HomeMy WebLinkAbout15052 Springdale St - CofO (14)CERTIFICATE OF OCCUPANCY
020
HUNTINGTON BEACH
Business AddrE
Business Owne
Business NamE
Business Type
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION
(3rd Floor - The Applicant Must Apply In -Person)
Date
Zip Code OVUM -7
Telephone No.
Bus. Phone1+ U4N._ X,*�13
Property Owner Information (required) Tenant/Emergency Contact (required)
Name l,�Gi I 1 Name .SlJ(AWj 110YC0 V
Address �S�Sy 5 1�1�d U IG S Home Address (00LI - CA IV IY1 CO Y.
City yl 'hf kitate/Zip A • �_1W 01 City � Uh'i11'II�0� 1 &X&te/Zip CA 61Z(Fli1 .
Telephone No.11 y �� a U� 6 Telephone No. �-I I �I� 3I U - otp j o
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or KExisting Building
IS THIS BUILDING FIRE SPRINKLERED? AYes ❑ No
CHECK ALL THAT APPLY:
❑ Change of Business Owner ❑ Change of Occupant 18 Change of Use ❑ Additional Occupant
• Indicate former type of business RaiyI V1Ci MCI 14ssis+AMCC -
• Are you requesting that the electricity be turned on? [--]Yes KNo
• Will operations produce dust/wood shavings or similar material? ❑ Yes ® No
• Will operations involve the repair or replacement of automobile parts? ❑Yes f&No If yes: Describe the
components repaired or replaced.
• Does the operation involve the use of welding or open flame? ❑ Yes 81 No
• Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? ❑ Yes
• Will there be storage racks, gondolas, or shelving exceeding 5 feet 9 inches in height? ❑Yes 9 No
• The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑ Medical/Dental
❑ Warehouse/Manufacturing/Distribution ❑ Restaurant/Take-Out Food ;9 Other &,0GtU� &AVC
• Will any meat products including beef, poultry, and/or fish be cooked or fried onsite? ❑ Yes 91 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: ❑ Yes jgNo
Grease Interceptor Verified Inspected By Initials: Date:
For Official Use On/y
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied:
Bldg. Permit #
Planning Initials(? —,—Date: ' 18
Conditions of Approval or Other Notes:
Area:
Area:
Area:
No. of Stories:
Entitlement #:
Use Permitted: Y / N
No
,SM.?.
Occ Load:
Occ Load:
Occ Load:
TIF Review: Y/ N
Zoning:
Parking Meets &de (for use) (Y� N
Building Reviewed By Initials:(' Date: `Z Y& lb
South Coast
t Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
Phone Number (909) 396-3529 http://www.agmd.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).
Coml
Props
City:
Conti
G
Type of Business: F)e61V'M &y+ia Vr,- Sm P Telephone: -1 ll� - UL4L)
Fax Number: ci (nh E-mail Address: s Um
Applicant (print name): Sh(Aw 1 j 1 �1 i W41li Signature: Da
1. Will the facility release air pollutants, including but not limited to, d umes, gas, mist, odors, smoke, vapor, or a
combination of these to the atmosphere? ❑Yes S,No
2. Will the facility result of fuel -burning equipment including, but not limited to, boilers, generators, and internal combustion
engines? ❑Yes MNo
3. Will the facility result of hazard eri ats, including but not limited to, chemical, plastics, rubber, resins, solvents,
paints, and other parts cleaners . esNo S,
4. Will the facility have use of above or underground storage tank? ❑Yes XNo
5. Will the facility consist of manufacturing, fabrications, finishing, or treatment of wood, metal or plastic products? ❑Yes DNo
6. Will the facility result in the use of the equipment listed below: Al
(Select all that apply)
❑Abrasive Blasting Cabinet/Room ❑Internal Combustion Engine (rated > 50 bhp; e.g. back-up generator)
❑Air Conditioning System (containing > 50 Ibs of refrigerant)
❑Baghouse/Dust Collector
❑Bakery Oven (gas fired)
❑Boiler/Water Heater (max. heat input = or > 1 million BTU/hr)
❑Charbroiler/Smoker
❑Mixing/Blending of Liquids and/or Powders
❑Molding /Extrudi ng/Cu ring of Plastic
❑ Pharmaceutical/Nutraceutical
❑Plasma/Laser Cutter
❑ Printing/Coating/Drying
❑ Production of Fumes/Dust/Smoke/Odors
❑Coffee Roaster/Afterbunner ❑Refrigeration Systems (containing > 50 Ibs of refrigeration
❑Deep Fryer (excluding equipment located at eating establishment) ❑Soldering Oven
❑Dry Cleaning Equipment
❑Electrostatic Precipitator
❑Fermentation
❑Gasoline Storage & Dispensing Equipment
❑Spray Booth
❑Storage of Acids/Solvents/Organics Liquids/Fuels
❑Storage Silos (sugar, flour, etc.)
