Loading...
HomeMy WebLinkAbout15061 Springdale St - CofO (32)— --- --------- r f - Aj APPLICATION FOR CERTIFICATE OF OCCUPANCY E ' CITY OF HUNTINGTON BEACH eurmNcroN OF COMMUNITY DEVELOPMENT BEACH DATE - (PRINT OR TYPE ONLY) ATE 1 •, V _ V.III Address '%/i[l! 11C-,WnDistrict_ -Q_�lf_r i Business Name_--'2 Tel.qvf �d Business Type ' CS 0 I Occ. Grou^ BUILDING OWNER BUSINESS OWNERIMANAGER L Name A � �) N Address !/l6L 11CC Home Address (/ (40* e—Tel.City D� City ylP Z" ( Y Home TeL _ THIS USE WOULD BE DESCRIBED AS: ©g!i ❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER CHANGE OF OCCUPANT 1 i EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT Indicate former use, if any ! t, r°S I �' �iCl �� ancy SQUARE FT. OF BUILDING TO BE OCCUPIED rQ� Z f NOTICE: 1. Occupancy of any building is prohibited and a basin g has been inspected and a certificate of occupancy is, issued. 2. No electrical service will be released for any existing buil ng ntil til vice h een inspected and l certified safe. All applicants for occupancy in an exis i b ing re uire o schedule an electrical 'fuse up' inspection in the Departrr— " of C-; m en e ' e this application is filed. 3. Change of occupancy or use inspection i/h n r it is n sar make inspection of abuilding or premises in order to determine lfachang ay deist c r^ rofoccupancy oruse ofthebuilding or premises which would place the buildin 1 a d fer t dI ' i of the same group of Occupancy or in a different group of occupancy, a change of o u c I s tion fee of $ shall a� be paid to the city. 4. Huntington Beach Fire Code Section 10.2 uirat building numbers must be a minimum of four (4) inches in height with one half (1/2) inch stro d of a contrasting color from the background. Theoe numbers must be posted on your bu'lding iri location that is visible frgm the street. j 5. Huntington Beach Fire Code S" ciion 10.30f requires fire extinguisher selection and distribution per the National Fire Protection Association pamphlet 10 (see reverse side). TRAFFIC IMPACT FEE DATE PAID AMOUNT RECEIVED , NAME e t (FOR OFFICE USE ONLY) SUPPLEMENTAL INFORMATION (FOR OCCUPANCY GROUP PLA e CHECK NO NO_ PARKING SPACES fi OCCUPANT LOAD PERMIT NO, HEALTH DEPT APPROVAL ' NO. OF STORIES ADMIN, ACTION UTILITIES RELEASED l? CERTIFICATE OF OCCUPANCY FEE APPROVED BY DATE CHANGE OF USE OR OCCUPANCY FEE t TOTAL 75-039 rev. 1/97 COMMUNITY DEVELOPMENT fl SUPPLEMENTAL INFORMATION 1. BUSINESS ADDRESS r, VL4:-" Pi 00 2. Person to contact in case of emergency: Telephone number: :Lob C 3. Does the building in question have electricity? 15C Yes 13 No (a) If No, are you requesting that the electricity be ❑ Yes turned ten? ❑ No 4. The building is sprinklered? Yes El No 5. Operations will produce: dust/wood shavings or similar material? El Yes No 6. Operations will involve the repair or replacement of ❑ Yes automobile parts? No if Yes' b. (a) Describe the components ,epaired or replaced. El Yes (b) Does the operation involve the use of an open flame? VNo 7. The business is drinking, dining or assembly use that will result in an occupant load of more than 50 persons. El Yes EMo 8. The hollowing best describez my operation; Office Only Retailr Sales Warehouse Manufacturing/ Distribution (describe proce ss and end product) Restaurant /Take Out Food Medic-;4, / Dentai Other (describe) SUPPLEMENTAL INFORMAMOM a p SUPPLEMENTAL INFORMATION (Continued) Does the operation involve any of the following materials? ❑ Yes I�No If Yes, indicate quantities: Material Quantity i 1. Flammable Liquids Class I -A Class I-B Class I-C 2. Combustible liquids Class I`l i Crass III -A 3. Combination flammable liquids f 4. Flammable gases 1 5. Liquefied flammable gases 6. Flammable fibers - Loose - I ! Flammable fibers - baled i 8. Flammable solids S. Unstable materials- ; 10. Corrosive liquids 11. Oxidizing material - gases 12. Oxidizing, material - liquids 13. Oxidizing- material - solids 14. Organic peroxides { 15. Nitromethane (unstable materials) I 16. Ammonium nitrate i 17. Ammonium nitrate compound mixtures containing more than 60% !nitrate by weight 18. Highly toxic material and poisonous gas _18. Smokeless powder 20. Black sporting powder ! hereby certify that the above information JSr true and correct to the best of my knowledge. q / Signature _ Date i e I r I a k South Coast AIR QUALITYMANAGEMENT DISTRICT 21865 E. Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-2000 AIR QUA-LITY PEST CHECKLIST i for nonresidential buildings only Conipany Name: J� I/11/lCG�P�i/ IDC to f-e�� ' 150 & 1 e, rt � i � Location of Property: � �G� G[. � � �, f'?i � 0 ,� Zip Code: q.�-c,�qG Contact Person: `�ayV - sk Title: 1)112 4 e_1'" Telephone Number: '% 1 q Cg1 66 i Fax Number: 7l t-� S c q c)-115 Type of IndustryBusiness: `f 1t11�1 7t f e S %-1 �� ( rye s 6 I,cS E nq� — 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 any internal combustion engine with greater than 50 horsepower operate at the facility (excluding motor vehicles)? ] Oki 3. Will operations at the facility involve mixing, blending, or processing of solvents, adhesives, paints or coatings? 