HomeMy WebLinkAbout15061 Springdale St - CofO (18)X
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HUNTINGTON BEACF
CERTIFICATE OF OCCUPANCY 020
CITY OF HUNTINGTON BEACH -
DEPT. OF COMMUNITY DEVELOPMENT APPLICATION
(3'd Floor — The Applicant Must Apply In -Person)
Business Address k d G 1 Date
Business Owners Name = 'a s _ vUe iti� oe-mle., Zip Code 92c�, Y 9
Business Name C ` �"" ^ �'"0 Telephone No. g s g - zz�5-63�y
BusinessType S \... ..s Bus. Phone 3) o
Property Owner Information (required) Tenant/Emergency_Contact (required)
Name Sir-omJig< S'N C Name A c-4&r U4-t-J
Address 53y i--i , l 1 A%.X- J�- 22 Home Address ►-t awl A j
City State/Zip CA s 2-zo S City L.o s A 1 a. — %A State/Zip < A a o __� -2-
Telephone No. !� W 2j- z so -- g l o o Telephone No. 31 o - 4z '? �-1 - O 0% S ci
THIS USE WOULD BE DESCRIBED AS: 4xisting
O Newly Constructed Building or Building
IS THIS BUILDING FIRE SPRINKLERED? C'Yes ONo
CHECK ALL THAT APPLY:
❑ Change of Business Owner ❑ Change of Occupant ❑ Change of Use Ef Additional Occupant
■ Indicate former type of business c-�
■ Are you requesting that the electricity be turned on? Yes ff No
■ Will operations produce dust/wood shavings or similar material? ❑ Yes 4No
■ Will operations involve the repair or replacement of automobile parts? ❑Yes ✓dNo If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? ❑ Yes No
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
❑ Yes ENO
■ Will there be storage racks, gondolas, or shelvin exceeding 5feet 9 inches in height? ❑Yes Ao
■ The following best describes my operation: Office Only ❑ Retail Sales ❑Medical/Dental
OWarehouse /Manufacturing/Distribution ❑ Restaurant/Take-Out Food ❑ Other
■ Will any meat products including beef, poultry, and/or fish bee cooked or fried onsite? ❑ Yes ENO
If you answered yes, please proceed to the next question.
• Does your facility currently have a grease control device (i.e. grease trap or grease interceptor)?
Check one: ❑ Yes 19 No
For Official Use Onl
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied: _
Bldg. Permit #
Planning Initials:6E_Date: -ZS- go
Area:
Occ Load:
Area:
Occ Load:
Area:
Occ Load:
No. of Stories:
TIF Review: Y/ N
Entitlement #:
Zoning:
Conditions of Approval or Other Notes: n.ffj !.? JAD
Building Reviewed By Initials: Date:
Grease Interceptor Verified Inspected By Initials: Date:
Air Quality Permit Checklist
California State Law Code 65850.2 prohibits cities from issuing an occupancy permit to a
business 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:
Property Address: kS b e, i S p r n6 oko, Le 2 0-7
City: 1-1 �,,. �, , n Qe Q U Zip Code: G Z(o ,-I 9
Contact Person: A r4-k,,,ry c-A,9-1c, Title:
Type of Business: Telephone: 31 o - fS 1 y - 0'1rj
Fax Number:
e-mail address:
Applicant (print name): L= t� Fti(Qs Signature: �,,�� - Date:
Will the facility have any of the following equipment? Yes ❑ No [�
Charbroiler
Dry cleaning machine
Spray booth
Printing press (screen/lithographic/flexographic)
Internal combustion engine greater than 50 HP (excluding motor vehicles)
Boiler/combustion equipment (greater than 1 million BTU/hr. maximum input)
Abrasive blasting cabinet/room
Baghouse/cartridge-type dust filter/scrubber
Motor fuel storage and dispensing equipment
• Will any of the following operations be performed? Yes❑ NoZ
Application of paints or adhesives
Etching, plating, casting, or melting of metals
Molding, extruding, or curing of plastics
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 question, you must contact 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. You can call AQMD at their Small
Business Assistance Office at 1-800-CUT-SMOG (1-800-288-7664).
IPA
APRL ICATION FOR CEh'TIFIr,ATEOF,7CCUPANCY.i7i"
MEN OF HUNifN
COG'ori BEACK
iwrmrratawr DERARTMENTOI Mie7! ""'rr O:V5!.OvWFNT. j
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Sines Namr:_LG�]��—
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THIS USE WOULD BE DESCRIBED AS:
NEWL'f CONSTpUC1EG + :; F :yr :,:;qr,r-is 1. r; i (Nr:o; ::F CC,CUPANT
. ED £XfSTINGR'.LL'd.dfa .. L_I (: t ,—..'ACLITirlYa:t>r`„':UV.Qt:tT - ..
.. .' ..., : "..' . ' Ind:Cale t0irier u �. it %1'lY _.: ............._. __ .._.... __ . _. _ ..... ..+,.::, •r �_L� t;;
SQUARE_FT. OF D 17. U',C !f"Ei
# NOTICE: 1 Occupancy of any building ispichibAadandab: mp_.:"ficer,seWill nofbe:ssuedun!illhebuildiriphas tuen
I inspected.and aceit!ficate of cccuPancy.is issue:.
II 2. No electrical servioe will ba relea56d for any exist^;• bwldmg until the service has F3en inspected and 1
c tilted safe. All applicants (or occupancy in an existt,fwiding are ayuired to schedule an electrical .
fu c up' inspection inthe 0epar.tment of Community Dev eigpment at the time this Application is filed
Change of occupancy or use inspection tee. Whenever it i s necessary to make inspection of building oi-
Y�r�� premises in order to determine ifachangemay bemade. +nthecharacte,ofoccupanc; or use of thehuiidmg l s
ur premises ivfi. h.would piarethe b ilding i!i.a different division of the same groJp of occupancy or in a
difteren! grouo,of occupapcy, a:c;h nge of occupancy inspecapn tee of W
' tze paid to the city. T f
4. Huntington 6.ac11 Fire Code Section 10.10i3'regtsires that Uuttdi g n tubers riust be a minimum oI tour t4) ,
i inches in height wiih`une half (';ct incn stroke and of a r onsrasting C.bfor from, the background,, These'
j numb>rs mu t be poaed o i your build ny in a incat`an +h fi is Ji;ible from the street f
P
S. Huntington B each Fire Code Section 10.301 iequir.s fire exi:riguish r selection and distribution per the .�
National Fire f rhtecfion Associati•_;i pamphret 10'seereverse sidel
(FOR OFFICE USE ONLYI
SUPPLEMENTAL!NFORMATION
NO OF SIORIF.S __. _._._. _._. _..... _. .... ...__. !.. , ... .. _ ..Fla .
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