HomeMy WebLinkAbout15131 Triton Ln - CofO (14)APPLICATION FOR CERTIFICATE Or OCCUPANCY
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT
HUNTINGrON BEACH (PRINT OR T"PE ONLY( DATE
dress/ //`//0,0 410 '#/O /� 1j^,V (CX / aC �� District
stness Name11,6/�% 11,1'.r�s Tel.
Rginess Type Z&aC _ Occ. Group
BUILDING OWNER BUSINESS OWNERIMANAGER
_\
�yame /i`%/�L/,g��� /?9a'.0 1� t�lame Vzimz,5 %/e6
ress
%ome
�30 Sc). 5CV2?/ is ��� lie cress 3/2�
--Home Tel.
I'
THIS USE WOULD BE DESCRIBED AS:
}
❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER CHANGE OF OCCUPANT
EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT
Indicate former use, if any Occupancy Gr Div.
SQUARE FT. OF BUILDING TO BE OCCUPIED303
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OTICE: 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 inspr ied,and
certified safe. All applicants for occupancy in an existing building are required to schedule an electrical
'fuse up' inspection in the Department of Community Development at the time this application is filed.
3. Change of occupancy or use inspection fee Whenever it is necessary to make inspection of a building or j
premises in orderto determine if a change maybe made in the character of occupancy or use of the building
or premises which would place the building in 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 in height with one half (1/2) inch stroke, and of a contrasting color from the background. These T,
numbers must be posted on your building in a location that is visible from the street. 4c
5, Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection and distribution per the is
National Fire Protection Association pamphlet 10 (see reverse sid
IV
,/�
(FOR OFFICE USE ONLY) s
SUPPL/MENTAL INFORMATION ZONING
OCCUPANCY GROUP PLAN CHECK NO. NO PARKING SPACES
OCCUPANT LOAD PERMIT NO HEAL PT APPROVAL-,i
NO. OF STORIES ADMIN. ACTION U ITIES RELEASED l;
2 CERTIFICATE OF OCCUPANCY FEE S , I'
API E BY t ATE CHANGE OF USE OR OCCUPANCY FEE g
TOTAL
75-039 Rev. 11190 COMMUNITY DEVELOPMENT i
i_
a
SUPPLEMENTAL INFORMATION
1.
BUSINESS Xf /`3 �h, *167 4� ,2c
�,19
ADDRESS
2.
Person to contact in case of emergency- 7 4F^WA9
4'
Telephone number: ;39l1.29d
3.
Does the building in question have electricity)
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
F
material?
❑ Yes'
® No
i;
6.
Operations will involve the repair or replacement of
❑ Yes
automobile parts?
No
t
If Yes,,
(a) Describe the components repaired or replaced.
(
)
(b) Does the operation involve the use of an open flame?
El Yes
CJ No
I
7.
The business is drinking, dining or assembly use that will
result in an occupant Toad of more than 50 persons.
❑ Yes
No
8.
The following best describes my operation;
Office Only
R Sales
1,
Warehouse X
Manufacturing / Distribution (describe process , and end product)
I"
i,
j'
Restaurant/Take Out Food
Medical /Dental
Other (describe)
x
f,
SUPPLIMENTALINFORMA`iION
i
�.
SUPPLEMENTAL INFORMATION
(Conti(lued}.
Does"',the oIoer'atto'n ': Irfloly ' any `of 'the' folfowl g 'ate-
11
iafs? 'f Nos
if Yes, indicdtd-4uantitiesr._. Quantity
SViateriai
1. itammable liquids
Class I -A
Class I-B
----
,'
Class l-C
�.
Combustible liquids
Class !l
"
Class 111-A
3.
Combination flammable liquids
4.
Flammable gases
5,
Liquefied flammable gases
i`
6.
Flammable fibers - loose
l
7.
Flammable fibers - baled
i
8.
Flammable solids
is
g.
Unstable materials
{,
10.
Corrosive liquids
11.
Oxidizing material - gases
12.
Oxidizing material - liquids
13.
Oxidizing material - solids
14.
Organic peroxides
15.
