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HomeMy WebLinkAbout15061 Springdale St - CofO (38)714/536-5271 Business License # Business Address_ Business Owners 1\ Business Name -1 Business Type (:�e o Certificate of Occupancy No. 02009- by APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH - DEPT. OF BUILDING & SAFETY (3rd Floor - Must Apply In -Person) Date , 2q • 09 Zip Code 9210 Telephone No. $9' 9 Bus. Phone S. 39 Property Owner Information (required) Tenant/Emergency Contact (required) Name S lijMnj- p,Q.�S141�Q.o Name b fkca5 Address 4 &L--1*LS-0 Home Address 91a. City (:,State/Zip �, 2(p0 City �� State/Zip � Q?��T Telephone No. Sect 2So -9i l L7v Telephone No. CTA)1-bS'21 THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or Existing Building CHECK ALL THAT APPLY: ❑ Change of Property Owner ❑ Change of Occupant ❑ Change of Use X Additional Occupant ■ Indicate former type of business ■ Are you requesting that the electricity be turned on? YesQNA ■ Is the building sprinklered? Yes bV0I] • Will operations produce dust/wood shavings or similar material? YesQNVA ■ Will operations involve the repair or replacement of automobile parts Yes QN9�a If yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? Yes QNo�q/ ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? Yes QNo> , ■ The following best describes my operation: X Office Only ❑ Retail Sales ❑ Medical/Dental ❑ Restaurant/Take Out Food ❑ Warehouse /Manufacturing/Distribution (describe process and end product) ❑ Other (describe) For Official Use Only Occ Group: Occ Group: Occ Group: Total Sq Ft Occupied: Bldg. Permit # Area: Occ Load: Area: Occ Load Area: Occ Load: No. of Stories: TIF Review: Y Entitlement #: Zoning: CC-C Plnr Initials:_ Date: Plan Chkr Initials: Date: Insp Initials: Date: Conditions of Approval or Other Notes: AoD'L- ©cx,--tpAw • ra rvQ oP*:-%cC qsz: Gx.,o Inspection Date: (G:Building/Forms/document id goes here) Certificate of Occupancy No. 02009-- 00 APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH — DEPT. OF BUILDING & SAFETY 714/536-5271 Business License # A Business Address IS0 to I, S Business Owners Name lh Business Name P Business Type ' (3rd Floor — Must Apply In -Person) Date 1t" 2 4 -09 Zip Code g2fo Telephone No. Wso Bus. Phone m Property Owner Information (required) Tenant/Emer, ency Contact (required) Name S , ttmrj L Name CkR_5 Address " zuu_ ,�, LSD Home Address `11a. City 1.te.� 0k Qa,u Mate/Zip Q, 2(AP0 City goag�q State/Zip (2)A 92 Lj ci Telephone No. 149 Telephone No. 'lq '3 • 1 -b; ', THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or /�VFxisting Building CHECK ALL THAT APPLY: ❑ Change of Property Owner ❑ Change of Occupant ❑ Change of Use X Additional Occupant ■ Indicate former type of business ■ Are you requesting that the electricity be turned on? YesQN0A ■ Is the building sprinklered? Yes )V0❑ • Will operations produce dust/wood shavings or similar material? Yes❑NA ■ Will operations involve the repair or replacement of automobile parts Yes QN� If yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? Yes QNo�i ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? Yes QNo> , ■ The following best describes my operation: �< Office Only ❑ Retail Sales ❑ Medical/Dental ❑ Restaurant/Take Out Food ❑ Warehouse /Manufacturing/Distribution (describe process and end product) ❑ Other (describe) For Offtcial Use Onl Oce Group: Occ Group: Oce Group: Total Sq Ft Occupied:, Bldg. Permit # Area: Oce Load: Area: Occ Load Area: Occ Load: No. of Stories: TIF Review: Y Entitlement #: Zoning: CCU Plnr lnitials:_ Qr_ Dater Plan Clikr Initials: Date: Insp Initials: Date: Conditions of Approval or Other Notes: AdD'L occ.