If you answered "No" to any of the above questions and your facility will not have the following
equipment listed, 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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CERTIFICATE OF OCCUPANCY
„. CITY OF HUNTINGTON BEACH - -
Dale
Address .i_. _
Oielricl
Businesc Name -
Tel.
Business Type Occ. Group
BUILDING OWNER BUSINESS OWNER/MANAGER
Name .. , _ _ ... Name
Address - - come
Address
City 7a1. Home
CITY Tel.
Construction No. of Stories Occupant Lr : £pdnklers
CONDITIONS OF APPROVAL
This Certificate of Occupancy
SMALL BE posted In a conspicuous Platt on the
prarnlses and shall not be removed except by the
Building Official,.
DEPARTMENT OF COMMUNITY DEVELOPMENT
ty
COMMUNITY CEVELOPMENT
IN ___ . � -* - - -
�3�tll
APPLICATION FOR CERTIFICATE OF OCCUPANCY
`>F
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT
L-
,n rr,A:.ae nw r•
I:ArE
.7--_1 A- .-. 4-. ACC- ' n�.7_-L. N�------- To: 7114 PY3- 5, 7 41
Busmcs: Type.P!ZEPtj R AT L0 ti. -. --_---..� Oc-. h+uu
-- - —.._.
!::/::;"• .. ":.'.f. i1V i'r!. `,:: :'.l'lVCn 7!1,:1.1._,�R
Ro8E1ZT iLm� ?J.--
15oSb S..'PrNL D<lLC__ ST HVn''r• I
Andress-- —. _.. naa•.,:.:.:._._P4__J7_CEit.F_�E�-1� ------
city __AV• `Lt 1'�NEro N_ _ (3 E� CA . '�. ... . _.. __ C•mr_.iiit/i N GA'_ -.__- _Homi, Te; 55.7-/g28
THIS USE WOULD B'c uESCRIBED AS:
F7J11 NEWLY CONSTRUCIFD CLDG ❑I _I+tiNriF. ^k 0 NI R J& C'.ANL:L OI OCCUPANT
1LJ. EXISTING BUILDING �� C`1rJr11- r,r U51: ❑ A[?[:I!Ir)NAL Ui.(;'JFANI
Ind,cale. 10•1,,er uc .' an.\' — � .. •:•.''. is --[).y
SOUAuE FT OF HUIt DING ii1 GE ;;r t'-'.lr91. D__. ....�.._ .
NOTICE: 1. Occupt ncyof any building s prumblted and a business license will not be issued until the building has been
inspE.aad and a certificate of occupancy is issued.
2 No electrical service wLl be released for any existing building until the service has been inspected and
cegtiried sa(e. All appl!canls for occupancy in an existing building are required to schedule an electrical
•fuse up' inspection in the Department of Community Development at the time Ihis application is filed.