Nitromethane (unstable materials)
16,
Ammonium nitrate
17.
Ammonium nitra, ^ompound mixtures
it
containing more an 60% nitrate
i
by weight
18.
Highly toxic material and
poisonous gas
19.
5Smokeless powder
>.
20.
Black sporting powder
z
k
I ove information is
hereby certify than the ab
true and correct to
'
th bes knowledge.
R
/�-
0 /=
[ate
Signature
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SOUTH COAST AIR
QL7ALITY biANAGEMEIIT DISTRICT, '
(Nonresidential Buildings only)/
/
Location of Subject- Property: �, `i/ .37�'"//
Property Owner Name: ,_.i�E,lc� /�/!�f/� phone r� � ,
�ri_nt
;ame of. the Person preparingthis form in 1
Signature : `
person
Or
applying
The person preparing acing this form must be the sa questions regarding
c.rmits. Please answer the Eollovring q
building p'
arO�osed ccr,upanc.y of t:he subject;�f,Si1�:nTUMtd:Tr i'QiJ n0 NQ`I° KNOt7
rtlt r t I >'f ! t)d7 MARK I N 'I'lll?
ltC�hS{) PI?R?•it"i l']NG I:
k
•j. i.. t•!t)
F t:
V
1 DuLti
Your {rrc:)li,.;, usc: any oil
int,r;,},}1 c OmTnr:;!.i
C,ngines clrr rt, r !ban 50
processing Arc f l,' 11'. v i!
cir coatings'? t , cn clr: c,! snurlcc:`? i
} I)aCS your f ac r 1 , -'t cs 2;nr, l :y itl:` r.)i sc)1 i�iti a
you,' I ); ,
Uoc,s , .
or r:eC]trirn any n)r ;y{.} in {
your < {� 1. r,v rr)n (. ;. ; „tc In") },r„ +ar,t'
Lott: u r hd4 l ��cl Oven
i.e. ho�]er, ,urn�rcc.s, _._
i.e. raked groater than 2,000,nao fITU/itR7
Nandie or: st:c,•r, sOlvc"nts tar
Your [ac.iIiI,y 6
Dees y i/
motor. Euel'•
Do you use or store any acids? �
g Doyou use any chemica] {,roc:ess"?
10.
Do you use any so]venLS for clean
]]. Are you a dry cleaner, r:c:<;t.aur,:)G ~•,tilt )
c.harlDroilei , body shop' gaso].i,te station,
printer, or [)art enp rer)
;2, Is the subjerL building to aLnd
000hiic)lh)in on(!
t
;
thousand fl, )
PROPERTY LINE TO PROt'E"It'I`t LINE. Glznnl.::� IC•-1.7..
r f d "NO" in all columns, you do not need i.n
an T,ir
Quality permit at this Lime. if- you have marked, any questions you have marke
the "YES" Column you must contact the South Coast Air Quality
Manage
District located at:
27.865 E • Copley Drive
Diamond Bar, CA 91765-4132
Please call: Plan Check
714) 396-2000
(136od-2)
City ,of Huntin.gto nbeach
a. 2000 MAIN STREET CALIFORNIA92648
' '�
..1j DEPARTMENT OF COMMUNITY DEVELOPMENT
,.-,'�,`�, .:cam-w=r :�t•:
Building Division 536.5241
Piann;ng Division 536.5271
Government Code Section 65850.2(b) requires the City of Hunting Lon
Beach Building Division not to issue the final certificate of
occupancy unless the applicant has met or is meeting the
r.equiremeni,s Of the SouLh Coast Air Quality Management District
(AnMl'1) The Cui].dinq Division must obtain a vrr iLten elease from
hQt-i(1 to shoe Lhe appl ic.Ernt: has complied with t 1)1 s 7 a�: The (;heck
lisl, on the reverse aide is desi.c� d to help Lhe applrcant: and tiu
in) il-ling clivision Ln ment Lhesc rrgtrirerncitt:s. }
hhc. applicant. (trhe a(iGr1U 0L)p_1_a4�__.lr-._tit rmil's ,Cram
11�0 Utii1�7i1iy Di,vaS9��) mu cornplc t.r. t:h(check list which
Can het obLain,etl tither at Lhe Btliltliny Drvisinn or at AC�VtI`�.
i.
