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CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
3 a 0 Q / 9 4
Date
Address
3 C 1` 1 T R T`I'f'3i
District
Business Name
P A C T F j C A T ;r (' A R F
Tel.
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r
Business Type
ATR TVICT ? AT R FETT,TFP
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Occ. Group r
BUILDING OWNER
BUSINESS OWNER/MANAGER
Name RREEF
VIANAGEI-MT
Name J j , WILLIAV. S
Home
Address
Addressy J G ^: r rF }r9T—
r �-
Home
City LI, 1,-m l T'
F Tel.
City I; _ r n Tel.
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c'
r
,
Construction
No. of Stories
Occupant Load Sprinklers
CONDITIONS OF APPROVAL
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DEPARTMENT OF COMMUNITY DEVELOPMENT
This Certificate of Occupancy
SHALL BE posted in a conspicuous placr on ti c
premises and shall not be removed except by the by _
Building Official.
COMMUNITY DEVELOPMENT
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APPLICATION FOR CERTIFICATE OF OCCUPANCY
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!.
CITY OF HUNTINGT'ON BEACH
ON DEPARTMENT OF COMMUNITY DEVELOPMENT"
DATE
It.UN11NGTEN BEACH.` (PRINT OR TYPE ONLY)
1
� ,e �E��
boo,
j �� �v\.�Cs7!" S,-��� ��ISZ ��District ,
-
g SRO
�siness NameTel. 1 I I -lei
�� ems"'
Business 1�3'J✓ `s ` p
g1i-�.1,t`o Occ. Giou \
BUSINESS OWNERfMANAGER
Type
BUILDING OWNER
W J
�r
� L ome
/ NameL
Address Address
�� J� ,Ae Tel ,,e City �y.� �N Home Tel .^
CityA c
THIS USE WOULD BE DESCRIBED AS:
' ❑ NEWLY CONSTRUCTED BLDG. ElCHANGE OF OWNER ❑ CHANGE OF OC CUPANT
❑ EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT
Indicate former use, if any Occupancy Gr. Div
SOUARE FT. OF BUILDING TO BE OCCUPIED-i &- $-
NOTICE: 1. Occupancy of any building is prohibited and a business license will not be issued until the building has been
s issued.
'
I
inspected and a certificate: of occupancy I
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 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
premises in order to determine if a change maybe 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 in height with one half (1/2) 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.
Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection and distribution per the
National Fire Protection Association pamphlet 10 (see reverse side).
1
(FOR OFFICE USE ONLY)
ZONING
:SUPPLEMENTAL INFOR
MATION
,- r' SPACES `
K O:
NO. PARKING OCCUPANCY GflOUf PLAN CHECK N
r
OCCUPANT LOAD PERMIT NO.
HEALTH DEPT.APPROVAL
NO. OF OCCUPANT
LOAD
S ADMEN. ACTION UTILITIES RELEASED —
CERTIFICATE OF OCCUPANCY FEE $ttx'����
OVED Y DAT CHANGE OF USE OR OCCUPANCY FEE $
TOTAL $
VOZ
75.039 Rev, 11/90 CommUNIT DEVELOPMENT
SUPPLEMENTAL INFORMATION
1.
BUSINESS ADDRESS
2.
Person to t in case of emergency
1 �,
elephone . . "Lip
3.
Does the building in question have electricity?
El -`Yes
❑ No
(a) If No, are you requesting that the electricity be
❑ Yes
turned on?
❑ No
'.i
4:
The -building is sprinklered?
2Yes
❑ No
5.
Operations wiii produce dust/wood shavings or similar
material?
❑ Yes
�0 1
6.
Operations will involve the repair or replacement of
❑ Yes
automobile parts?
LzJ-tGo
If Yes:
(a) Describe the components repaired or replaced.
(b) Does the operation involve the use of an open flame? ❑ Yes
C�-IVo
7.
The ,business is drinking, dining or assembly use that
will
result in an occupant load of more than 50 persons.
❑ Yes
�o
3.
The following , best describes my operation;
-6ffice Only
Ret� aIT—SaIe
Warehouse
Manufacturing / Distribution (describe processand end
product)'
Restaurant / Take Out Food
Medical / Dental
Other (describe)
WPPLIMENTAL INFORMATION '
`j
SUPPLEMENTAL (Continued)
Does the operation involve . any .of the following matt�ria:ls? ". Yes
if Yes; rn'cfloatu-"�txsl�i�ities � .., .