3. Change of occupancy or use inspection fee. Whenevo, a rs necessary to make ,nspection of a building or i
premises in order to determine if e change maybe made in the character of occupancy or use of the building j
or premises which would place the bni)Jing in a different division of the same group of occupancy cr in a
different group of occupancy. a change of occupancy inspection fee of i- ...__-____._._:_.._ Shall
be paid to the city.
4, Huntington Beach Fire Code Section 10.208 requires lhatbuilding numbers must be a minimum of four,4)
inches in height with one half [S'i) inch stroke. and of a contrasting color from the background. These
numbers must be poster' oo your building in a location that is visible from the street.
5 Huntinglon Beach Fire Code Section 10,301 requires fire extinguisher selection and distribution per the
-_ —_-- National Fu•� Protection Association pamphlet 10 (see reverse side).
(FOR OFFICE USE ONLY) zs(91
SUPPLEMENTAL INFORMATION
OCCUPANCY GAOI JP _ `-r - _ t•t l,N r.'.+ll (:n rJi) —_--__ _.._-.__. NO r+Akh(rJC; S^ACk$ .
OCCUPANT LOAD . -—_---�-y--- Ff phtlT NV -..--___— ilr Al TN Ci P7
NO OF TORTES - {.— AA7,9tJ N1I-)N.__.... __.__.. ._— i:71:i'11:S RELFASEp-__-._..._-._______..�_
.x v r�Rnrn:arf on re,C,LJPAN', Y FL't
A.PPROVE BY DA[F CHANG[ 0J USk , ,R L1N:UVANC f 1 Lh
O
TOTAL <.
-7 -,
�•% ) // ' offal
75 d39 Aev. I uao COMMUNiiY DEVELOf G1ENT /V
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SUPPLEMENTAL INFORMATION
1.
BUSINESS ADDRESS 11 05 Z S ('2 rwG
a
2.
Person to contact in case of emergency- I:oH6P'T ArviccTI
Telephone number: 714 ?93-777 55
3.
Does the building in question have electricity?
JZ Yes
❑ No
(a) If No, are you requesting that the electricity be
❑ Yes
turned on?
❑ No
4.
The building Is sprinklered?
❑ Yes
❑ No
5.
Operations will produce dust/wood shavings or similar
material?
❑ Yes
I -No
6.
Operations will involve the repair or replacement of
.7 Yes s,
automobile parts?
Cry No
If Yes:
(a) Describe the components repaired or replaced.
❑ Yes
(b) Does the operation involve the use of an open flame?
� No
7.
The business is drinking, dining or assembly use that wi'il
result in an occupant load of more than 50 persons.
❑ Yes
e
® No
6.
The followln best describes my operation;
Office Only
e ail Sales
Warehouse
i
Manufacturing / Distribution (describe process and end product)
,
SUPPLEMENTAL INFORMATION (Gontineed)
Does the •rrperation involve any of the followinn materials; O Yes
L-No
It
Yes, indicfIr mantities•
ti;a:sri: iOu��tity
1.
-lammat le lnauids
Class i-A
1-5
-
Class I-C _
Class ii
Cless VI -A _
3.
Combination flammable liquids -�,-----
A.
-Flammable gases-•------^
5.
Liquefied flammable gases
6.
--Flammable fibers -loose -.- -
7
Flamma�Ie `•ib�rs -baled - ---- _ ----.._---..._
8.
Flammable solids
9.
Unstabl:� materials _
10.
- -,-- ----,----_-----
Corrosive liquids
11.
Oxidizingmaterial- gases-
12.
_
Oxidizing material- liquids
-Oxi9izing materiat - solids
14.
Organic peroxides
i
-- -- —^ -
15"
Nitromethane (unstabie materials)
16.
^Ammonium nitrate
17.
YAmmonium nitrate compound mixtures
containing more than 60% nitrate
by weight
r` 18.
flighty toxic material and
poisonous gas --,— - -_
19.
Smokeless powder _
20.
Black sporting powder - _s
4
i
I hereby certify that the above information is true and correct to d
'
the est �oknowledge.