2. if rll box('; in l;he li st are r_heckcicl "ncr Lnr Ilui ldinq r
List rr; the r:e:c.aSe.
1)i v i s ion car; ,w r.pt. tlrc, char ,; k
3. if there are any "yes" an5%rers in thre list, the applicant
I
must; ::ontacL ar-r AQMD engi1)Cer }ay ca1.lir.g (714) 396--2.,000 Lo
find Out Whethcr air. permits are -required EOr the proposed
Coiiz;l ru(;ti.(n project:. if
11 If El r permits are not
Gyuiicc), lie ap( >l icanl• will obtain
a 4,ritten release from nQhtU }y
5, 1r air permits are required', the 'applicant inu,L :yularnil. t.hc:
neGessar.y pei-miC aI)pIi.Cati0ns berore the rele'ise can 1.u:
issued.`
of the time iL may Lake [or ,AQI�113 to go through tlrt,, above
Because
p1.Ocedur.es, L•he applicant i.s advised to ConLat:t nQrv1) rnunr(iaLrly
' rL't:ur apr)lyi.ng Col.-Iiuil(ling Pe -emits.
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(1360D)
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RTIFICATE OF OCCUPANCY
APPLICATION FOR CL
(`3`f Floor — Must Apply In-Perven)
Business License
Address lc [ 8�1 —Mt ;xs
Business Name tz Telephone
Business Tvve
�1 rrer
;FitEi ertc�;. 0111.act Inforrrtatrt�it �usineg ,Qvriter
awe
Natne
Add;ss r ,..., Florae Address
City -►� A wj. _ � ��.��� City ��� �• ���. � �: �����
TII C l'§i 'W!J ULD DE D'BS CRIBEM AS,
New;y C.oastmeled Building or 8EXisting Building
CIIECK ALL THAT APPLY:
C2(7haw!e df 0vvner C ha)ige of Occul ant UC bange f l,:rse ClAdd tional tccupant
indicate ;Rvi'i e trsi�, i and
Does the building have electricity? Yes
If Nox are you regtiesting that th); elecuichy be tumed uio Ves ':] No
The buildirg is sltri klered`l Yes Nt00
)peration.� v61I ��i ?tduct dt s6voo s21"rivingv Or :"irailar I21aleriall Yes N70.0
laer"Itions x ill in olvv The repair or re lat eroeui crlTitmctiaaob le }Marts ices NN
'cs: Des,. rite the e�riatpon ttts i� 1? iz°e�i or re lacc t#.
I'l.e t siaaess i4, kiri king- dWIT or assets°altlr use dot will result in anoccupant load
of m(ov than 50 Persons, Yes
"Ehe xq)xiCjkvmg lg;°,at describes my aperai9ion.,
ts';s; 4'letall dalesedicai:easaZesiatirrttaaloe Out Food tars lipase I„ttat tt k a;*rt4> i titihi7ti stt fdeseribe process and end product)
4
i. �., w�.....�.-�ww::,*,....,..-x.r..�:.,.wax+....m.+.+.:«., ..-.-�+.....:..-way+.-.�......•..,..c.w.,+«*..�-++ — .,...—.r.+..,..
� 70
OtPer zics rill;:,
V'se- yy. �..�..�...�,.�..w.:..�.�.,...__.,�-....,.�,�.�...�.�.�..�...,..-..--.�....�.�_.,...r.�.„.K...;,.�...��..��,,...,....,�._.,�.�.,��..:�.-µ-w--i t rF,.f'S"�rrx Jl t4�
Sq Ft occupied.' Oco Group, Oce Load
0: st'xws. � Parking SPaces: _ TIF Roview: W N Aizat Pya��tyy�i ;. y
^pp 4 E4 Sln;i fit? F4 �h»Lt r
,�'�oi%t at .,«y-•.,::w...««,...,....:.: Fntj1jeir Ant, 4.
