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HomeMy WebLinkAbout15201 Springdale St - CofO (2)L" to APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT o2 HurJTIN6TON W.Oi DATE (PRINT OR TYPE ONLY) " Address GQ©! ��rinq c�ct�G lAnYin on :Bea t.Q I District F Business Name WG's S t �!'f ila � I L sI_ eSOu rGC G ro ter Tel'714 294 ' OU/ J Business Type C 1 b ie_t / E. AA* r a+o a Occ Group BUILC'NG OWNER BUSINESS OWNER(MANAGER Name _VDI' bcrAl he P' J Ir Name C?�tCCt Q' R a� �%M-ew! S4�' Home Address ^ `_b a� ,gyp Address City t � •a-D— 2 � t_Tel _0_ ±� .;City n r I y—Home Tel. THIS USE; WOULD BE DESCRIBED AS: i 0 NEWLY CONSTRUCTED BLDG FI CHAiJGF OF OWNER LJ CHANGE OF OCCUPANT s ❑ EXISTING BUILDING CHANGE OF USE ❑ ADDITIONAL OCCUPANT Indicate former use, if any __Occupancy Gr Div SOUARE FT. OF BUILDING TO BE OCCUPIED —J -0 (FOR OFFICE USE ONLY) SUPPLEMENTAL INFORMATION ( ,— J� ZONING r OCCUPANCY GROUP IL PLAN CHECK NO. NO PARKING SPACES OCCUPANT LOAD _ PERMIT NO. _' HEALTH DEPT APPROVAL: NO, OF STORIES ADMIN. ACTION_ UTILITIES RELEASED CERTIFICATE OF OCCUPANCY FEE $ l APPROVEDVBY DATE CHANGE OF USE OR OCCUPANCY FEE S* TOTAL 75•039 Rev, 11/90 5 CO MUNITYDEVELOPMENT _� SUPPLEMENTAL INFORMATION 4 1. BUSINESS ADDRESS y1%lo.i I G11 ° YLQ ` 2. Person to contact in case of emergency �`r' a S Telephone number: Ll-*�Yes 3. ilding in question have electricity? Does the bur m - 0 No (a) If No, are you requesting that the electricityr be El Yes No turned on? C'TYes 4. The building is sprinklered? El No e 5. Operations will produce dust/wood shavings or similar El Yes z. material? R No 6. Operations will involve the repairor replacement of ❑Yes ` l'No 1 automobile parts? If Yes:` l ' (a) Describe the _components repaired or replaced. i k , (b) Does the operation involve the use of an open flame? ❑Yes 2 No t 7. The business is drinking, dining or assembly use that will p Yes result in an - occupant load of more than 50 persons. RN o f i T 8. The following best describes my operation; Office Only ? Retail Sales l Warehouse Manufacturing / Distribution (describe process and end product); t. l Restaurant / Take Out Food tMedi / Dental } Other (describe)ca r. s „^ SUPPUMENTAL INFORMATION 3 i SUPPLEMENTAL INFORMATION (Continued) • e a * Dops' the o{g`erati' no` f valy# =anyr -of : tib� .. .s fin following' materials? C, "Yes ' ❑ No If Yes, r WioatE�quantities; Nfaterihl ak . , Quantity 1. Flammable liquids Plco6l SOo rn(. (Sopr®pyl -.Class I -A Yn e+hy I A"tcohal L . Class' 1-S y� "`a� go=• ` Class 1-C _ z 2. Combustible liquids Class 11 Class ilf-A .ore+cc��{ 5 o-0 3. Combination 'flammable liquids ' 4. Flammable gases 5. L quefied flammable gases ;r 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) 16. ammoniumnitrate { 17. Ammonium nitrate compound mixtures: containing more than 60%' nitrate by weight 18. Highly toxic material and poisonous gas 19. Smokeless powder 20. Black sport;nc dowder I hereby certify that t_thre�:above information"; 's true and correct' to I -' the f my knowledge.; Lo L `'LI Signature Date ' l y.,t� South Coast AIR QUALITY MANAGEMENT DISTRICT } , 21865 E. Copley Drive, Diamond Bar, CA 91765-4182 (714) 396-2000 is DATE: February 27, 1992 K ` TO: H+ntion Beach Buil ing Department. FROM: AAir Quality Engineer SUB4ECT: BPERMITTING UNDER AB3205, WATERS BILL r .,. Regarding pLAN-CHECK #: LOCATION: Weisenthal-Dill Cancer Resource Group 15201 Springdale St. - Huntington Beach, CA 92649 This site has met or is meeting the requirements of sectioon 42303 of the Health and Safety Code and i;he requirements f a permit to construct and operate for .the South boast, Air Quality ManagementDistrict