HomeMy WebLinkAbout15181 Springdale St - CofO (3)1
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e APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
° DEPARTMENT OF COMMUNITY DEVELOPMENT
DATE
HUNMNOTON 8FA01 (PRINT. OR TYPE ONLY)
15163
/� �1 7 -"' �-" 5 �✓ / �slJ / (I�y / District
Address rQ� �
Tet(% 1 r,/
1 t'� (1� }C. G��2Qv�' 9.-s lil,•-� �
Business Name 4,91%C
S Occ Group
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Business Type �—
BUSINESS OWNERtMA?1P.GER i
BUILDING OWNER %J
yf7ri /LL`J'� s�/t 0_,�'C=L° S Name
Name Home tj( ell /"cticvye f-�Si- ti-C e
Address r �LrL�Ar Addrje��
".I�� tys,'i /iineL� Y Home Te
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THIS USE WOULD BE DESCRIBED AS:
CHANGE OF OWNER ❑ CHANGE OF OCCUPANT
❑ NEWLY CONSTRUCTED BLDG ❑ ADDITIONAL OCCUPANT s
❑ EXISTING BUILDING ❑ CHANGE OF USE
_Occupancy Gi D'v
Indicate former use. It any 7L
�rsta. 1: 3
SQUARE FT. OF BUILDING TO BE OCCUPIED
G:
6-0
NOTICE: is
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 )n 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 f 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
different group of occupancy, a change of occupancy inspection fee of $ building in a different division of the same group of occupancy °sha I
)
3 be Paid to the city. )
4. Huntington Beach Fire Code Section 10208 requires that building numbers must be a minimum of four(4) s
Inches in height with one half (1/2) inch stroke, and of a contrasting color from the background. These
numbers must be posted on your building in'a location that is visible from the street:- t
5 Huntington_ Beach Fire Code Section 10.301 requires fire extinguisher selection and distribution per the
Natiooal Fire Protection Association pamphlet 10 (see reverse side):
(FOR OFFICE USE ONLY) ZONING
SUPPLEMENTAL -------
SUPPLEMENTAL INFORMATION
^� NO PARKING SPACES --
OCCUPANCY GROUP PLAN CHECK NO
HEALTH
�,7 PERMIT NO __ DEPT APPROVAL 14
OCCUPANT LOAD — ADMIN. ACTION —-—UTILITIES RELEASED }
NO, OF STORIES/ 1,
G� ,h` f J/ CERTIFICATE OF OCCUPt-NCY FEE y r h
APPROV BY DATE CHANGE OF USE OR OCCUPANCY FEE $_
TOTAL $
75-039 Rev. 11i'90 C11 COMMUNITY DEVELOPMENT
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SUPPLEMENTAL
INFORMATION (Continued) 4
1
Does the operation involve any of the
following materials? ❑ Yes
No
If
Yes, indicate quantities:
Material
Quantity
1.
Flammable liquids
Class I -A
Class I-B
,
Class I-C
i
2.
Combustible liquids
Class li
ti
Class Ili -A
3.
Combination flammable liquids
j
4.,
Flammable gases
5..
Liquefied flammable gases
6,
Flammable fibers - loose
i
7.
Flammable fibers - baled
8.
Flammable solids
9.
Unstable materials
10.
Corrosive liquids
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11.
Oxidizing material - gases
j
12,
Oxidizing material - liquids
13,
-
Oxidizing material - solids
i
' 14.
Organic peroxides
15.
hlitromethane (unstable materials)
}
16.
-Ammonium nitrate
i
17.
Ammonium nitrate compound mixtures
I°
containing r- than 60% nitrate
i.
by weight,
-
18.
Highly toxic material and
poisonous ,gas
r,
19.
>keless powder
—
20.
Black sporting powder
C
i hereby certify that the above information is true and correct to
the best of my knowledge.
Signatu
Date
x
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M
SUPPLEMEN :FAIL INFORMATION
1.
BUSINESS ADDRESS
2.
Person to contact in case of emergency -
Telephone number: C-714 )) 37$'
:
Does the building in question have electricity?
Yes_
❑ No
(a) If No, are you requesting that the electricity be
❑ Yes
'
turned on?
❑ No
!
4.
The building is sprinklered?
T V-Yes
x
❑ No
5.
Operations will produce dust/wood shavings or similar
material?
❑ Yes
a
JkNo-
6.
Operations will involve the repair or replacement of
❑ Yes
automobile parts?
CSfNo
If Yes:
is
_ f,
(a) Describe the components repaired_ or replaced.`
t:
(b) Does the operation involve the use of an open ' flame?
�❑ �Yes
.No
T.
The business is drinking, dining or assembly use that will
result in an occupant load of more than 50 persons.
❑ Yes
XN+
8.
The following best describes my- operation;
Office Only
Retail Sales
t
Wareho
Manufacturing, / Distribution describe process and end product)
a
l
Restaurant/Take Out Food
Medical / Dental
Other (describe)
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SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT
(Nonresidential Buildings Only)
Location of Subject Property: /J f I -D(, aA 2�4
y, c
Property Owner name:_l bN � Z f _T-XA Phone #�I_ld g3-A,,03 I
Name of the Person Preparing this form in print and signature r
Name- �o�..ti�1t- � Signature
The person preparing this .form must be the same pe son applying for
building permits. Please answer the following questions regarding your
proposed occupancy of the subject building. IF YOU DO NOT KNOW THE ANSWER
TO A QUESTION MARK IN THE "YES" COLUMN; f
SCAQMD PERMITTING CHECKLIST
i
S
YES NO
1. Does your facility use any internal combustion
engines greater than 50-HP? (]
2. Does your facility involve mixing, blending, or
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? F:�
i x i
Reclaim any metals? s
5. Does your facility plate or coat anything?
6. Does your facility have any combustion equipment C�
i.e. boiler, furnaces, broiler, baking ovens, etc.) i
rated greater than 2,000,000 BTU/HR?
7. Does your facility handle or store solvents or 'motor
fuel?
8. Do you useorstore any acids?
9. Do you use any chemical process?
10. Do you use any solvents for clean-up?'
11. Are you a dry cleaner, restaurant with a charbroiler,
body shop, gasoline station, printer, or part coater?
�. 12. Is the subject building located within one 'thousand
(1,000) feet of any school?
PROPERTY LINE TO PROPERTY LINE. GRADES K-12.
If you have marked "NO" in all columns, you do not need an Air Quality
permit at this time. If you have marked any questions in the "YES" column
Youmust contact the South Coast Air Quality Management District located
at:
� 9150 FLAIR DRIVE, EL MONTE; CA 91731
Please call these offices: Plan Check (818) 5,72-6406
D:AL00603 (818) 572-6111, (818) 572-6261
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