# k MIMU9
gy
k3'x `! .� # `��0 #i i Cl COM
i ,��...v�w,-mr ^�:�r•,... ..»,,.�s+w-,.Mw.r a�a.,�*,-,-,..»...w....,.�..a...,.s:+�:.p�s«.,.K..4«.,s+w�,«..,a� `";uc.w. ;;.�, - r�.Tw.»,. �/iv....
♦+'4^ u+:`.av+rirr'focrc°aaxw!t'13RF+r.N4 9*»+r,4�"am�X^'+a"�WfYaaBro-v...-.y.-�:
77.�#
APPLICATION FOR CER.TMICATE OF OCCUPANCY
CIT 1 OF HC1NTINGTONT BEACH - DEPARTIVIENT OF BUJ'i..DI.N-G & SA.F�'TY i
(3"' F loor*— APO Appljr In -Person)
Btus tress License ,,4;
ate; �J2-,..lj�a
near n� = ssnt t ini+ rn7 t?a� uga€nqs, w mr
Address, � ? a� .� Rome Address
City �t 3 MCA Tel, - . 3L. city Tel.
0;k*ewly Construmd Building or 813xisfing Buji ua
CRECK ALL THAT A.i'PLY Off."Ilangeof0wner C'i ange of Occupant CIChangoofUse OAdditional Occupant
iJocs rite: b<sll.tir��; list cleetrie its° 'es OD
I
f No, are you requestingthat the clectricity be turned W. yes 0 Nr0 x
The buildlt g ,*�::�,prizzklere4? Ias 0 \t01j
Ci txion; r3 ,YI prodmet dusVNVAXc d sh-- ings or simil ir° material? Ws -D �co
(Jilzialioni will ulvoh, tY3� iC ,ii: � R� t� j�l ii; 3t�G'i 1 tfaEii k.ii loll pa0 Ye'S �o'
It :;" % The evi:"kI) new w lvpll wee$,
i9, 3 tl,a = rntiti r involvethe use; ol'w4ding r open fiame°l Yescl No Q
'File busrifless is drinkmg, , dit ing r assaR-ibly use tint will result in an. occupant load
(if more tfran 50 Perso#ts. `Yei ,..j NO
The i01lo. ing bcv dme y �a ribes ml�c�mion:
11 Office . ;, 0RemiI Sales Q.MedieaMental 0Restauranttrake Oct l.7a0a `varvltmse
J:(doscribe p,oc-tssand end product)
Of
Y _ I
P .t$13E-K.JkF I' as 1`4 ' i�L
CofO
p
y y:«r.�w:w.kaw„rr+`+aean..aorw+'+w�w�.ei.nu;.+w..e .'++*.ewe++.++r•—:w..s�..w:vww.».r..m�
}x.�rr lr�i st�II.I 3'tarr "leeltrt T itials3"' .� l
»,
VF
South Coast
Air Qua lty ainagement District
21865 E. Copley Drive
Diamond )Bar, CA 91765-4182
(909) 396-3529 htpp-,//wwNv.aqmd.gov
Air Quality Permit Checklist
California Government Code 6500.2 prohibits cities from issuing a Cez fscate of Occupancy to a business
r ivithout clearance from the localair quality agency. This checklist will, determine if you need to obtain
i
clearance from. the South Coast Air QuaUty Iv.Ianagern L,--t 74, a° c;t (AQ ).
f
Company Na-.= ►3 v ►z o C'+ . .
