HomeMy WebLinkAbout15131 Triton Ln - CofO (17)er rl
I'm
APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH''1
t » DEPARTMENT OF BUILDING & SAFETY
iK,�ru Ycy. r e° r , e �A = : i W y "OAT
Address l l I '}�-�-.,�.L._!�.'�.�t.te..'_ 1'` r� f-_ w. District--- /.-
Business NameZ2 . _'=� .. _ ' � .__. Tel
Business Type _ 1' �d �l C,d'� .r. G � __ .. ,H. Occ Group.._,._..-5-..._...
BUILDING OWNER {; tiuS1NE: OWI*VWANAs t R
Name c Wr ,_%2 � C-�> .._, ,_. Namem E ► _ .,Q ,.. .�
Home
Address. s .. ��'... AddreS,
City� TrI 3 -
2
THIS USE WOULD BE DESCRIBED AS:
D NEWL`r CONSTRUCTED L LDG � __J gwk?AraGl lit tl rvrJt ft Y-N CHANOE r IF O(/ UI AtiT
EXISTI14G BUILDING L._� C'HANGI 0r U ak � At DITIONAL Ck4,'�'SS>ANT
Indicate Iotmer o.se ti any.
SQUARE FT OF BUit CLING TO dk
NOTICE: 1 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 sate. All applicants for occupancy in an existing building are required to schedule are electrical
'fuse up' inspection in the Department of Community Development at the time this application is hied. I
3 Change of occupancy or use inspection Ine. 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 buiiding
or premises which would place the building in a different division of the saute group of occupancy or sn a
different group of occupancy, a chant',. of occupancy inspection tee of $ shall
be paid to the city.
4 Huntinqton Beach 'Fire Code Section 10.208 requires thal building numbers roust be a minimum of tour (4)
mchns in height with one half tea:} inch stroke, and of a contrasting color from the background These
numbers must be pasted on your budding in a location that is visible from the street
5 Huntington Beach Fire Code Section 10 301 requires fire .extinguisher selection and distribution per the
National Fire Protectr:m Associal n pamphlet 10 (see reverse side)
r
(FOR OFFICE USE ONLY) r a ZONING. 7::. :
OCCUPANCY GROUP PLAN CHECK NO a NO BARKING SPACE'S
OCCUPANT LOAM � PERMIT NO _ HEALTH DEPT APPROVAL
NO OF TORIES . f X AOMIN ACTION,_ UTILITIES RELEASED
,r
CERTIFICATE OF OCCUPANCY FEE
P tO EIJ By ATE CHANGE OF USE OR OCCUPANCY FEE
TOTAL
Pt %iM +. „;4 iNr ` c "tx, .,ir,rt14 tttri Ti4 kik0
n w°
SUPPLEMENTAL INFORMATION
1,
BUSINESS ADDRESS C
2.
Person to contact in case of emergency
Telephone number: '7lj- s(c -
62-
3.
Does the building in question have electricity?
ar Yes
❑ No
(a) if No, are you requesting that the electricity be
❑ Yes
-turned on?
❑ No
4.
The building is sprinklered?
Yes
Q,No
5.
Operations will produce dust/wood shavings or similar
material ?
❑ Yes
No
6.
Operations will involve the repair or replacement of
❑ Yes
automobile parts?
1 No
E
b
If Yes:
(a) Describe the components repaired or replaced,
(b) Does the operation involve the use of an open
flame? ❑ Yes
R No
7.
The business is drinking, dining or assembly use that
will
result in an occupant load of more than 50 persons.
❑ Yes
U No
S.
The:-foliowhg.,q best describes ;my operation,
t Office On'i°
-rRetai —8i'les
Warehouse
Manufacturing/ Distribution (describe process and end product)
E
Restaurant l Take Out Food
_
r
Medical 1 Dental
f
Other (describe)
i
r
SUPPLEM ENTAL
INFORMATION (Continuedl
Does
the, operation involve any of tt;a
following materials? Yns
*'1'No
i
If
Yes, indicate quantities.
,r��..�.�.�..
Material
Qsrantst
f .larrsmahla
ligsicls
"lass #-A
Class I-B
Class f-C
u�5!'rit5R3Stl�tta [iQiiids
Class ll
Cass lil_A
Cc�r�rbinatiort fla`_m_" Sabi li-gs-rris
.
1, 1Gi y; flamMab1P gases
...m.-
lµi rrsmal xa flb: s loose
�tamm�lu s�lsrf,�
... .......
:... w.wm+... n,.n+......,y:a wu+= , .-..+. . ,..rv--,_.. -„ ..x...ar.._ ., r«.-.w,_.. „n .v.. .. a., ,...-
�•y� q icy
�F gr+mr*4 301 Q.� ..
r
. w...w...... ..... >...+r ...-. . r.. . , w... ....... ..a..v...«r.. .+., .
. ......�.x..
- ,_...,....., ....... ,,.....,....,�.,_d,.....;_..,....,..m.—.......,.u..,.�..:...w......«+.,,.vw.::...,....+-.F.....we..w+„.,..K.,...:s.e,:.�.Awusw..,,s.+na......,.....:+�..,
Corrosive liquids
.,.w.«.�.--......ew.,...,,.w.w�..ar......,...•�n.�:..�......
