HomeMy WebLinkAbout15239 Springdale St - CofO (4),pia APPLfCA f ION FOR CERTIFICATE OF OCCUPANCY
® CITY oa NU�17it1GTON BEACH
DEPARTMENT OF Ct'3fV MUNITY DEVELOPMENT t� Z,rWit'
i iurrrRICION MACH DATE
(PRINT OR TYPE ONLY)
Address j� 2- District '
Business Name �v��t +�-r C�.s, µ �. G.dip-,s yet 7ZI-e�3?-
Business Type f '�-, rf`a t. �, 4-rA Occ Group
BUILD;NG_OWNER BUSINESS OWNENMAN ER
Name VOIJ-P Ql r gr f L 4 Name
�f _ NAddy
ame
sses 7 AddqCityI,t s GityfAIS THIS USE WOULD BE DESCRIBED AS:
EVJLY CONSTRUCTED BLDG 0 CHANGE OF OWNER ,CHANGE OF OCCUPANT
EXISTING BUILDING � CHANGE OF USE
ADDITiC'IALOCCUPANT
I. Indicate former use, If any --,-----Occupancy Gr - Div
SQUARE FT, OF BUILDING TO BE OCCUPIED Ltd 276
—� C40 C, 0 FFI CZ)
NOTICE: 1. Occupancy of any huildmg is prohibited and a business license will not be issued until the building has been
inspectedand a ce,tificate of occupancy is issued.
2. No electrical service will be released for any existing building until the service has been inspected and
--- certified safe. Ail applicants for occupanoy in an existing building are iequired to schedule an electrical
'fuse up' inspection in the Department o' Community Development of the time this application is filed.
3. Change of occupancy or use inspectio,l fee. Whenever it is necessaryto make inspection of a building or M'
premises in order to determine if achange maybe made in the character of occupancy or use of the building
or premises which would }dace the building in a different division of the same group of occupancy `r in a
different group of occupancy, a change of occupancy inspection fee of $ shall
be paid to the city;
4. Huntington Beach Mire Code Section i G.208 requires that building numbers must be a minimum of four (4)
inches in height with one Half (ra) inch stroke, and of a contrasting color from the background. These
numbers must bra posted on your building in a location that is visible from the street.
5. Huntington Teach Fire Code Section 10.301 requires fare extinguisher selection and distribution per the s
National Fire Protection Association pamphlet 10 (see reverse side),
7
i�
1
=,OE PAW, t%..
A"-,1.7tlty Rt-4 -4.v (FOR OFFICE USE ONLY) I
NAME --- ZONING
OCCUPANCY GROUP - - - PLAN CHECK NO NO PARKING SPACES
OCCUPAtK LOAD PERM#T NO f3SALT 1�EPT APPRO`JAL-,
NO OF 5.TOR S ADMiN ACTION _ �. m €_ITILME'S RELEASED
s�
CERTIFICATE OF OCCUPANCY FEE $
AP OVED k6Y DATE CHANGE OF USE OR 0 CUPANOY FETE S
TOTAL $ i
�l M1
SUPPLEMENTAL INFORMATION
1.
BUSINESS ADDRESS i��.�� �r�'.c��.����� ��, � 1�F�d 44
2.
Person to contact in case of emergency
Telephone number: —�
3.
Does the building in question have electricity?
No
(a) If No, are you requesting that the electricity be
❑ Yes
turned on?
0 No
es
4.
The building is sprinklered?
Q No
5.
Operations will produce dust/wood shavings' or similar
material?
es
LT No
6.
Operations will involve the repair or replacement of
❑des
automobile parts?
No
If Yes;
(a) Describe the components repaired ` or replaced.
(b) Does the operation involve the use of an open
flame?,�'es
E; No s
i 7.
The business is drinking, diming or assembly use that
will f
result in an occupant load of more than 50 persons.
0,r'Yes
8.
The following 'l describes my operation,
r c'e Only
i
Retail Sales
facturing/ Distribution (describe ' process and end product) 1
"Restaurant / Take Out Food
Medical / mental
r
Other (descrit.je)
TO
}
South Coast
AIR QUALITY MANAGEMENT DISTRICT
21865 E. Copley Drive, Diamond Bar, CA 91765-4 ; 82 (909) 306-2000
A.M. QUALITY PEPdVHT CHECKLIST
for nonresidential buildings only
��IG'I;;v� G� �r 'IDS �CGd1 �� l G'Al`� 0 5
F
Company Name,� i
LoIcation of Property. mq '.a "o St
city: :Zip Code- t
Contact Person: , -��n 44e: r ; zajgf� tG
Telephone Number. Fax Number; V3 ". 5 /5?cZ
Type of,Lndustry/Business:u CG`�1duLa�t�
_
To apply for a nonresidential bolding permit, you r.�ust complete this checklist, if you have any
questions about compledng this checklist, please call (800) 388-2121.
'YES
N
1. Will the facility have a charbroiler?
2. Will any internal combustion engine with greater than 50 horsepo' ver
operate at the facility (excluding motor vehicles)? [ ]
[
3. Will operations at the facility involve affixing, blending, or processing of
solvents, adhesives, paints or coatings?
4- Will dust or smoke be generated at the facility? J
'
5. Will refining o any liquids or solids be done at the facility? [ ]
6. Will any plating or coating of materials be done at the facility? [ ]
x
7. Will any combustion equipment rated greater than 2,,000,000 BTU/hr be
operated at the iacilit r? [ J
[
8. Will any acids, solvents, or motor fuel be used or stored at the facility [ ]
9. Will any organic liquids or gases be reacted or produced? [ ]
10, Will any ovens be used to dry or cure products at the facility?
at the facility. i [ ]
IL Will any CFC (Freon) recycling machines operate
Signature:
(Print name clearly)
If you have marked "NU' in aid the boxes, an air quality permit is =1 needed at this time,
and this checklist is your written release,
If you. r=ked "YES" in :any of the boxes, you mrast contact the South Coast Air Quality
Management District ict (AQ ), Please read toe requirements on the back of the checklist
ADD k iONAL SU!"PLEMEN 1AL INN,
Trancode: (PERMIT] C0MMUNTTY
D E V
E L 0 P 1,1 E N T (4000]
Function: [:HST] P E R M T T
M A I N T E X A N C E PG 0.
r****r** K E Y
S C R B
E ?S ***r******
Key Fields '3e yr *':t
fie* * **
(
Functions and Keys x >t * 1
Permit Number: Type [ ] Seq ]
( ADD:
Permit Type, Address
INQ:
Permit/PC Number, Page
Address: ]
} U'PD•
Permit/PC Number, .Address (if
Sheet Number ^1523 ]
Subunit - "SAPQE," Address will
Street Name [SPRINGDALE ]
i
remain unchanged)
Subunit C ]
VOD:
Permit/PC Number
t
HST:
Address
'
Next Page Number: [1]
COP:
(Copy from existing permit to
'S
new permit): Enter the, Type and
Msg.- [Er4D OF.FSLE OR NOTFOUND ]
Address of the new permit; enter_
the existing permit number in .:he
Copy From Permit Number: ( ] " ]
"Copy From" field.. if Subunit
"SAME," Address on new permit
Plan Check Number: Yr( ] Seq'
will be same as that on permit
.Unissue Permit Number: ( ] ]
copied from.
**** AVAILABLE PAGES ****
]
NOT:
Permit/PC Number
O—Key Screen 3-Inspections
BAT,
INS, ISS, FIN, EXP, SEC,, BYE,
M
1-Identification 4-Multiple Address
PRT,
PCL, PCR: No keys required.
2..Fees/Issuance
F
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