoke or strong odors
• If you answered "trio" to both questions, this checklist is your clearance from AOMD.
• If you answered "Yes" to either question, you must contact AQMD to determine if air quality permits are
required. If permits are needed, AQIviD will assist you in submitting permit application(s) and then provide you
with a clearance letter. You can call AQTVID at their Small Business Assistance Office at (800) 383-2121.
APPLICATION FOR CERTIFICATES OF OC' JJPANC
CITY OF HUNTINGTOv BEACH - DEPARTMENT OF BUILDING & SAFETY
(3r4 Floor - lklust_4pply ln-Pei"son)
Business License ' A 17d)!,40 Date -1 ba la��
Address f �s LGiPt it
Business Name d-10, r=�r�� `tomuit.r�Erz Telephone &-1
Business Type _ G �a,a-'Go�,-rscrrrr
zgen oa t Information Owner
IT
plame
Address GPI i A-'t Oa—,u- 1-- z , Home Address -70 �1e, V P,rf f->1 • 4-- 1C�20
City T ;--1- r s . Tel, e 4b -Vv f�q 7City N21r� ar�i- z" ei t Tel. eep5 - I o r -5
THIS USE WOULD BE iDESCEBED AS:
nNewly Constructed Building or 12Existinrj Building
CHECK ALL THAT APPLY:
® Change of Owner Zkhange of Occupant ❑ Change of Use El Additional Occupant
Indicate former use., if any"1 c.
Does the building have electricity? YesO' N! OU
If No, are you requesting that the electricity be turned on? Yes C3 No
The building is sprinklered? Yes` i\To
Operations will product dust/wood shavings or similar material? Yes No
Operations will involve the repair or replacement of automobile parts Yes CJ No o
If yes: Describe thecomponentsrepaired or replaced.
Does the operation involve the use of welding or open flame? Yes 0 No 0,
The business is drinking, dining or assembly use that will result in an occupant load
of more than 50 persons. Yes 0 No.4
The following best describes my operation:
C1 Office Only ❑Retail Sales 6�1Mledical/Dental ORestaurant/Take Out Food Warehouse
Manufacturing/Distribution (describe process and and product)
® Other (describe)
Office Use Only: _
Zorin 'I L Sq Ft Occupied. �,G "�� `; J Occ Group: Occ Load:
i g s: TIF Review: Yi N Amt paid' 1 J S
r Stories: Parking Space ,
} Paid BEFORE Final Inspection
Building permit Entitlement r: ;
1
k Comments,VtV z
Plan ier Tni�ials F� Bldg/Plan Checker .Initials; CofO r r.
CD
` APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH - DEPARTiV IN'T OF BUILDING & SAFETY
(3r' Floor — J'UustA4pply In -Person)
Business License A i '70 i,4Date "r (9) /o��
Address I r '�� cl P► PEA r ► a
Business Name Telephone +2 -0 -
Busieess Type C��-as�W-r Vic; nr
t�v�I r. mer,?enc -C-oa# vt Information sigass Owner
Name ('7 G_a E't a `r3y (L m I P'&
Address Home Address r4-70 lJev or+ .Fai r2o
City 1-1•r? Tel. e46,,5,1�,q-Mty Tel. &Rf> - ioz 5
THIS USE WOULD BE DESC'i2IBEB S:
QNewly Constructed Building or Existing Building
CHECK ALL THAT APPLY:
QChange of Owner &hange of OccupantQChange of Ilse 0Additional Occupant
indicate former use; if any
Does the building have electricity? Yeso, Nod
If No, are you requesting that the electricity be turned on? Yes ❑ No Q
The building is sprinklered? YeSA NO
Operations will product dust/wood shavings or similar material? Yes Q No
Operations will involve the repair or replace.nent of automobile parts Yes ❑ No
If yes: Describe the components repaired or replaced.
Does the operation involve the use of welding or opca flame? Yes Q No w
The business is drinking, dint--ig or assembly use that will result in an occupant load
ofmore than 50 persons. Yes Q No,
The following best describes my operation;
QOffice Only ORetailSales ®Medical/Dental URestaurant/Take Out Food 0, *Warehouse
Q ivlanufactvrim�[Distribution (describe process and end product)
Q Other (describe)
tiff ce Use 0111u:
Zoning; Sq Ft Occupied: �\C �) �0 Occ Group: Occ Load, {
TW Stones; Parking Spaces: TIF Review: Y/ N Arnt PaidS
i Paid BEFo.RH Final 1n5F-crian ;
Building Permit= Entitlement r
Comments:;
Planner Initials -S -1 - ' Bldg(Plan Checker Initials: CofO
CERTIFICATE OF OCCUPANCY EVALUATION FORM SKETCH ARE ;
GENERAL BUILDING INFORMATION
Owner name: I Address and/or suite #:
i
Emergency contact: Phone number.
Occupancy Class - primary use(s) & sq. ft.: I Occupant load:
Occupancy Class - second use(s) & sq;
r
t
{
Type of constructuon:
Stories & Height(ft)
Sprinkling used?