�r^NT -rr> rwj CuS1-%K' -yPy►cC c95` • Inspection Date: (G:Building/Fonns/document id goes here) FJS'-5271 CERTIFICATE OF OCCUPANCY 020 CITY OF HUNTINGTON BEACH DEPT. OF PLANNING & BUILDING APPLICATION --- (3d Floor — Mint Apply M-Person) Business License # Date Business Address 1 U&Lo Lip Code-9Z- �qq 7EW Business Owners Name e­ Telephone No. -1 lq- Business Name Bus,Phone Business Type 6 N� r ricu VNf3,0 f Property Owner Information (required) Teriant/Emergen.cy Contact (required) Name aMName L Z�M,& Address H--Ga2Lr Horne Address - tit I _1z AASIIAoc, City A-_State/Z,ip ate/zip Telephone No. Telephone No. THIS USE WOULD BE DESCRIBED AS: 0 Newly Constructed Building or :�rExisting Building CHECK ALL THAT APPLY: 0 'Change of Property Owner ii''Change of Occupant D Change of' Use 1-1 Additional Occupant Indicate former type of business Are you requesting that the electricity be turned on? Yes I-) No P- Is the building sprinklereld? Yes [�No D Will operations produce dust/wood shavings or similar material'? YcsQNo[� • Will operations involve the repair or replacement of automobile parts Yes QNo B- If yes: Describe the components repaired or replaced. Does the operation involve the use of welding or open flame'? Yes [)No [U- Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? Yes QNo 9- ■ The following best describes my operation: 61-Office Only n Retail Sales 12- Medical/Dental ,11 Restaurant/Take Out Food 0 Wareliotise/Manufacturitig/Distribtition (describe process and end product) 0 Other -(describe) For Official Use OnI, Occ Group:_,_ Occ Group:---,- Occ Total Sq Ft Occupied: --- B idg' , Permit ff Plnr Initials: —r*— Datej[L-5514 Area: Area: Area: No. of Stories: F,ntitlemcnt #.-__ Oce Load: Occ Load: Occ Load: TIF RevieW I Y/ w... Y10 zorling:. Plan Clikulnitials:----- Date:--." Insp Initials: Date: Conditions of Approval or Othcr Notes: � TO vt�;T�/ -ivo U, C7 (I Inspection Date: (QBuilding/Forms/document id goes hero) HAZARDOUS MATERIALS DISCLOSURE INFORMATION Huntington Beach Fire Department California Health and Safety Code require the Fire Department to regulate businesses that handle hazardous materials. Motor oil, hydraulic fluids, gasoline, dry cleaning fluid, etc., are 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 f6llowing basic quantities, you are required to disclose: 9 55 gallons of liquid 0 500 pounds of solid * 200 cubic feet of compressed gas * Any amount of radioactive materials * Any amount of Class A plosive exp * Any amount "of chemicals known to cause cancer • Any amount "of commercial pesticides • Reportable quantity of any chemical on FTA 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 Fire 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: No chemicals are used, handled or stored at this business. Chemicals are used, bridled or stored at this business, but do not meet the requirements for disclosure Chemicals are used, handled or stored at this business. Disclosureforntv will he sent to you. Amounts will be verified by the Fire Department during annual inspections. It is unlawful for any person to kfilowingly'violate any provision of this ordinance. I certify, under the pq alty of perjury, that the above information is true and correct to the best of my knowledge, pe "Y Signature Date - Home Phone_ m-21q. , -P-t Please call 714-536-5676 with questions regarding the Hazardous Materials Program. IM, Air Quality Management District 21865 E. Copley Drive Diamond Bar, CA 91765-4182 (909) 396-3529 htpp-://www,aqmd.goN, 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 clearance from the South Coast Air Quality Management District (AQMD). Company Name: Property Address: City: Contact Person: —ZipCode: Title: Type of Business: Telephone: ()I -qo Applicant, (print name) WtCCA Signature: OWill the facility have any of the following equipment'? Yes []No Cliarbroiler Dry cleaning machine Spray Booth Printing Press (screen/lithographic/flexographic) Intenial combustion engine (greaterthan 501-1P) (excluding motor vehicles) Boiler/combustion cq4ipment (greater than 2 million BTIJ/hr, maximum input) Abrasive blasting cabinet/room Baghouse/cartridge type dust filter/scrubber Motor fuel storage and dispensing equipment 0 Wil I any of the following operations be performed? Yes 0No P,- 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 Production of fumes, dust, smoke or strong odors Olf you answered "No" to both questions, this checklist is your clearance from AQMD. Q. If you answered "Yes" to either question, you must contact 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. You can call AQMD at their Small Business Assistance Office at (800) 388-2121.