HomeMy WebLinkAbout15052 Springdale St - CofO (26)• CERTIFICATE OF OCCUPANCY 020110 — 9-163
J� CITY OF HUNTINGTON BEACH —
DEPT. OF COMMUNITY DEVELOPMENT APPLICATION
HUNTINGTON 9EACF (3d Floor — The Applicant Must Apply In -Person)
Business Address t) cJ Z s4- C Date ``l -LI I to
Business Owners Name u 6 Zip Code 112615
Business Name cL i J a VA s,— t Telephone No. 1 N q q.7 V3
Business Type N1 A t j For 14 ,kt S Bus. Phone
Property Owner Information (required) Tenant/Emergency Contact (required)
Name Name .1 t"c , 6aALAUriy
Address 150,62, •-c e- <4e L-' Home Address 61 � Sf .
CityR1U,,-ji;n�koN gd1 State/Zip a 61-1&41 City::Q)Sft'-_ rr State/Zip Z6
Telephone No. 61 NS g C, a 0-718 Telephone No. 1-7110 3 ZZ-'qt! %
THIS USE WOULD BE DESCRIBED AS:
ONewly Constructed Building or I& Existing Building
IS THIS BUILDING FIRE.SPRINKLERED? OYes ONO
CHECK ALL THAT APPLY:
O Change of Business Owner OChange of Occupant OChangd of Use ®Additional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity be turned on? OYes # No
■ Will operations produce dust/wood shavings or similar material? OYes I&No
■ Will operations involve the repair or replacement of automobile parts? OYes ®No If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? O Yes *No
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
OYes fNo
■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? ®Yes ONO
■ The following best describes my operation: ® Office Only ORetail Sales O'Vledical/Dental
OWarehouse /Manufacturing/Distribution ORestaurant/Take-Out Food OOther
■ Will any meat products including beef, poultry, and/or fish bee cooked or fried onsite? Oyes *No
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: OYes ®No
For Official Use Onl
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied: _
Bldg. Permit #
Planning Initials:_J'M Date:
Conditions of Approval or Other Notes:
Area:
Area:
Area:
No. of Stories:
Entitlement #:
Occ Load:
Occ Load:
Occ Load:
TIF Review: / N
Zoning:
Building Reviewed By Initials: Date:
South Coast
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
(909) 396-3529 • http:// www.aqmd.gov
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: A,
Property Address; 1 S 6,5 2, '-*jA-$U e141e sJ
City: ii..� t�.nc /SGh Zip Code: -q 26�l9
Contact Person: haclr wwa, Title: Ou,47
Type of Business:tl6w,(Seivu.- Telephone: �JGf) 3y 8-R 3 f(3
Fax Number: e-mailaddress: 0a oJtwGt e wig ����o• Gam"'`
Applicant (print name): iu�o 6ae%4,r2 Signature. Date: k 211
• Will the facility have any of the following equipment? Yes No M
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
Bagliouse/cartridge-type dust filter/scrubber
Motor fuel storage and dispensing equipment
• .,Will any of the following operations be performed? Yes❑ NoK
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).
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APPLICATION FOR CERTIFICATE OF,OCCLIPANCY
CITY OF HUNTINGTON BEACH �r ,
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DEPARTMENT 6F COMMUNITY DEVELOPMENT
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THIS USE WOULD BE DESCRIBED AS: - - -
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❑gEltiL Gc-t{!';1F _..'t.0 FLC,1 - ... ..lf !. rFT•. I/i.`ilnJ JPlJJT
_ ❑ EXISTLJ:i F3111Lf dJ:> +. ! i .. .. ., . _ i.- J Al:DIWONAL `.:h:.La1PAIIT
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SCUA1lEFT OFEin -.-( er--
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NOTICE 1.. Occupancy 0 any building is pfOliP 'e.1 and a busines�i uconse will not be nisued unfiIJ .e building has been
inspected and a certificate of occupancy is issueA.
2. No. elec4icz1 service x,ll he retpa:ed for any erisU9 n b J,idu1 9 unLV the service has been mspeued and
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certified safe. All applicant, fpr. occupancy in an e�tsbng building are requned to schedule anelectrical
'fuse up' inspection in the Department all Commmity Oeveiopment at too time this application is -filed
{ 3. Ch'nge M occupancy -at use Inspection fee. When=ver a Is n_c ssari`Io make Inspection of a building or
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j premise>inordellodelettnmeil hangemaybo? leer lhPrharaclerofncwpancyoruseofthebuilding
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or prerrlses Ahich would place the b wing r + t different drvrsinn of the amp group of occup ncy or In a
ddf ,ent of oc:cupancy.;a chanai, of occupancy inspection tee of v -shall
be paid to the city .
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3. Huntington Beach Fire Code Section 10 208 req':ues thul budding numbers mu •t be a minimum of four (4)
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1t _ incnes in height with one -hall i".) Inch stroke, and of a contrasting retol /[u i the background These ,
- numbers must be posted oil your hulldmg Jn a location tftal is i,vble Iran the street
111 F,. Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection Lind Mslhhuflon PEi.the ;
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National Fire Protect on Association pa•nphh 1 70 isce reverse aide)
IFOR OFFICE USE ONLY) 9 J
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SUPP4EMENTAL INFORMAT!ON
1.
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OCCUPANCY GROUP
: O=PANi� LOAD_.._{'P--._.,II +�t F'r ( 1„?JAI. __ ._ I•
NO OF ST11 JES-....-_ _... A it. A, -PJ
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.:._ .. APPROVE y f - - -
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COLEIKUNITV OEVELP,
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