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CERTIFICATE OF OCCUPANCY 10 / 27 / 9 4
CITY OF HUNTINGTON BEACH Date
15246 ; RAId C I STOIC
Districtf
714-373-3300
Address
THE HYPER CORPORkTICE Ter .�_----
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Business Name
i MFG CF" POLYURETHANE
SKATE WHEELS _ Occ. Group
Business Type>
`BUSINESS OWNER/MANAGER
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BUILDING OWNER
TOE PETERSOt
NELSON/VON ULtt HL ll'.
Name _
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Name
2CC` Home 662} SILVERSPUR LN
26440 LA ALANFDA
Address Home 847 -4759
HB; CA
Address
I�ISSIONVIEJO
_ Tel. I
49�g0 City i
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Tel.
City
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Occupant Load _ _ Sprinklers
Construction_ No. of Stories _
t, CONDITIONS OF APPROVAL
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DEPARTMENT OF COMMUNITY DEVELOPMENT
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This Certificate of Occupancy
SHALL BE posted in a conspicuous place on theme
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premises and shall not be removed except by the
by
Building Official.
COMMUNITY DEVELOPMENT
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HEAPPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH19 is
DEPARTMENT DEPARTMENT OF COMMUNITY DEVELOPMENT
HUNTINGTON HWH (PRINT OR TYPE ONLY) DATE '
Address District
Business NameI� rcIAFQ;�7Za�:` Tel -11 �i '93 ° 3 ✓D�
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Business Type��-�-� -5' Occ. Group
BUILDING OWNER BUSINESS OWNERIMANAGER
lJec s bN ��rt A - TPill"A C�L&c�►� #
Name Di:V. Ct9 Name
Home
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Address 24440 LA Af-%TQ #7 Address_ U Q'L-I` eASP*
I, City.%A%S6%qb-)Ak '12J661 Tel.-q— CityRziff"ii.—Home Tel.
THIS USE WOULD BE DESCRIBED AS:1
❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER CHANGE OF OCCUPANT
EXISTING BUILDING❑ CHANGE OF USE ElADDITIONAL OCCUPANT
Indicate former use, if any f1! Fr, ce Occupancy Gr Div.
SQUARE FT. OF BUILDING TO BE OCCUPIED
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(FOR OFFICE USE ONLY)
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SUPPLEMENTAL INFORMATION
ZONINCa
i OCCUPANCY GROUP
PLAN CHECK NO.
NO PARKING SPACES
OCCUPANT LOAD Z
PERMIT NO.
HEALTH DEPT, APPROVAL
NO. OF STO C ADMIN. ACTION
UTILITIES RELEASED
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s /V v�RTIFICATE
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OF OCCUPANCY FEE
$^ r1(
OVED DATE
CHANGE OF USE OR OCCUPANCY FEE
$
TOTAL
$ —
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75.039 Rev. 11/90
COMMUNITY DEVELOPMENT
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SUPPLEMENTAL INFORMATION
1. BUSINESS ADDRESS—��2`�1•-`��S'ri5ca
Ac�L Yr*ibJ�Pr
2;_ Person to contact in case of emergency
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Telephone number:
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3. Does the, building in question have electricity?
❑ Yes
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(a) If No, are you requesting that the electricity be
Yes'
❑ No
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turned on?
'F
�1 Yes '
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4. The building is-sprinklered?
❑ No
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5• Operations will produce dust / wood shavings or similar
❑ Yes
material?
;n No
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6• operations will involve the repair or replacement of
❑ Yes
91 No
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automobile parts?
4;
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if Yes: aired or replaced.;
(a) Describe the components rep
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en flame'?
the operation involve the use of an open
G Yes
,� Na
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(b? Does
A use that will
is drinking, dining or ass�mbly
❑ Yes
7. The business persons.
an occupant load of more than 50 p
No
result in
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8. The �i$Hrrwirr9"_ t describes my operation;
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0lice' Only
e al a es
Warehouse and end product}
/Distribution (describe process
Manufacturing
Restaurant !Take Out Food
Medical / Dental
Other (describe` -----
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TION
NTAL INFORMATION
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L.iyucucu ila7n11tGUiC (J, dSBS_
6.