4. WiIl dust or smoke be generated at the facility? [ ] 5. Will refining of any liquids or solids be done at the facility? ] [ 41 6. Will any plating or coating ofmaterials be done at the facility? [ ] 7.. Will any combustion equipment rated greater than 2,000,00013TU/hr be operated at the facility? ] M 8. Will any acids, solvents, or motor fuel be used or stored at the facility? [ ] [] 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? [ ] f1 11. Will any CFC,(Freon) recycling machines operate at the fac' 'ty? [ ] ; A I Applicant: U Signature: (Print name clearly t�GLe-t'- i If you have marked "NO" in all the boxes, an air quality permit is not needed at this time, 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 (AQMD). Please read the requirements on the back of the checklist. (800) 388-2121 ADDITIONAL SUPPLEMENTAL INFORMAMON .�,. .. { SUPPLEMENTAL INFORMATION � �k s 1. BUSINESS ADDRESS ��(�Znj �a��i� IINC�D L �51'� 1 100 2. Person to contact in case_ of emergency' E Telephone number; ,roZ2�-OiS"? Yes 3. Does the building in question have electricity? ❑ No ;a) If No, are you requesting that the electricity be ' ❑ Yes It k turned on . No y br Yes trr 4. The building is sprinklered? No 5. Operations will produce dust/wood shavings or similar � material? ❑Yes -EpNo 6. Operations will involve the repair or replacement of ❑Yes No automobile parts? If Yes: (a) Describe the components repaired or replaced. 4 (b) Does the operation involve the use of an open flame? ❑ Yes ❑ No rl 7. The business is drinking, dining or assemaaly use that wiii ' result in an occupant load of more than 50 persons. ❑ Yes ' Y No 8. The f` describes myoperation; ffice O Retail Sales ; i l Warehouse r ` Manufacturing / Distribution (describe process and end product) I a C S � 7 � ! Restaurant/Take Out Food i Medical / Dental Other (describe) • r . SUPPLEMENTAL !ldFORiL7AMOR! PPL s• 4 , r '" ';.,. �il.-ti 6'6 . p. '� _aT e ` .oP Y! P � V • fib M/E^ ^gal .Y� . i- -^ R:` i1" • �9Cp. rU � 1 I}". -s 1 N r I SUPPLEMENTAL INFORMATION (Continued) Does the operation involve any of the following materials? ❑ Yes ONO I If Yes, indicate- quantities:�� Material Quantity 1. Flammable liquids Class I -A 1" Class I-B k Class i-C 2. Combustible liquids Class I! �. Class 111-A i 3. , Combination flammable liquids, 4. Flammable gases 5. Liquefied flammable gases 6. Flammable ;,hers -`loose' 7. Flammable fibers - baled 8. Flammable solids 9. Unstable materials I 10. Corrosive liquids 11. Oxidizing material - gases 12. Oxidizing material - _liquids `! 13.. Oxidizing material - solids 14. Organicperoxides �;.'.. 15. Nitromethar.e (unstable materials) : onium monium nitrate Amm Ti 17. _ Ammonium nitrate compound mixtures containing more than 60% nitrate y b weight ` 18. Highly toxic material and ? poisonous gas 19. Smokeless powder { 20. Slack sporting powder I Hereby certify that the above information is true and correct to the best of j%�j/owledge. 4-7/7, Z Iq 5' na ure ate i :,,,>a.�,,. ,.�...,.-.... —-.......,......�....;.yv. .,. f^'^.+fFr�S^.—•.»«.,`."»w.-:....u^-^�'. �^ ;..^,.�..-""±-�.�.m.-.=`r,.,.^:�;r...dari--�.�..,.....-;:..,-,.,.K-,-•—..4r wyyr• t3•"'...e-'i t 4 1 f, f" Or, _ . aa.—"ate. — _ �s � - : o . ,�r - +�os�e. ; • mn y ?„ 47. J NOTICE OF REQUIREMENTS � f GOVERNMENT CODE SECTION 65850.2 (A D3205) i ` California State Law (Government Code 65850.2) prohibits the Building Departments from issuing a fnal certificate of occupancy unless all requirements of the local air quality agency are met. All applicants are required to complete'the air quJity permit checklist. The checklist is designed to aid the applicant for a nonresidential building permit only. If the ansv er to any of the questions is "YES," the Building Department must obtain a written release from the local air quality agency.verifying that the applicant is in compliance. 1. All nonresidential building pen -nit applicants must complete this checklist. 2. If the answers to all questions are "NO," the Building Department can accept the checklist as the written release. 3.' If any questions are answered "YES," the applicant mmt contact the AQMD by calling (800) 388-2121 to determine whether air quality permits are required for any equipment which may be operated at the site. If the AQMD determines that air quality permits are not required or that all requirements have been met, a written release will be issued. 4. If air quality permits are required and apnlicat;ons have not been submitted, the applicant y, i must submit the necessary permit applications) and 'appropriate fees before a written; release be issued. t :, I f AQMD is committed to expediting all clearance letter requests. However, it may take several {. weeks to verify compliance with all requirements. Therefore, you are advised to contact AQI�M immediately after applying for building permits. t (800) 388-2121 i rinsed 8195 ,n ' q ! ,I I a r 5 { " 1 t �fa i ..,. nee --as w .r._ iw m-- A.. " � '�- e►-5 ,;