❑Story increase -
❑City Ordinance
❑Unlimited area
❑One hour construction
❑Atria
OArea increase
❑Cha ter9
E Area allowed:
Basic;
Yard;
Area separation:
I Sprinkling:
For multi storied and mixed use attach a separate work sheet or include in sketch area
Attach work sheets b Piannin or Fire�if nroVided i
j......... ........: f
j
FL
YARD 2
jj�RMNAG R
sTwPr+e REeernee =.ETARY
YARD 3 (STORAGLI RM E+4TN
i ,M.,«, YARD 1
a wSSE'ai RECEP110N
' EN1R
'r OPEN OFFICE
PARKING
i m ® e-> IC.t�_
SAMPLE
INDUST'LICOMMERCIAL USE -�
JP+J GLD
Vow tJP tee.
r
STREET NAME
G:iBUILDINGtFORMSICOUNTERICOINDRY.DOC May 1,1996
}
Trancode : [COFO J C O M M U N I T Y D
E V E L 0P M E N T [44121
Function: [HST] C E R. T I F I L A T E
OF OCCUPANCY
' Addr [153291 [PIPELINE I [ l Issue
Date [ '4171997] App.Rcv. 31719971
Business Name [AMBBROSE AUTOMOTIVE
1 Phone [ ] [ ] ;
Business Type [AUTOMOTIVE ELECTRILCAL REPAIR
] Occ. Group C ]
Building[R.B. ALLEN COMMERICAL ] Addr
[
Owner City L
7 Phone: [7141 {9669494]
Business [LARRY AMBROSE ] AddrA
5942] [EDINGER ] [113 ]
Own/.Mgr City [HB,' CA ]
Phone: [7141 [89360401' '
Comment:[
_ ]'
[ ]
New? [N] Chg Own? [Nl Chg Occ? {Y] Old Bld?' [Y] Chg Use? [N] Add Occ? [N]
Former Use [AUTO REPAIR
] Former Occ. Group [ ]
Sq.Ft.Occupied T 16063 District " ] .PC
No " ] Parking Spaces j
Occ. Load " . 8 ] Buildings Permit [
) Health App . By
No. Of Stories ^ ] Admin. Action [
j Zoning Use [IL ]
Fees: COFO (125.001 Ch. Occ. [ .00]
Special? [N] [ .00] Total: [ 125.00]
Building Appr. [JW ] Building Date
41119971
Land Use A;: r. [HBBJ Land Use Date
' - 31719971 COFO Nbr-[T006510J
Issued By -[ECD] Issue Date
41719971 Certificate Printed ? [N]
Utilities: Gas Date~ ] Elec.Date
] Released By C
L
1, fi
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APPLICATION FOR, CERTIFICATE OF OCCUPANCY
CITY Of IrUNTINe TON nn ACH
OtfARTMENT OF DEVELOPMENT SERVIC[t-
VRINT On TYPE ONLYI DAYS
Address _1.53 'll r-%.c--LiN c— '
Weti^ntNome fs�tLlrJ� i'� �_i,� rj"�(�_ TO
iutlrmi Type
l
P-PA91NO QWNEn ecLLrLC i.6t4N�nenlnrr�rltR
Noma(t<^ Ga
Adnrest Addrnl`��lr� tom:. pp
City t. City
THItt USE WOULD ii! ;�Z:SCRISED As: S !
N.;;VLY CONSTRUCTED BLDG
EXISTING BUILDING
Indicate former uta, if any —
i
CHANGE OF OWNER L-KCIIANGF. OF QCMIPANT
CHANGE OF USE ACDITIONAL O(CrUPAN't
C>ccupsncy Gr, •':,.1 . Div. d:7L'.,. >.. ..
NOTiM 1. Occupancy of any buiiding Ir prohibited and a business license will not be Issund until ihn building l
has been Inspected and a cortlficote of occupancy Is issued.
2. No electrical :arviae will be released for an, existing building until the saryi,n lint Ivan Inspnotfnl
and rartiflao safe. All applicrnts foe occupancy In an existing building are required to K'hrduls in
electrical 'Rise up' Inspection in the Deportment of Development Services At that tfma this spplIcs.
,Ion is filed.
3. Change or occupancy or uvs inspection fee. Whannver it is nocastnry to inake inmpecilgn of a build
Ing or promises In order to determine If a change may be made In the 0 ttracint ri occupancy or use
of the building c- premises which wouid,piace the building In a differnn, division nI ilia ♦amp group
of occupancy or in a ditfe;unt group of occupancy, a chanrie of occupancy Insontsllon fort of $30,00
.fall be paid to the city,
A, Huntington Beach Fire Cock Section 10.208 requires that building numbers must h+ a minimum
of four (4) inches in haight with one hall N inch stroke, and of a contrasting color (rain the hook,
ground. Those numbers must be posted on your building in a location that It v(sih(a from tilt street,
5, Huntington Beach Fire Coda Soctfon 10.301 requires fire extin 4elactlon and (1Htrfbutlon
per the National Fire Protection Association pamphlet 10 side).
iruii. VrrllGl •I41: UNlri
SUPPLEMENTAL INFORMATION,
SOUARE FT. OF DUIL VG x tA� PLAN CHECK NO . _ NO PARKING SPACI li
OCCUPANCY GROUP I hYr_ « ✓. PERNtIT NO _ . _ IiF nt, rH OE PT APPFIOVAL
OCCUPANT LOAD .._,�` _.. ADMiN ACTION .._ _ uTILll st s ate t.t As4n`
NO, -OF 9fl)ES
Ci,RTtFICATC OF OCCUPANCY FEE S
APPnovf BY OA rE CttANGE OF OCCUPANCY FEf
TOTAL S
�t.u. Al at. , J"ed
f
�jt-0J�nc . DEVELOP+ALNi SEOYIcr3
Trancode: [PERMIT]
COMMUNITY DEVELOPMENT
C40701 ,
Function;
[HST]
P E R M I T H I G T O R Y
PG 1.
1 (B0716521
Address (153291 [PIPELINE
[PLEASE CONTINUE ]
Unit
aPermit Issued Status Effective Building Use
Link
Pge
] [B071652] [01282000) [EXPIRED ][080.520001 [IND ROOF
] [
7 [ l
I
] [E026259] [04091997] [CANCELLED] [04111997] [COM MISC
] [
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