Property Address: k5t 3 w '" rY1,Tzr►j t ►J t s'"t
City, . 3, Zip Code: gL�
. Contact Pcrson; Tale
Type of'Business: �t +r..a rm*�-"'-a�s�f-„�►«+rTelelahorte. (j 't,� �g c P
Applicant: (print name) Signatures
Will the facibtyhave any of the foLoMng equipment? Yes Q No ID
Charbroiler
Dry cleaning machine
Spxay Booth
j Printing Dress (sercenAit iogzaphic/texographic)
! Interrial combustion, engine (greater than 5011P) (excluding motor vehicles)
13oilerlcombustioa equipment (greater than 2 ini. on 8TU/hr. maximum input)
Abrasive tale; Ling cabimt/roora
13aghoase,/cartridge type dust filter%scrubber
Motor fuel storage and dispensing equipment
Will any of the following operations, tee performed? Yes Q Na
Application otpaints or adhesives
Etchirtg, plating, casting, or melting of metals
Molding and blending of liquids and/or powders
Steerage of acids, solvents, organic liquids or fuels
Froducliott ofacids, solvents, organic 'Hquids, or f'uets
Production of fi : s, dust, smok-. or strongodors
*'If you ans-veered "Vo" to both questions, this chec'lclist s":� your elearanco from AQUD. 1
* If you, answered "Yee' to either question, you must contact AQMD to determine if air quality permits are
required. Ifpermits aloe neede-d, AQMD will: assist you in subn4tting,permit applications) and then provide you
with a clearance letter; You can call AONU) at their Small. Business Assistance Office,at (800) 388-271,21. a
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�kPPLICATION FOR CERTIFICATE OF OCCUPANCY
TY a CI T�'?t T¢J �"'BE;A.�CH - DEPARTMENT OF DVILDI O & SAFET'�x
(3 :Floor - Mast Apply fnPervon)
3)
Business License Date
Address 1061 1 .s �„ e t a
Biuiness Name Lic. At_oc,��� �� ~� Telephone -` [1-k"' C U-64, `
Business Type <�d-Waz
feet Information Business Owner
game te- � � _ . -e— -- --Name � .� � *� .�'a �- �?�•-w
AddressPc� t"1' Marne cress rc._��z.! �'r
City ►: ' yt -gvW t cxTeL 33q1_
TfUS USE, ti'VOULL SIE DESCR BED AS: �
JNTew"dv Constructed Building or ZgEtisdng 13uil ling
CHECK ALL TRAT APPLY-
0 Change of Owner &(Change ofOccupant 'OChange of Use UAdditidnal. Occupam
Indicate former Use, if any
Does the building have electricity? Yes. -INTO
If No, are you, requesting that the electriciLy bt: turrie any? Yes Q No fl
'the building is sprinklered? Yes W NO
Operatimts will product dust tivood shvings or similar material? Yes No
Operations Nvill involve the repair or replacemeait of autdtaobib., pants 'fires 1'410I
If yes: Describe the components repaired or replaced.
acs th operation involve the Use of weld ing or apart flame? Yes El c? r''
17he business is drinking,, dining or assembly use that will result in an occupant load
of more than 50 persons. Yes C No
The following best describes my operation:
U0ffjce-4WF- QRetall Sales Q.lvfedical/Dezntal ORestaUTanYrake Out Pood Q&Warehouse i
ar?uf cturing°T7istril ttiil . (describe process and end product)
a
Other (descdbe)
__
a l�f Ice s rx7s .
Zoniog .. Sq Ft Occupied. Occ Group, Occ Loads
#� Sttarit s; Parking Spaces. T T.1F Review.- Yt N Arnt PaidS; �AM
1
7aad Ft f I ri. 3nsp ton
lauild'11% P'a h 44 Ent tlernent' ,_
I i�iruUaer initiaS. �,d i',.-�,,.»..•.,�._.,......:._.«.-....
it
CERTIFICATE OF OCCUPANCY EVALUATION FORM
GENERAL BUILDING INFORMATION
Oww mm A teu andlac stige N.