Flammable fibers - loose
7.
Flammable fibers - baled
8.
Flammable solids
9.
Unstable materials -
10.
Corrosive liquids
11,
Oxidizing material - gases �-
12.
Oxidizing -material - liquids
13.
Oxidizing, material - solids
14.
Organic peroxides
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Nitromethane "'(unstable materials)
" 16..
. AmmowUm nitrate
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17.
Ammonium nitrate compound mixtures
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containing more thEn 60% nitrate
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by weigrit
18.
Highly toxic material and
poisonous gas
19.
Smokeless pow der
20,
Black sporting powder
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I hereby certify that the above information
is true and correct to
the best of my knowledge.
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Signat ire
Date
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Government .Code Section 65850.2(b) requires that the City of Huntington Beach not issue he final
is the requirements of the South-
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certificate of- occupancy unless the applicant has met or meeting
District (AQMD). The Department of Community Development must
Coast Air Quality Management
from AQMD to show the applicant has complied with this law. The check
obtain a written release
list o the reverse side is designed to help the applicant and the building division to meet these
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requirements.
1. The applicant (the same person who applies for permits from the
the check list
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Department of Community Development) must complete
from the Department of Community
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which can be obiained either
Development or at AQMD.
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2. If all boxes in the list are checked "no", the Building Division can accept the
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chec; list as the release.
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3. 1f there are any "yes" answers in the list, the applicant must contact an
396-2000 to find out whether air permits are
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AQMD engineer by calling (714)
required for the propcsed construction project.
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4. If air permits are not required, the applicant will obtain a written release from
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a AQMD.
5. If air permits are required, the applicant must submit the necessary permit
applications before the release can be issued.
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* , g P applicant is
Because of the time it may take for AQMD to go throe h the,above rocedures, the app '
advised to contact AQMD immediately after applying for building permits.
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INFORMATION SUPOLIMENTAL
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STERTICT
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:(�_Y'�..�ei--`�iJ�:..1 �.- !7�Q. + _._ 13�+, iP' .'' ��.�i.� 1
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this formin print and signature:,:: ;
Nacle t.s d +>...0 £ a: re ar rxg
pt, hc,,at 1�.J Signature,
The person preparing,Ws form must be the same person applying for i3widing permits, Pease answer the
following que:.tio as r garding your proposed occupancy of the subject building. IF YOU DO NOT KNOW
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THE P CISWER TO A QUESTION, MARK IN THE „YES" COLUMN:
AWAD PERIWITTfNG CHECKLIST
F
, YES ; NO f
1, Does your facility use any internal combustion engines greater tha9150HP?
2. noes your facility involve mixing, blending, or processing any solvents, K
adhesives, paints or coatings?
6. Dees your facility create any ► usts or smoke? -- —
4. Dori your facilityrefine efine any liquids or solids or reclaim any metals? �
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5. Does your facility plate or coat anything?
6. Does your faci<lty have any combustion equipment (.e, boiler, furnaces,
broiler, baling ovens, etc.) rating greater than 2,000,000 STU1HR? -- --
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7, Does your facility handle'or store solvents or motor fuel? -- --
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6. Do you use or store any acids? _ _ � _ _._
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4 p 9. Do yoasa any chemical pruc:ss?
? 10, Do you use any solvents for clean-up?---'�-- —
11. Are you a dry cleaner, restaurant with a charbroiler, body shop, gasoline . .
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station, primer, or {cart coater?
1 Is the subject building located within one thousand (1,000) feet of any
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school? PROPERTY LINE TO PROPERTY LINE. GRADES K-12.if
you have inarkeo "NO" in all dwolumns, you do not need an Air Quality permit at this time. If you nave marked
_ any quest.i0 0 the "Y'_-.a°' taiumn you must contact the South Goast Air Quality Management District located at:
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21865 E. Copley Drive
Diamond Bar, CA 91755-4182
Please call: Flan Check (909) 696-2000 '
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