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15131 Triton Ln - CofO (108)
s ». 9) r,? 'j APPLICATION FOR CERTIFICATE OF OCCUIP Y CITY OF HUNTINGTON BEACH ' E+irvtuv4TM +?E DEPARTMENT OF DEVELQ --NT SERVICES (0 ra Nf {..rx f z"PE;�NI.Y' DATE Addresr, D'.S#rict Busines; Name Wt -5v4ti/ C95 , TIA Business Tyte � ?- : Occ Group---- ' 13t.IILI)IN4, OWNER '— —r-� - BUSINESS OWNERfMANAGGR Name ,,,,� rsartia , � 6. AddressLICr S Jaz HomeAddres 8 ��1Orx r City- $ �M _ Cl� CiiY V-''�- L4 Home 7eI, 7 THIS USE WOULD BE DESCRIBED A:;. NEWLY CONSTRUCTEE? Bt,DG. � CHA'4GE OF OTNNER k"! CHANGE OF OCCUPANT EXISTING BUILDiNC. CHANGE OF USE � ADDITIONAL OCCUPANT Indicate farmer use. it `�^}+ ..fit t. Gr. f7w I SQUARE FT OF SUILOING TO BE t)GCUptE(3::26, NOTICE. I: Occupancy of any building is_prohibar;r,7 anj a bul,;ineSs license will not be issued until the builcbng has " beer, lm: rpected and a certificate of occupancy is t.SSued. - 2. No electrical service will be e!ClaSed for any exisfing,pullding ur ri! tlf Service tree been inspected and certified safe: Ali appiicarats for occ:uoarIcy ,n . r, exes ng building are required to Schedule an elec'ricai Juse up` inspection jr. PhA Cepartment GI Development Services at the tirrje thi application is fitecr 3. Change of Occupancy or Free inspection tee. i'dr,enf,ve it is npc.essary !o make inspection of a building Or premises in order to detesmiri!• if c;riar, e may be made in the character Of occupancy or use of the building Or prNrniues which would place the building in a different division Of the -Qarne grotto Of Occupancy or in a different group of occupant'V a Change? of Occuppancy inspeati; n fee of �r Shail be paid to the city. -�^ -- 4 Huntington Beach Fire Code Section M, 208 regta rm-,1kiat building numbers must be a minimum of four (4) tnMhes in heigFt with one half t : z j inch stroke, and of a contrasting color from the background. These numbers rriust be posted on your building in a Location that is v;sible from the street.S. Huntington Beach Fire Code Section 10,301 repuerFs fire extinguisher selection and distribution p~r the National Fire Protection Assoeiatio!� pamphlet tv fsee reverse side>, (FOR OFFICE USE ONLY),_ SUPPLEMENTAL INFORMATION CCUPANT faROUP_ {`3-^e _ PLAN ctir-CK NO _-�..._.-�..,�.,.-- NO. PAt3KING SPACES NO. OF STORIES _ .�,.: Pet MIT NO. — _ ___ HEALTH VAEPT, APPr?OVAL NO. OF STORIES ADMIN ACTION--_ UTILlTIBS RELEASED CERTIOCATE C F OC'UPANC' FEE ' APPROVED BY D,'�a CHA?';Gi CF €.;SP Oki OCCUPANCY FEE $ �M TOTAL $ 71,34+39 ri v i APPLICATIONN FOR CE1itTIFICATF OF OCCUPANCY CITY OF HUNTINGTON PEACH. - DEPARTMENT OF BUILDING & SATE T Y (3" ' Floor — Must Apply fit -Person) Business License #1 Date 1 7- i t"3 Addressi!;L3 1 —rg-`ttow l--N ' '�-"yi 4 i C is -�A'JtaC14`) Busine .:Nartie Telephone '7f14) 'SI L-1 Business Type kyI E= irs ► _t,t _?` -\I . t&' - 1141EO Business Owner Name �if'N �tt�t'�-c' Dame 2-, i�aY Address l� o L Home Address L. t T 2-' Tel, -7,q,ro --2n1 City &�-il)THIS SE 'WOULD i3E DESCRIBED AS: ❑irewly Constructed Building or Existing Building CHECK ALL TI-]AT APPLY: QChange of 0wrer, Change ofOccupant 1Change of Use ©Additional Occupant lndicat=,a-^nneruse, *tfany Does the building have electricity? Yes NOD if No, are you requesting, that the electri ity be turned on? Yes El No ❑ The building is sprinklered? Yest! NOS Operations -vvill product dust/Nvood shavings or similar material? Yes 0 No � Operations will involve the repair or replacement of automobile parts Yes ElNo U. If yes: Describe the components ropaired or replaced, Does the operations involve the use of welding or open flame? Yes El No d 'the business is drinking, dining or assembl_ use that will result in an occupant'load of more than SO persons. Yes rl No' b" The following best describes my operation: d Ofrice Only Cl rtetail Sales O%4edicallDernal ❑ Restaurant/Take Out Food *Varehouse Oi%4anu acluringr'Distr'ibutioii (describe process and end product) Other (describe Office Use illtly: Zoning:� Sq, .Ft OccupiedOec Group: ace Load:� , 11 Stories, Parking Spaces- TlF Review YIN Amt. Paid$: Paid DEFOR6 rrjuat ligcaion Building Permit # lwntitlement #: Comments. E.c .