HomeMy WebLinkAbout15175 Springdale St - CofOCOMMUNITY DEVELOPMENT
y
O
_T
e
APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
• DEPARTMENT OFCOMMUNITYDEVELOPMENT T �Z
HUNTV4L1oN BEACH ATE
(PRINT OR TYPE ONLY)
Address �sC�� District
Business Name i H�-� n � M � yy-i'�-o Tel.
Business Type �\'i \ U'1 V Occ Group
' BUILDING OWNER(� BUSINESS OWNER/MANAGER
Name �bYl Q'ZL PPrSL1 J7�"�i NameHome
--^t3llVS 2.1ZYt_..
Add res YCI12 W�h�rl� I Address r•O. C��3X ���i ���
`�� f3 City —Tel --City �AM n l 'EK3-- 01t1_,0 L Home Tel 9d W TJ�
r THIS USE WOULD BE DESCRIBED AS:
NEWLY CONSTRUCTED BLDG. 21-cHANGE OF OWNER
' 9-EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT
Indicate former use, it any Occupancy Gr. Div
SQUARE FT. OF BUILDING TO BE OCCUPIED A J
cAi
i
j
(FOR OFFICE USE ONLY)
%- �70
-
I SI PPLEMENT.IL INFORMATION
_
ZONING-
OCCUPANCY GROUP
PLAN CHECK NO NO PARKING SPACES
OCCUPANT LOAD
PERMIT NO — HEALTH DEPT APPROVAL
# NO, OF STORIES
_ ADMIN 'ACTION UTILITIES RELEASED
O�TE
Q CERTIFICATE OF OCCUPANCY FEE
APITROVED
CHANGE OF USE OR OCCUPANCY FEE $
TOTAL $
55
75-039f ,W89
COMMUNITY DEVELP. 1N1
�w.. ® .nr.✓..s
.emu �
.: TrCA � I {ft1'}ljjj{-'
to
SUPPLEMENTAL INFORMATION
1.
BUSINESS ADDRESS i---)i�
2.
.Person to contact in case of emergency: 2�t R C
Telephone number:;d
3.
Does the building in question have electricity?
es
❑ No
a. I'f No, are you requesting that the electricity be
❑Yes
turned on?
C3NO
4.
The building is sprinklered?
1(26es
❑ N:,
5.
operations will produce dust/wood shavings or similar
material?
Mes
Ono
6.
operations will involve the repair or replacement of
OYes
automobile parts?
o
If yes;"
(a) Describe the components, repaired or replaced.
(b) Does the operation involve the use of an openLlave?
QYes
c� F10
7.
The business is drinking, dining or assembly use that will/
result in an occupant load of more than.50 persona.
Oates
No
r ®
8.
The following best describes my operation:
Office only
Retail Sales
warehouse
Manufacturing/Distribution (describe process and end
product) �vi1�r- �Ih�iD l'�P�11 Yl
;
-
e Out Pood
® ® 0a
tal
t t tribe)
s
s
i
(0562D) (12/8/86).-
i
SUPPLEMENTAL INFORMATION
(Cc-'atinued)
Does the operation involve any of the following
:materials? 05�es
❑No
If Yes, Indicate quantities:
Material
Quantity
I. Flammable liquids -
Class I -A
Class I-B
Class I-C
2. Combustibleliquids
Class II
-Class III' -A
3. Combination flammable liquids
�t G/�C L ✓
4. Flammable gases
5. Liquefied flammable gases
6. Flammable fibers -•loose
7. Flammable fibers - baled
8. Flammable solids
9._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
17. Ammonium nitrate compound mixtures_
containing more than 60% nitrate
by weight
18. Highly toxic material and
i
poisonous gas
19. Smokeless powder
20. Black sporting powder
® p
I hereby certify that .the above information is true and correct to the '
best of my knowledge.
Signature
Date
(0562D)
(12/8/86) i
Al
® ) r
1t'
a b- Us
t ..