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HomeMy WebLinkAbout15061 Springdale St - CofO (9)r` APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY of HUNTINGTON BEACH • DEPARTMENT OF COMMUNITY DEVELOPMENT 'DATE � HUNIFIMUON i tPRINT ON TYPE ONLY) - Address �`� � � i.t �� _L, s � � � District f �yJ� Business Nam — -- -- y � Tef s Business Type � � � Occ Group BUILDiNG O~WN BUSINESS QWNERIMANAGER Name f ' Name Home Address �� Address c .City j ,�_Tef �W5� City +.•.-' .:Acme Ti 4( i THIS USE WOULD BE DESCRIBED AS: i ❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER �CPANGE OF OCCUPANT I EXISTING BUILDING ` CHANGE OF USE /❑ ADDITIONAL OCCUPANT /Indicate former use if any rcf_I�,TSG `�) � _� Occupancy Gr. Div a SQUARE FC. OF BUILDING, TO 8E OCCUPIED �Z llP/ 0 t [i�d;7CE-1. Occupancyof any building is prohibitedanda business license will notbe 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 certifled 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 #ee. Whenever it is necessary to make inspection of a building or i premises in order to determine if a change may be 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 occupancy or in a different group of occupancy, a change of occupancyinspection fee of $ shall be paid to the city. 4. Huntington Beach Fire Cod: Section 10.208 requires that building numbers must be a minimum of four (4) inches in height with one half ('/'a) inch stroke, and of a contrasting color from the background. These numbersmustbe posted on your building in a "location that is visible from the street, a S. Huntington Beach Firr, code Section 10.301 requires fire extinguisher selection and distribution per the Nstional Fire Protection Association pamphlet 10 (see reverse side). i i C ATC PAI l ??IL'f °aKtt �Y" `I gel D (FOR OFFICE (ISE ONLY) laiilg8 ZONmNG�w OCCUPANCY GROUP : -..s...i FLAN CHECK NO NO PARKING SPACES - OCCUPANT LOAD I'ERMfT NO HEALTH DEPT APPROVAL NO. OF . TO ES ADMIN. ACTION UTILITIES RELEASED �tG CERTIFiCA'`E OF OCCUPANCY FEE S '?� f\PPRCVEfI BY DATE CHANGE OF USE OR OCCUPANCY FEE -- ' S TOTAL — it 75 03�38ev.1�9 E .: }a'I 1— € L-V _1_0P SENT SUPPLEMENTAL INFORMATION 1. BUSINESS ADDRESS L26-1 �5'rZfr t 2. Person to contact , in case of emergency • Telephone ,mber:g!?() x S' 3. Does the building in question have electricity? (a) If No, are you requesting that the electricity be turned on? ❑, No 4_ The building is sprinklered? yes ❑ No i 5. Operations will produce dust/wood shavings or 'similar material? 0 des j VN0 6: Operations will involve the repair , or replacement of ❑ Yes automobile parts? CD/No '! It Yes: • (a) Describe the components repaired or replaced. s (b) Does the operation involve the use of an ` open flame., ❑ Yes ; No 7, The business is drinking, di,e.ing or assembly use that will result in an occupant load of more than 50 persons. ❑ yes t i 8. The following best describes my operation; No Office Only , Retail Sales Warehouse l i Manufacturing / Distribution (describe process and and product) 's Restaurant 1 Take Out Food Medical / Dental ,� Other (describe) / P'Zrjve srti� ~� 2U E l f 1 SUPPLEMENTAL I�iPO..��,�u'i�1c?OFI "UPPLEMENTAL INFORMATION (Continued) ©o.es the operation involve any of the follwwing material$ ? � Yes No If i. Yes, indicate quantities: Material Quantity Flammable ll�uids Class l- Class l- F Class l-G 2 Combustible liquids' Class l i =. Class ill-# C r 3. ,..,...�,,.......,....,. --.,....,.ter-;.. ...��.„ Combination flammable liquids ..�_ 4, Flammable gases Liquefied flammable gases 6. l tarrimable fibers . loose 7. Flammable fibers baled Flammable solids 1. Unstable materials, 1�. Corrosive liquids 11. Oxidizing material - uses 12. Oxidizing material liquids 13. Oxidizing material - sofids 14. organic peroxides. v. I6. MtrDmet.hane (unstable materials) 16, Ammoni ern nitrate 17, Ammoniuno nitrate compound mixtures -ontain nc more than 6011k aitra'te by weight 18 Highly toxio rnat3IT, and poisonous gas 1 , Smokeless powder �6. Slack sporting pp. %crier r 1 hereby certify that the, above information is true and correct to thebest Of knowledge. Soot! 1 Coast AJR QUALITY MANAGEMENT DISTRICT 21665 E. Copley Drive, Q aniond Ear, CA 91765-4182 (909)896-2000 AM QUALM PEPMT CIUCKLIST for nonresidential bu:ldinigs only Company Name: ' = `, Location. of Property: -�� '-� � 10 S— z Ci v Zip Code: 1 Contact Person: (/ U y Telepl:ione Number: 7� Fax Number: Type of Industry/Business: 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)? [ ] 3. Will operations at the facility involve mixing, blending, or processing of solvents, adhesives, paints or coatings? [ J 4. Will dust or smoke be generated at the facility? [ ]] 5. Will refining of any liquids or solids be done at the facility?' [ ] 6. Will any plating or coating of materials be, done at the facility? [ ] J 7. Will any combustion equipment rated greater than 2,000,000 BTUIhr be operated at the facility? J CJ 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? [ J !] 11. Will any CFC (Freon) recycling machines operate at the ir? i ] j Applicants �z3 r `�N3gature: -- �-�� y (Print name clearly) If you have marked "NO" in 41 the boxes, an air quality permit is �t needed at this time, aDd this checklist is your written release. If you marked "YES" in any of the boxes, you: mast contact the South Coast Air Quality Management District (AQTN 3). Please read the requirements oil the back of the checklist. (800) 3 8- 2121