� Planner rnttials: ��" HAZARDOUS MATERIALS DISCLOSU RE INFORNLMON Huntington Beach Fire Department s California Health and. Safety Code requires the Fire Department to regulate businesses that handle hazardous materials, Motor oil, hydraulic fluids, gasoline, dry cleaning fluid, etc., are considered hazardous materials and niust be disclosed. If you use, handle or store hazardous materials or waste materials equal to or in excess of the following basic quantities, your are required to disclose: • 55 gallons of liquid 500 pounds of solid 200 cubic feet of -'compressed gas • Any amount of radioactive materials • Any amount of Class A. explosive a • Any amount ofchemieals known to cause cancer =1 • Ariy amount of commercial pesticides £, Reportable quantity of any chernical' on EPA. Extremely Hazardous Materials Substance List _ _ a Di*;closure is not required for the following: i 1. Hazardous substances contained in food, drug, cosmetic or tobacco products. 2. T. on approval. of the Fire Chief, hazardous materials contained sol ;ly in consumer products packaged for use by and distributed to the general public, however; pesticides, Ixerbicides, and; am;nonium z nitrate fertilizers over the required disclosure amounts are not exempt .from disclosure. 3. The transportation of hazardous materials accompanied by shipping papers prepared in accordance with the provisions of49 Code of Federal Regulations. 4, bJfectious waste generated by healthcare facilities that are regulated under Title22 of the California ? Administrative Code; Chezk one of the following: i to chemicals are used, handled or stored at this business. Chernicals are used, handled or stored, to this business, but: do not meet the requirements for disclosure Chemicals are used, handled or stored at this business. Disetosure forms will be seat to yom prnounts will be verified by the Fire Department during annual inspections. It is unlawful for any person to knowingly violate any provision of this ordinance, 4 I certify, under the penaltyafperjury, that the above infonnatiort is true and correct to the best o f my knowledge. Sigrxatitre 1 . :Date 2" Home Phone, Please call 7.14 5'364676 with questions regarding the :Hazardous Materials Program. s`. A. `�fl'J , ... c .. �.IYs''�]v'-' a .. .. ,. .ra ➢.i.�w.':.r. .._ ., _. .. __ a.. d. 1; _d 1 l , i . t LSouth Coast Air Quality Management District 21865 E. Copley Drive Diamond Bar, CA 91765-4182 (909) 396-3529 htpp://www.aqmd.gov Air Quality Permit Cheeklist California Government Code 65850.2 prohibits cities from issuing a Certificate of Occupancy to a business without clearance from the local air quality ag,etacy. This checklist Nvill determine if yo+.t need to obtain clearance from the South Coast Air Quality Management District (AQMD). Company Name:�C lc� Property Address: City: f Zip Code: Contact Person; L� % Title: RSIr i' Type of Business: Telephone; () I --- Applicant. (print name) M76r'� l i•, ,t C� Signature• 'I`` /� I^ Will the facility have any of the following equipments Yes Cl No Charbrotler Dry cleaning machine Spray Booth Printing Press (screen/lithographie/flexographic) Internal combustion engine (greater than 50HP) (excluding motor vehicles) Boiler/combustion. equipment (greater tha i 2 million BTUAir. maximum input) Abrasive blasting cabinetlroorn Baghouse/cartridge typ y= dust filter/scrubber I Motor fuel storage and dispensing equipment 1 • Will any of the following operations be performed? yes ❑ No " Application ofpamts or adhesives Etching, plating, casting, or melting of metals Molding and blending of liqu ds and/or powders Y Storage of acids, -solvents, orgaiuc liquids or fuels Production of acids, solvents, organic liquids, or fuels Production of fumes, dust, smoke or strong odors • If you answered'Vo" to 4-00� questions, this checklist is your clearance fror. AQMD, a • If you answered "'Yes" to either question, you must contact AQMD to determine if air quality permits are required. Ifpernts are needed, AQMD will assist you in submitting permit applications) and then provide you with a clearance letter.YOU can call AQAdj) .at their Small Business Assistance office at (800) 388-2121 `