��
C�+Ai�F6.5Qi i7 AC,4t3sR YC{i L3 a7�aZ
��.
-..>..w...
12.
......:........... .»..,..=,..r r.�.-.-.»�.....,.....�.»..-.,o-ww. ...wr ,.,.. .. ,m.»,...«..>,..._.,...,...>w...........d,.,,t,....
Oxidizing material- - liquids
,.»..,,...e.,......-.,.. .»._.-.w. _. ,. ,,,. �..z,.. »,. _..,...,,... .-.......,,...�.,,.a...,...:....,..r..,�.,,�... ....�r........., .,........
13.
Oxidizing material - solids
'�+�.
Crgansc; p+�rxr�s�s
m ,...
16
Ammonium nitrate
...,w
ate ,compound� mixtures
conta►nmg more than ii% nitrate
by wesght
is
Highly toxic material and
poisonous gas
"g.
Smokeless powder
� sporting powder , .•.� >>.,,..,�..�..�...ww_»...
.,a,..,,�., �_,..._..,..».,..,. .......b
l hereby car ify that the above information is true and correct to
the meat of rn k fudge:
I
Signature
late
e
South Coast
AIR QUALITY MANAGEMENT DISTRICT
21865 E. Copley Drive, Diamond Rar, CA 91765-4182 (909) 396- 000
AIR QUALITY PERART CHECKLIST
for nonresidential buildings only
' Company Name: Q=kM (`
t
Location of Property: I,,'j 1 ?-) \ 4 t
City: �7'R 4 Zip Code:/
Contact Person:+, d t C' rf/IIW</� 9- �/ Title: Cif `
Telephone Number: 7 "1- �� � �^ cj Pax Number. `7 t L r
Type of Industry/Business:
To apply for a nonresidential building permit, you must complete this checklist. If you have any
questions about completing this checklist, please call (800) 388-2I21.
YES
NO
1. Will the facility have a charbroiler?
2 Will any internal combustion engine With greater than SO ;horsepower
operate at the facility (excluding: motor vehicles)? (
t4(l
3. Wilt operations at the facility involve xn xing, blending or processing of
solvents, adhesives, paints or coatings? [
[h9
4. Will dust or smoke be generated at the facility? [ )
[]
6. Will refining of any liquids or solids be done at the facility?
• 6, Will any plating or coating of materials be done at the facility? [
7� Will any combustion equipment rated greater than 2,000,000 BTU/hr be
operated at the facility? [ ]
[DC
8. Will any acids, solvents, or motor fuel be used or stored at the facility?
9. Will any organic `c liquids or gases be reacted or produced?'
10. Will any ovens be used to dry or cure products at the facility?
11. Willi any CFC (Freon) recycling machines operate at the facility?
Applicant- �R 41 C C G t L LZ Signature; {--
(Print name clearly)
If you 1, ive marked "NO"" in & the boxes, an air quality permit is =t needed at this time,
and this checklist is your written release.
Tfyou marked "YES" in any of the boxes, you must contact the South Coast Air Quality
Management District (AQMtD). Please read the requirements on the back of the checklist,
(800) 388-212
a
� °n7, drii,7 i$ '.°t+Y�.. ,«. e%^..a ♦. .�:��., . _. �:9 ..�. ".: �+ �,.,.'. A" a"','�,: i=Y..a.«. �� ,,;=z, to
- s:..,. 4�" oY. &wci.r« 'N.x: •nws.r € �. w.*.':i �al,aab� ... c... 1"x. .�,°6a %,. �:". r �. .rk� C i 'k{.ici xtr et-,�. �
de as _.x <' s toa�� ,..ro 1a : i 3 �.. :Y� :*'��. 'F r .r ae Mg if t«1 :. nr gyp y
a ' vf«t,.. .. :9e!� a �8 ..�? �i,lrt btwy •i :i: �. aMAO W :. « n rr..,. mMut It WOW .x."
o J `..
F. to ra` x . ona «. 1 «f +y, . vs, t, , »k`
n - if Any v s . iL +:% .. .. y., ve + 1 a` • s ,. • Omni... _ p.' 3x ) b n ;,
N"
y
.:; G,.,..," p�,xTri'3,tC'zis" re �iaTiwd arn c,
$?.,ell mmt:t, a'Arrgzcm Mum 14H L>e bxx»
r. $ti ail ^ •':. 4 at":;.y4 ay is e�. ,t- e, +n :,s Aa . .�a k, wakv ea Ss+V .-. iG .i - MA !"Uh litt d, fl-W tn�i� �uu ta�i
:....1"t ° to: «, r.'4't'.: cir.4;"'tiW,.l,iuni ,9 iin.d tL'f'.`s i"^rWre u %voiM,
: x r . :r.o ., '3
:+a.,._. t•,a>? ,.�a1^as+�,:# sa E`x��xs�ss �1., ,_�tcfe�.,��,a.c,� #es.>.5` cqC3eiF.a. However, it, �+aa4''.�' M�*."�'a�1
1
uee a, to ♦er.ik i.,-<:,-*tr�'�.., .»k, ,, �«. wY.:"< 0 fi:."w!.'."t c -1w." £: } d4.a..sc "?1. .. olj +ar,: w�.�it�ti�f'.�U. to co?a-aK a k,QMD
a