e_,faorrai Quantity
r I. Flammable liquids
Class 6-A '
Class I-8
Class I-C
2. Combustible liquids
Class 11
Class Ill'
-A _
3, Combination flammable.. liquids
4. Flammable gases _
5. 9dquofled flammable gases
6 lFlammable f,Qers loose T —
7. Flammable fibers - baled
Flammable solids
9. Unstable materials
10. Corrosive liquids -
11. Oxidizing material gases _
1,2. Oxidizing material - -liquids _
13. Oxidizing; material - solidp
14, Organic peroxides
Y 8
1'5 Nitromethane `'(unstai3le materials}
16{, ammonium nitrate
l 17. ammonium nitrate compound mixtures
containing more than 60% nitrate
by weight _
18. Niggly toxic: material and xM,
poisonous gas
SOUTH COAST AIR QUALITY MXNAGEMENT DISTRICT
(Nonresidential Buildings Only)
Location of Subject Property: —
Property Owner Name: Phone #.r1
Name of the Person_ Preparing this form in print and signature
Name: 04 _' %. Signature: `
The person preparing this form must be the same person applying
for
building permits. Please answer the following questions regarding
your proposed occupancy of the subject building. IF YOU DO NOT
KNOW
THE ANSWER TO A QUESTION MARK IN THE "YES" COLUMN:
` AQMD PERMITTING CHECKLIST
YES
NO
1. Does your facility use any internal combustion
engines greater than 50-HP?
2. Does your facilityinvolve mixing, 'blending, or
processing any solvents, adhesives, paints
or coatings?
3. Does your facility create any dusts or smoke?
4. Does 'your 'facility refine any liquids or solids
or 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 2000,000 BTU/HR?
7. Does your facility handle or store solvents or
motor fuel?
8. Do you use or _store any acids?
9. Do you use any chemical process?
10. Do you use any solvents for clean-up? _
11. Are you a dry cleaner, restaurant with a
charbroi ler, body shop, gasoline station,
printer, or part coater?
12. Is the subject building located within one
thousand (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;
21865'E. Copley Drive
Diamond Bar, CA 91765-4182
Please calls Plan Check (714) 396-2000
(1360D-2)
14
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1 CERTIFICATE OF OCCUPANCY r
I 4
' CITY OF HUNTINGTON BEACH 3/09/
Date
Address Ic R T mn to T c District
r Tel. 71it n
Business Name P A t' T F T( fi T R CAM.- R T-. _, - !
Business Type ATR PIlfF ATR 6TTTrr, n-1rP7pI,,rTrT1 Occ. Group
!;
b T `
- BUILDING OWNER. BUSINESS OWNER/MANAGER
Name RREEF f�,ANIAGENEV'T Name j- WILLIARS
j
Home
Address Address] � c c ^
Home
City E1 Mfait717 _ Tel. City E4-, j Cr Tel. r n r,nr
Construction No. of Stories Occupant Load _ E, Sprinklers
u
CONDITIONS ;rF APPROVAL a
I �
1
DEPARTMENT OF COMMUNITY DEVELOPMENT
I
1
This Certificate of Occupancy I a l
4 SHALL BE posted in a conspicuous place on the =�
premises and shall not be removed except by the by _ azz
i
Building Official. '
1 � i
b � i
COMMUNITY DEVELOPMENT
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A APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH 1-51
DEPARTMENT OF COMMUNITY DEVELOPMENT "A' g!
Turmr+cTOWREAGi DATE
(PRINT OR TYPE ONLY(
'-Address -- t-r`?��° � '`�"� —1_.�> .f "`�(g �"- ��e - Di,tnct
siness Name Tel U4 (-, S tO
Business Type tg°d+' �rc.� eS e�....1�. fr�'.✓ �t�v -7t °�� 1�-1 o- _ — Occ Group
BUILDING OWNER BUSINESS C"AINER'MANAGER
Nam " �_ 1�.1a� .tea me 'Get_ Flt� AAA- cal.v�� 1
1 / �fo rr e i
" Address Aodress
city Te; lClty� `Home Tel
tS USE WOULD BE DESCRIBED AS:NEWLY CONSTRUCTED BLDG ❑ CHANGE OF OWNER ❑ CHANGE OF OCCUPANTEXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPAN r
ate former use. d anyOccupancy Gr Div
ARE FT. OF BUILDING TO !3E OCGUPIED`6'.�2�nc{•
f I
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 issues'
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 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
premises in order to determine if a change may be made in the character of occupancy or use of the building
t-
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.
„I 4, Huntington Beach Fire Code Section 10.208 requires that building numbers must be a minimum of four(4)
inches in h.ight with one half (112) 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 fire extinguisher selection and distribution per the
National Fire Protection Association pamphlet 10 (see reverse side).
