HomeMy WebLinkAbout14900 Springdale St - CofO (2)I
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`—' APPLICATION FOR CERTIFICATE OF OCCUPANCY I
/ CITY OF HUNTINGTON BEACH '
DEPARTMr %r OF COMMUNITY DEVELOPMENT _m� ` 9z
DATE
WJNTPCTON KACH -0
(PRINT OR TYPE ONLY)
VAddress District
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Business Name Tel.
J�c�t.�r?.t _ Occ. Group
VAusiness Type _ p
BUILDING'OWN/ER BUSINESS OWNERRv1AN/AGER
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✓Name lam` /' .(/Jil�!� _o�sc ✓Name �' Gi If-7`" 4 h YJ S' O
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i/Address_ 13 2 CX e- Li /3 L`L' /� ✓p,omess�+�� / ' it ,4 /7 /Q l,- 19/
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1 �" (fS /?131. C / h /� a �° Home Tel, 729S-4'ZJ
,t j�4 y7Tc h G /� -� � � Tel, city
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SCRIBI-D AS
THIS USE WOULD BE DE:
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NEWLY CONSTRUCTED BLDG. L CHANGE OF OWNER ❑ CHANGE OF OCCUPANT
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EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT
'irldicu�ta former use, if any _ /> Occupancy G:. Div.
C!IrARE FT. OF BUILDING TO BE OCCUPI _ 500
NOTICE: 1, 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.
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 maybe made in the character of occupancy or use of the building
or premises which would place the building in a different division of the same group of occupancyor in a
different group of occupancy, a change of occupancy inspection fee of $ — ` —shall
be paid to the city.
4. Huntington Beach Fire Code Section 10,208 requires that building numbers must be a minimum offour(4)
inches in height with one half ('/z) inch stroke, a_nd of a contr,�sting color from the background. These
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numbers must be posted on your building in a location that is visible from the street.
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5, Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection and distribution per the
National Fire Protection Association pamphlet 10 (see reverse side).
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TRAFFIC IMPACT i Eta
DATF PAID
AMOUNT RECEIVED
NAME
F (FOR OFFICE USE ONLY) ZONING
SUPPLEMENTAL INFORMATION
i OCCUPANCY GROUP PLAN CHECK NO. NO. PARKING SPACES —
OCCUPANT LOAD PERMIT NO. I iEAtTH DEPT.APPROVAL
NO. OF STORIES ADMIN. ACTION UTILITIES RELEASED
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1QC�l 2� - CERTIFICATE OF OCCUPANCY FEE $
PROVED B DATE CHANGE OF USE OR OCCUPANCY FEE $
TOTAL $
75-039 Rev, 1797 COMMUNITY DEVELOPMENT
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SUPPLEMENTAL INFORMATION
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1.
BUSINESS ADDRESS
Person to in case of emergency L
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2..
contact ,Yh
Telephone number:
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3. `
Does the building '" in quF 'ion have electricity?
Yes
No
(a) If No, are you requesting that the electricity be
❑ Yes
turned on?
❑ No
4. `
The building is sprinklered?
El Yes
No
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5.
Operations will produce dust/wood _ shavings or similar
material?
❑ Yes
1�-No
6.
Operations will involve the repair or replacement of
❑' Yes
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automobile parts?
`0-No
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If Yes:
(a) Describe , the components' ` repaired or replaced,
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(b) Does the operation involve the use of an open flame?
Yes
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The business is drinking, dining or assembly use that
will
result in an occupant load of more than 50- persons.
❑Yes
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-No
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The following best describes my operation;
Only
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�Rffice
etail Sales
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are Ouse
Manufacturing / Distribution (describe process and end
product)
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Restaurant / Take Out Food
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M al / Dental
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the (describe)
SUPPLEMENTAL INFORMATION
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SUPPLEMENTAL INFORMATION (Continued)
Does the operation involve any of the following materials?
❑ Yes
R—No r`
If Yes, indicate quantities:
_
Material Quantity
1. Flammable liquids
Class : I -A
Class 1-B
Class I- G
2. Combustible liquids
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Glass _ 11
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Class 111-A
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3. Combination flammable liquids - -.
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4. Flammable gases
5. Liquefied flammable gases
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6. Flammable fibers ,- loose
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7. Flammable 'fibers - baled
8. Flammable solids
9 Unstable materials
10. Corrosive liquids
11 Oxidizing material - gases _
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12 Oxidizing materialliquids
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13: Oxidizing material - solids
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14. Organic peroxides
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15. Nitromethane (unstable materials)
16, Ammonium nitrate
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17. Ammonium nitrate compound mixtures
containing more than ' 60% nitrate
by weight
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i8; Highly_ toxic materiel and
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poisonous gas
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19. Smokeless powder
20Black sporting powder
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I' hereby certify that the above information, is true and ,q correct.
to
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the best of my knowledge.
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