HomeMy WebLinkAbout15061 Springdale St - CofO (7)APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
HUhrnW,TON ernctt DEPARTMENT OF COMMUNITY DEVELOPMENT
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Name
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THIS USE WOULD BE DESCRIBED AS:
R NEWLY C01tiSTRUCTEb B-._D,:
OCCU"ANT
L-1 EXtSTING BUI-DING
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SQUARE E T CF BUII.i11N a Tr
NOTICE:
1. Occupancy of any building is prohibited and a business license will not be issued until the
inspected and building has been
p a certificate g
Of occupancy is issued. � T,
2. No electrical service will be released for any existing building until the service has heen inspected and i
// certified safe. All applicants for occupancy in an wasting building are required to schedule an electrical ;
' fuse up' inspection in the Department of ?'mm�; t p unity r it i opmPnt at the time this application is filed. i
3. Change of occupancy or use inspection fee. Whenever it is necessary to make inspection of a buildfno or
premises in order to determine if a change maybe made in the character Of occupancy or use of the builotng 1
or premises which
wculd place the building in a different division of the same group of occupancy or in a
different group Of occupancy, a change of occupancy inspection fee of S -__ ___
be paid to the city. - shall
4 Huntington Beach Fire Code Section 10,208 requires that building numbers must be a minimum of four (4)
inches in height with one half (° z) inch stroke, and of a co,itrasting color from the background. These
numbers must be posted on your building in a location that .s visible from the street.
D 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).
SUPPLEMENTAL INFORMATION (FOR OFFICE USE ONLY)
—A.L_ �
I' OCCUPANCY GROUP • `.:Hf t h J > �, � Pr�ri. ^,
-- �^� •ti`; ACt-, _ OCCUPANT LOAD __-�G� ---
NC r P STORIES fJ , _ --- F Al 7 , ('kPT Ar Pi• 3V� T �_— �_
OVE Y :Er TfF'f�A tt r ji n�,• t i , f d—L
t. C,t+t,^tt,E
TO T41.
75.039 Rev. 11190
COhtflUPdITY —J�VE:.. F��1cir.Lf,
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SUPPLEMENTAL INFORMATION
1.
BUSINESS ADDRESS 150(opv',F-iQ f" '.A '14. lb-1 + tO'e�
2.
Person to contact in case of emergency-_ ��'"
Telephone number: el'711I1e-53-2-F
3.
Does the building In question have electricity?
E-1 Wes
r o
(a) If No, are you requesting that the electricity be
i� Yes
turfed on?
❑ No
es
4.
The building is sprinklered?
1
❑
1NNoo
5.
Operations will produce dust/wood shavings or similar
material ?es
N o
i 6.
Operations will involve the repair or replacement of
❑ Yes
EKNo
automobile parts?
If Yes:
it
(a) Describe the components repaired or replaced.
(b) Does the operation involve the use of an open flame?
❑ Yes
❑ No
7.
The business is drinking, dining or assembly use that will
`
result- in an occupant load of more than 50 persons. -
❑ yes
No �
8.
The following best describes my operation'
Office Only
Retail Sales
Warehouse
I
Manufacturing / Distribution (describe process and end product)
A
Restaurant/ Take Out Food
Medical/ Dental
Other (describe)
i
SUPPLIMENTAL INFORMATION
JI
SUPPLEMENTAL INFORMATION (Continued)
rmaieri als'? 1-1 V e s
Dow:, t h e,
o
Ti Y F"� i n d I C a t el quant* cn, a n t i ty
Mater'al
i, �'Iarrimable liquids
Glass I -A
Class
;lass
2
Class 11
Class M-A
g. Combination 1Wri:ii;.atJr- iiquids
i rrii;able gases
Liquefied flammable gaser,
Flammable fibers !cose
7, 9:lammabie fibers baled
8Flammable. solids
--
9. Unstably mate,ials
En Corrosive liquids
—Ox i d i —zi g mat__
at-, r -i a -q-3 S' 0-,-
12. Oxidizing traverial liquids
137 Oxidizing material solids
15Nltromethane (unstable materials]
16. Ammoniu-n nitrate
17. Gmonhj-n nitrate (.)mpound mixtures
containing more than 60% nitrate
by
18. Highly toxic material and
poisonou,,; gas
19. Smokeless powder
20, Black sporting powder
I hereby certify that the above information is true and correct to
the best of my knowledg
Date
Signature
I
SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT
(Nonresidential Buildings Only)
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�'3 ! 7 '
Location of Subject Property: (� C "�v Vt c�a.1& �
Property Owner name:C1 - n ` US �� 1 /U TS _Phone # 1'O0474,b
Nameof the Person Preparing this form in print an signature /!
Name \ uS 7�-.i) Signature
arrg this form must be the sane person applying for
The personprepp
building permits. Please answer the following questions regarding your
proposed occupancy of the subject building. IF YOU DO NOT KNO19 THE ANSWER
TO A QUESTION 14ARK IN THE "YES" COLUMN:
SCAQMD PERMITTING CHECKLIST
YES NO
1. Does your facility use any internal combustion
engines greater than 50-HP.
2. Does your facility involve mixing, blending, or C�
processing any solvents, adhesives, paints
or coatings?
3. Does your facility create any dusts or smoke?
4. Does your facility refine any liquids or solids? }t=+�-�qI
Reclaim any metals?
Does your facility plate or coat anything? ��EZI
6. Does your facility have any combustion equipment
i.e. boiler, furnaces, broiler, baking ovens, etc.)
rated greater than 2,000,000 BTU/—s
7. Does your facility handle or store solvents or motor
fuel? '
8. Do you use or store any acids?
+ 9. Do you use any chemical process?
10. Do you use any solvents for .-:lean-up?
11. Are you a dry cleaner, restaurant with a charbroiler,
u body shop, gasoline station, printer, or part coater?
12. Is the subject building located within one thousand C�
(1,000) feet of any school?
PROPERTY LINE TO PROPERTY LINE. GRADES K-12.
in all columns
Ii you have marked: "NO" columns, you do not need an Air Quality y
permit at this time. If you have marked any questions in the "YES" Column
I you must contact the South Coast Air Quality Management District located
at:
9150 FLAIR DRIVE, EL MONTE, CA 91731
Please call these offices: Plan Check (818) 572-6406
(818) 572-6111, (818) 572-6261
D:AL00603
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