HomeMy WebLinkAbout15211 Springdale St - CofO (2)IAA
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lrr APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
aas DEPARTMENT OF DEVELOPMEI IT SERVICES ( ,
Hl'+Jrtk ;Tura BEACH
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THIS USE WOULD BE DESCRIBED AS.
r,HANI,3E tar OCCOPANT
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FXISINf- BURIANC3 t� EtANGE f OFF A#`D11014rit_ VCCUPANT
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NOTICE, I c`; t stag' i of ara t} i! a r t hI-V + , r 1 a' a Wif not t
ed u!itil the b :.. �,,,. E €rtldlnq haz;
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- No Electricalsamice _ he roomy!fm jnvn ,r+ t t: Y ! J id '} E- i; CvxC fZ;3� 3 eell lrlperfed acid
S..t'rSltiE (, f� Alt a)pl!wwn o- q wrt .f +, rr no nnixg .Jb x,;. i e .yt iYe d to sowdus an elec wo
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one up i C;I!E`.'„ n "I s E.��,alrrn,+ r a" t D f..P,,. rlr rri t7 t cti ? tt e r1Cr} to`?4tJ�it{:r'7fon A iilF&
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3 Change
I _ ange of occupancy or use Inspection tee q�`r} ?' ti 4 n (:k ij �C x'Y( c {.1 >At f, ffr F101 a ru jirig
{ l,r pm rm rl e r}er to dphypow t{ a r.l, 1er IMW bp rxn T chi t rt ac of occupancy w ancy or Lse of the
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Huntington
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='f. teach Fire Corte Section 10 20 . wire i i i{ t;n�, rv1 j ;t '"- i+ mtT im,,4rr, F}, four
14) inches in he Q4 t tORI one ha :iah Spoke, and Of _1"C'lr!? f')az"s<:ground. Tz eese �..
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S. Hunt,ingfon Batch Fire Code Section libSol r q ,ia.,
art x lens_bcbcn anj riser}njlon per
� tht-: NatSl,lr 4;xl F.; rf Pro
117
(FOR OFFICE USE ONLY)
SUPPLEMENTAL INFORMATION
C;C•!!r'AN Y L�F�C7Lt{_ f'i_:hiti tS E_`} t r7 "q.J {'A�;iSIfJ x: pA ti c
.)CCUPANT LOAD - [ �' ......_... _ . __.. ._ Fi=1 ti"It t,t:} - -. ..:. iF ,i :H 4.Pr APPI`A0 `At, . _,.. �..-..:�_._..._,v.:_
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AO tt FIDBt` A?E fit'J t(. OFOR t.�.t1l"rata. ff 5
SUPPLEMENTAL INFORMATION
1.
BUSINESS ADDRESS e "me;
e
2.
Persoai to contact in case of emergency. 14 4 Z,. Telephone number. oL�
3.-
Dols the building in question have electri^ity7
dyes
a. Tf No, arse ypu requesting that>the electricity be
turned on?
ONO
ONO
4.
The building is sprinklered?
5.
Operations will produce dust/Wood shavings or similar
material?
ONO
0Yes
ONO
S.
Operations will involve the repair or replacement of automobile parts?
Dyes
`
If yes:
(a) Describe the components repaired or replaced.'
(b) Does the operation nvn:ve the use of an open flame?
ones
9,�No
7.
The business is drinking, dining or assembly use that will
result in an
occupant load Of more than 50 persuns '
OYes
No
8•
The following best describes my operation:
Office
Only
r eta ; 1es"
L7arE?i14tiSe
Manufacturing/Distribution (describe
product) process and end
Restaurant Take out Food
Medical/Dental
Other ;(describe)
(0562D)12/8/6)
A
SUPPLEMENTAL INFORMATION (Continued)
Does the oiler.tion;.involve any of the
following materials? Dyes
' if ---Yes, n ic>ate quantitiesz'
Material
Quantity
- 1. Flammable liquids
C:ass I -A
Class I-8
Class I-C
2. Combustible liquids
Class II
Class 41I-A
3., Combination flammable liquids
v
4. Flammable gases
5. Liquefied flammable gases
6. Flammable fibers loose
7. Flammable 'fibers - baled
B. Flammablesolids y
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. Ammonium nitrate
_
17. Ammonium nitrate compound mixtures
containing more than 60% nitrate
by weight
18. Highly toxic material and
Poisonous gas
19. Smokeless powder
20. Black sportinr, powder
I hereby cert' y, that the'' ove information is true and correct. to the
best of my kt}ooi"e.
"° Sictlt re
bate; ,
' (0562b)
;, (12/8/86)