Signature Date
r
1
�
p
L.,
` 1
p
- t
SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT
I
(Nonresidential Buildings Only)
Location of Subject Property: 1 50S Z SPIQ I-i&pH 1_e S i X
Property Owner name: P>C!'�e- q-,05' Phone
i
i
Name of the Person Preparing this form in print and signMte
t
Name t\V8EPT- tgtmC-C-rI Signature
The person preparing this form must be the same person applying for
f
building permits. Please answer the following questions regarding
your
proposed occupancy of the subject building. IF YOU DO NOT KNOW THE ANSWER
f
TO A QUESTION MARK IN THE "YES" COLUMN:
is
Z'
SCAQMD PERMITTING CHECKL-ST
i
YES
140
1. Does your facility use any internal combustion
0
engines greater than 50-HP?
2. Does your facility involve mixing, blending, or
processing any solvents, adhesives, paints �--1
or coatings?
..
3. Does your facility create any dusts or smoke?
4. Does your facility refine any liquids or solids?
Reclaim any metals?
5. Does your facility plate or coat anything?
®
6. Does your facility have any combustion equipment
}
i.e. boiler, furnaces, broiler, baking ovens, etc.)
rated greater than 2,000,000 STU/HR? B
7. Does your cility handle or store solvents or motor
i fuel.
14. Do you use or store any acids?
'I. Do you use any chemical process?
,0. Do you use any solvents For clean-up?
11. Are you a dry cleaner, restaurant with a charbroiler,
body shop, gasoline station, printer, or part coater?
12. Is the subject building located within one thousand
F-D
i
(1,000) feet of any school?
PROPERTY LINE TO PROPERTY LINE. GRADES K-12.
If you have marked "NO" in all columns, you do not need an Air Quality
permit at this time. If you have marked any questions in the "YES"
Column
),
you must contact the South Coast Air Quality Management District located
at:
9150 FLAIR DRIVE, EL MONTE, CA 91731
�.
Please call these offices: Plan Check (818) 572-6406
f
(818) 572-6111, (818)
572-6261
D:AL00603
f
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* . Wlb ,„ - 3`zl mow"
�� APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT
NUMwr li n DATE
(PRINT OR TYPE ONLY) '
Address ✓ District
i
Business Name h 9%OU ( r yll��v�GK
Business Type ��P� CJ�1i1. Occ. Group
I
BUSINESS OWNEWMANAGERBUILOIN WNR
QJ��gG r
Name r�/LC!�0 Name )
� ` Home f
Addres5zsd SZ 4/dpdress
City TeT�—S/L�7t�(y Home Te
THIS USE WOULD BE DESCRIBED AS:
❑ NEWLY CONSTRUCTED BLDG ❑ CH4NGE OF OWNER M-el ANGE OF OCCUPANT t
i
'EXISTING BUILDING ❑ CH Aj E OF USE ❑ ADDITIONAL OCCUPANT
Indicate former use, if any --Y' 1[j06 q9 � Occupancy Gr. Div.
T
SOVARE FT OF BUILDING TO BE OCCUPIE
NOTICE: 0 Occupancy of any building is prohibited and a business license will not be issued until the building has been
Inspected and 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 occupancy in an existing building are «squired to Schedule an electrical
'fiise up' ;nspeclion in the Department of Community Development at the tine this application is filed.
3. Change of occupancy or use inspection fee. Whenever it is necessary to make inspection of a building or
premises In order to determine if a change may be made in the character of occupancy or use of the 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 change of 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 •.i 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.
5. Huntington Beach Fire Code Section 10.301 requires lire extinguisher selection and distribution per the {.
National Fire Protection Association pamphlet 10 (see reverse side).