�- j�' /fir R �•tY
L 3-
(FOR OFFICE USE ONLY)
SUPPLEMENTAL INFORMATION ZONING %�- t
OCCUPANCY GROUP PLAN CHECK NO NO PARKING SPACES
OCCUPANT LOAD f _ PERMIT NO HEALTH DEPT APPROVAL
NO OF STCOIES Q ADMIN ACTION UTILITIES RELEASED g
/ / CERTIFICATE OF OCCUPANCY FEE S ��'
OVED Y DAT CHANGE OF USE OR OCCUPANCY FEE $
TOTAL
f
NITY
Voe
75-039 Rev.11/90 COMMUDEVELOPMENT
SUPPLEMENTAL INFORMATION
1. BUSINESS ADDRESS
2. Person to contact in case of emergency S• vS<<x�c�--�
Telephone number: {(tt( $L((o CLA)
F
3. Does the building in question have electricity? P9 Yes
❑ No
(a) If No, are you requesting that the electricity be ❑ Yes f
turned on? ❑ No
i
4. The building is sprinklered? 2 Yes
❑ No
5. Operations will produce dust/wood shavings or similar
material? ❑ Yes
5. Operations will involve the repair or replacement of ❑ Ves
automobile parts? C9'ffo
f If Yes:
(a) Describe the components repaired or replaced.
i;
is
1:
i�
(b) Does the operation involve the use of an open flame'? ❑ Yes i
4 p-roo ,
7. The business is drinking, dining or assembly use that will -
result in an occupant load of more than 50 persons. ❑ Yes !}
p 8. The following best describes my operation; j
-6ffice Only
l;
Retai ales.
Warehouse I'
Manufacturing / Distribution (describe process and end product)
Restaur, / Take Out Food f:
Medical / Dental
Other (describe)
4
SUPPLIMENTAL INFORMATION
SUPPLEMENTAL INFORMATION (Continued)
f
Does
the operation involve any of the fol!,_,wing materials`?
,
Yes
�I o
If
Yes°, �'ndfcate t�ztantitiEs: '
_Quantity
—
j 1.
Flammable liquids
Class ,-A
Class i-8
i
Class I-C
2.
Combustible liquids
Class 11
Class
3.
Combination flammable liquids
4.
Flammable gases
5.
Liquefied flammable gases
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
t 13.
Oxidizing material - solids
1e
Organic peroxides
1
15.
Nitromethane (unstable materials)
r 16.
_. Ammonium nitrate
17.
Ammonium nitrate compound mixtures
i
1
'
containing more than 60% nitrate
by weight
is.
Highly toxic material and
poisonous gas
19
,+ J
Smokeless powder. ,
20.
t3la,k sporting,; ; powder
. _
I hereby certify that the ove information is true an correct to
the best of my knowledg
Si nature Date
a
I
City of Huntington Beach
« 2000 MAIN STREET CAUFORNIA 92648
r c'L DEPARTMENT OF COMMUNITY DEVELOPMENT
Building 536-5241
Planning 536-5271
Housing 536-5271
i
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Government -Code Section 65850.2(b) requires the City of Huntington
j
Beach Building Division not to issue the final certificate of
occupancy unless the applicant has met or is meeting the
requirements of the South Coast Air Quality Management District
(AQMD). The Building Division must obtain a written release from
P
AQMD to show the applicant has complied with this law. The check
list on the reverse side is designed to help the applicant and the
building division to meet these requirements.
1. The applicant (the same person who applies for permits from
the Building Division) must complete the check list which
can be obtained either at the Building Division or at AQMD.
2. If all boxes in the list are checked "no", the Building
°
Division can accept the check list as the release.
3. If there are any "yes" answers in the list, the applicant
must contact an AQMD engineer by calling (714) 396-2000 to
1
find out whether air permits are required for the proposed
construction project.
r
4. If air permits are not required, the applicant will obtain
a written release from AQMD.
,
5. If air permits are required, the applicar--t must submit the
necessary permit applications before the release can be
issued.
Because of the time it may take for AQMD to go through the above
procedures, the applicant is advised to contact AQMD immediately
after applying f6r Building permits.
4
(1360D)
,
SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT
i
(Nonresidential Buildings Only)
Location of Subject Property:
s
Property Owner Name:��;L.r_A Phone #8
Name of the Person Preparing this form in print and signature
Name:Signature:
The person preparing this form must be the same person applying
for
building permits. Please answer the following questions regarding
your proposed occupancy of the subject building. IF YOU DO NOT
KNOW
i;
THE ANSWER TO A QUESTION MARK IN THE "YES" COLUMN:
i
AQMD PERMITTING CHECKLIST
YES
N0
3
fi
1. Does your facility use any internal combustion
engines greater than 50-HP?
2. Does your facility invi•1ve mixing, blending, or
processing any solvente, adhesives, paints
or coatings?
3. Does your facility create any dusts or smoke?
c/
p
4. Does your facility refine any liquids or solids
or 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 BTU/HR?
7. Does your facility handle or store solvents or
P motor fuel?
✓
s
c 8. Do you use or store any acids?
9. Do you use any chemical process?
10. 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 (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 title. If you have marked any questions
in
the "YES" Column you must contact the South Coast Air Quality
Management District located at:
21865 E. Copley Drive
Diamond Bar, Cep 91765-4182
Please call: Plan Check (714) 396-2000
{
(1360D-2)