HomeMy WebLinkAbout15231 Springdale St - CofO (3)-7;o
APPLICATION F0 CERTIFICATE
OF OCCUPANCY ._
CITY OF HUNTINtaTON BEACH
wurauacrcAw DEPARTMENT OF COMMUNITY DEVELOPMENT
(PRINT OR TYPE ONLY)
Address / 3 / SPRING
" Distnct
Business Name -> e_c'__ TeL
Business Type ... 6Tr Ccc Group
BUILDING OWNER BUSINESS OWNERIMANAGER
Name 1, dlr l�i2a�ia - ?�1(l Name &C�iit�r97e
Address Home � il� r4,Z', ffN&7SS"
Address- C5r2f/�
city �
amity Home el.
THIS USE WOULD BE DESCRIBED As
❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER [_X7 _HANGE OF OCCUPANT
9..EXISTING BUILDING ❑ CHANGE OFUSE ❑ADDITIONAL OCCUPANT
i
Indicate former use it any Occupancy Gi Div
SOUARE''FT OF BUILDING TO BE QCCUPIED. ie) 1
1. Occupancy of any building is prohibited and a business license will not be issued until the building has been
inspected: ana 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 occuoanr y in an existing building are required to schedule an electrical
'fuse up' inspection in the Department of Community Development at the time this appiicaboo is filed.
3, Change of occupancy or use inspection fee. Whenever it is necessaty to make inspection of a building or
premises in order to determine if achange may be made in the characteroi c4cupancy or use ofthe building
or premises which would place the building in a different division of the same group of occupancy or in a
different group of occupancy, a changeof occupancy 'inspection fee of $ shall
be paid to the city:
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 contrasting color from the background. These
numbers must be posted on your building in a location that is visible from the street.
S. Huntington Beach Fire Corte Section 10.301 requires fire extinguisher' selection and distribution per the
National Fire Pr tion Assc*ciation pamphlet 10 (see reverse side)." Y Q/ � /-z 0 (k�
TL 14
(FOR OFFICE USE ONLY) j
ZONING_
OCCUPANCY GROUP PLAN CHECK NO _ _ __ � ._ NO PAF?Wtr SPACES
OCCUPANT LOAD PERk41T NO HEALTH DEPT APPROVAL —
NC OF ST IES - ADNIrN ACTION. .� UTILITIES RELEASED i
j s
( CFRTtt`ICATE OF OCCUPANCY FEE S
A'i'Fc ~8Y DATECHANGE OF USE OR OCCr WANCY FEE
TOTAL I1.1
{
75-0389m V97'
SUPPLEMENTAL INFORMATION
1.
s
BUSINESS ADDRESS 1 5�23 12,! 5 4 5
2.
Person to contact in case of emergency,
Telephone number:'
E
3.
Does the building in question have electricity?
Yes
13 N0
(a) if No, are you requesting that the electricity be
❑ Yes
turned one -
❑ No '.
4.
The building is sprinklered?
w
Yes
Na
5_
-Operations will produce dust !,wood shavings or 'similar'
material ?
❑ Yes
No
6.
Operations- will involve the repair or replacement of
❑ Yes 4
autornobite parts'?
No
f Yes:
(a) Describe the components repaired or replaced.
r
(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
6.
The following best describes my operation;
rt
ffice Only
etail Sales
l
Warehouse
Manufacturing 1 Distribution (describe process and end product)
t
Restaurant l Take Out Food
Medical 1 Dental
3
Other (described
e}}
i
6
4
'a
Does the operation involve anV of the folfoweit-Ci Materials? Yes
No
If des, indleate quantities:
Material Quaritit
� i=la mmaable liquids
Class t-
Class 1..
Class l-
2. Combustible liquids
�.. .._._.�.�.. ,�......�.-...ram �..,.�_..._...�...�..�.,..�.�.._...
Class Ill-
3. Combination flammable liquids
4. Flammable gasps
5. Liquefied 'flammable gases
Flammable fibers a louse
'Flammable fibers -_ baleen
8. Flammable solids
a. Unstable materials
-Co. Corrosive liquids i
11. O.'Idizing material gases -
12. - Oxidizing material liquids j
1 Oxidizing material - solids
14. Organic peroxides
16. Nitro methane ' f unstTble materials)
16. Ammonium nitrate z
17. Amonturn nitrate compound mixtures
containing mere than 630% nitrate
by weight
18. HV° Iy toxic material and
puisonous gas i
M Smokeless p�waer -
2.. Bled: sporting powder
s
l hereby certily that the above Information is true and correct ` t
the st of my knowledge. r
Signature �s e
-oath Coast
Air Quality Management District
21865 E, Copley Drive, Diamond Bar, CA 91765-4182
(909) 396-3529 ® http://NNwv v,agmd.gov
Air Quality Permit Checklist
California State Law Code 65850.2 prohibits cities from issuing an occupancy permit without
clearance from the local air quality agency. This checklist will determine if you need to obtain
clearance from the South Coast Air Quality Management District (AQMD).
Company Name: off Cc`ta�e�A, ffM '4.
Property Address:
City: Zip Code:
Contact Person; Title;
Type of Business: & Telephone:(7!�) olge, 9ZsZ
Applicant (print name) "-I a&7,�'rog Signature: oaip
e Will the facility have any of the following equipment? YES[ 3 NO [�
Charbroiler t
i
Dry Cleaning Machine l
Spray Booth
Printing Pi ,s (screen/lithographic/flexographic)
Internal Combustion Engine (greater than 50 HP (excluding motor vehicles)
Boiler/Combustion Equipment (greater than 2MM BTU/hr. maximum input)
Abrasive Blasting Cabinets/Roams
Baghouse/Cartridge-Type Dust Filter/Scrubber
Motor Fuel Storage & Dispensing Equipment
Will any of the following operations be performed? YES[ ] NO [/�.j
Application of Paints and Adhesives
Etching, Plating, Casting or Melting of Metals
Plastic Molding, Extruding or Curing
Mixing and Blending of Liquids and/or Powders
Storage of Acids, Solvents, Organic Liquids or Fuels
Production of Fumes, Dust, Smoke or Strong; odors
If you answered "NO" to both questions, this checklist is your clearance from AQMD. If you
answered "YES" to either gaestion, you must contact the AQMD to determine if air, quality
permits are required. If permits are needed, AQMD will assist you in submitting permit
application(s) and then provide you with`a clearance letter. Ifyou have any questions, please call
AQMD's 'Small Business Assistance off -tee at (800)-CUB'-SMOG, and press 41.