I
TPAi sirs urFACT FEL .. _ . . _....._
DATE
AMC LINT RECEIVED
NA'r: ? ._ . ._ .. _. (FOR OFFICE USE ONLY) /
ZONING C
OCCUPANCY GROUP - - — PLAN CHECK NO --- NO PARKING SPACES
OCCUPANT LOAD PERMIT NO HEILTH DEPT APPROVAL
NO. OF STORIES — AOMIN ACTION— UTILITIES RELEASED
CERTIFICATE OF OCCUPANCY FEE y
APPROVED BY DATE CHANGE OF USE OR OCCUPANCY FEE S
TOTAL S
75-03e Rw. 1197 Co txv,!"" 7:7EVCLOTt; Ceti
Yi W�`V�i
Aadre "� AL. bistrial
,
si
BUsrriesS N2 eL L_ i cup Tel
business TyNz CGroup_ �oe� .- 0►11 Occ,
BUI�piNG OYIN�R _ BUSINESS OWNER/MANAGER
:
..
Name r t:'Tia i�ViJi�T�f 1 Name
Hcme
�.
Address ,f!gor2^ �i Yr -. 'c � Address
LL City n� vim_ Tel: }iome Iel.
;
THIS USI_• WOULD.;BF D'ES.CRIBED. AS:
NEWLY CONSTAOCTE=D ULDG- 'CHANGE OF OWNER CHANGE O� OCCUPANT..
3
._ EXtSTjNQ 13tJILbING CHANGE OF USE �' ADiOITIONAL OCCUPANT'
rl=
indicate lor.iner use at any ' �1t�v�bywe.c C..+z— . w _Occupancy GrOiv.
OCCUPI 0 x..
J
SQUARE FT: OF BUILDING TO BE
,.
$ii
t
NOTICE.. license b.uild6g,has beer t!
. Will not bo issued until.the
7 ;' occupancy-ot ahy bulldmg.is prohibited and a business
":
>.: Ihspected.end a -certificate or':occupancyis issued.'
2. � No electric t seCrice writ be leased for any existing, buildinguntil. the service has been insp@cfed anri
;'.'
}
:
certifled sale. Ali.applicants for occupancy. In an existing building are required lo:schedble an Plectricai
-
k,
fuse up mspecllol.in the.Depactrrient of Community Development atthe time this application;is:fited
3.: CS�artge of occupancy or use. inspectiotl feie.Vhenever it is necessary to make in$pection of a building �r
'.
ptehrises iri ;�rder to determine If a Chang' eibaybemade in the characterof occupancy oruseofthe buildina
>t'
or. premises Which would.place'the building in a. different. division of,the same group of occupancy orin.�a
`'
tflfferent group.of occupancy, a change of occupancy1nspection fee' Ofi
7
-•. be .paid to. the city'
4 .: Hujitingtan ]Beach Eire Code Section'10,208 requires that building numbers 60st be.p rnihimum of four 4'
;
iholies in height.wi.th',orie,haif (rrx),inch stroke, and of a'contrasting color from the background. These
!:•
4
, numbers mu;a be masted or}.your.huiiding Ina Iodation that is vislble.rrom the street.
i
Hunti,nLjtan Seach:i�ire_Code $ecifpn;10.3b1 requires fire extinguisher.selection and.distributionper thc'
l •:
i National Fire Protection Association pamphlet 10 (see reverse side),
,,
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.:
TRAFFIC IMPACT t � J►{r///�/ /' �%
f3A E 0Aliei'.
3.
• 1hOk: ¢F'FtCln tiS
NA�AE, E ONLY)
ZONING
OCCUPANCY GROUP PLAN CHECK NO NO, PARKING SPACE
OCGUPAN7,16Ab. _�__� PERMIT NO: � HEALTH DEP1. APPROVAL
17b.:6� STOR ES'-..— -�- ADMiN: AG7il7N __ 1�71LIT1E5:AElEASEG
CERTIFICATE OF OCCUPANCY FEE
r 'PfiQVEO' $Y DATE . CHANGE .OF USE OR OCCUPANCY: FEE ; g
TOTAL .•
'
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s-oa9Fias+ l�s .. GOI iMUs`TtT D VELOPMEN ;
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