Ei ergete"y cpnkad Phone nwber
Z3ceerpda�Cji Gass pOmary use(s) 3 sq- Fi :
occupani l��i;
7y9aa cansttti�fcian
Stwlm & ktalght(M
Spti Wm uaa0
Ci5kar tnr�4KISA
7] tltctsnca
QtJngrtgkkerl area
ClO it bout cczss4n+ctkon
oklia
SIRrN lncreaea
OChapter 9
Area snowed;"
flaxta
Yaid;
Atsa smparakk!n Spt4 kd1r2
For multi-skoried and mkxed toe aetaah-s aeparats work shKet or 111t ide to sketab area _
Attach work sheets by Planniti of Fire it rnvided �4�
S. i t .� X 3 3 i i i 71 3:
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a APPLICATION FOR CERTIFICATE OF OCCUPANCY'
CITY of 1ifJNTINGTON BEACH
DEPACiTMENT NSF COtr MUNMY OEVELOPMENT
IS.M�r,44firPKH 11*/r..lY {HtirFi-r7ilG>'"r -
tFSa P,J ful 7P.,I, o �.Gf �'� I ! ��C! ��r e ,( ►��v 7 <... «. i}rrttt r i . , +- ., - ..w
a
.�1�:! �,GI+U• ,,;,t.�#"jtt!l r✓ «�.M,,.,.. 'C tacup..._._.a.-.-.---
f,� A ntJtttit4ltr'li'ardrr � � Ism{�r'tltrstlYlti,.i'/!'fAttfCwaFYI
P��V4j. Ra'.f'f%
f �y ,
...�'i�n `l,� �S•Pr�tF�,C,'�aTf,� 'sd/pG
yWiraSli.L1o.,.[�.�'.,� .�.s:.sJV/+.��IrS ,..«.. N +� p �.• _
11
rf�y�.W1J.�%.(!Y_ �i%,. �i�5'r'i �s tr> �.�`Y`.�4'$��,i,'' ��F•/if�g�,,,.�,�F1,°,I�+3^+dc�.,�ttymzi.�r}'� !t
rvp
IS USE WOULD BE DESCRIBED ASR
NEWLY CON�fRt3i; 40 t1i U" t t t,Aittii r r iitrjtiifil {�^��cjwi ,. 0f upwv
EYISTING BUILOihti L r,aii#'rt`st ter ;)S( L J Ai)tltiiCiNAt QC i:UPAN,"
lritST10E I Cacciiparicyot'anyboildoigisprohihitedand abusiness ticer{sew. 111nolbaissueduntiltha:buitdh}ghasbeen
inspecled and a cerhfivile Of OCC,iflnncy is issod
No alestrlcxt xrrvmcit Wiit be taiedsed lot an emisting" ui}diisq Until the rrrvica h�s tse9a ins�scirs! arid
b
certttied sate. All appllbar;ls tot `-oe cuparioy On Angrt+�ling tuifdtnq ate re puirad to sCheitute an eCectrici3C
`fusis up" inspection in the .pepadmenrtf=Of Comi-MY ReveCbpmartl at the Ume this app iCation is; hied, ,
Change at odczipenc :ar use IniP:ctiAn leer�lfhknevot it is necessary to make, inspection at abuilding or
z
premises' in order to drictrmne ata obarigampybd :matte in the ct ar<arterpt o4cupancY otuse of the, building
or premises wheth would plicia the buildc.lig An a 00erenR divisionn cil the sarlie gruup of occuparicy Orin a
dittcteot gt"O of O"VP''tnCy. Z Chinge of occtipw ncy tnspgr0on lea of s 0AA
be paid to the city
d Huntington Beach Ftrr Cady Sactlan itl 20#t regtliras that building numbs: s must be a minimum of tout (A)
inches in height with one hmll t14I inch spoke. and of A conlcosling COtot from tha background, These
nurtijets must be pointed on your building in 1+ tocigtion that is visible item the street.
5 10t requ+res fire extinguish-s selection and distribution per the
Nuttttngtan R•+<ch Fite Coda Section 10
y;�Cattonof Fite ratection ABsottalis}n p.imphfol 10 (st'e revelsesid (,
t
� (FOR OFFICE USE ONLY}
SUPPL. MENTAL INFORMAPOt{ s rtr ttJt""< �w M
f t?Gtrt3PANGYiiROC1p PtAt¢tIitCKits3 «„ tit) r+kfi,CltiGat;PAfC5 _ --
OCCUPANT LOAD t rttkli li
td 2 » , t nt r f f AI`PItC Y
!Jp ` &tQrii S n--- .•• Atit.tll'fi ACTItal^3.,,.« «« _ tt strlC.gArLfASEt7
C;Etlii tc.A1E � t�t~ttr�r}tt,�r }:t l 5 ..........�<—..�.-.. r..
A tiY A7 C►iANOC OF US( (ttOCCUPANCY I t L
s Total a -
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},