HomeMy WebLinkAbout15131 Triton Ln - CofO (113)V APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT
4 _' 6 - 0 Ci
TUN MA&H (PRINT OR TYPE ONLY) DATE
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Address District
Business Name SC n� ti C (ial to oi- Tel.
Business Type Occ. Group t%
BUILDING OWNER BUSINESS OWNER/MANAGER
.ne —(,hn 0c) 1Liurr2. Name Pj�r�, jJcUrl Hee-
Aoa, ss h 142 i)c)9ct /k✓a # lot Home 1�� hCGtSc nj G f`
Address
City r-(f.r,'f'iYlcol Tel- jity f,-" _Home Tel.
THIS USE WOULD BE DESCRIBED AS:
❑ NEWLY CONSTRUCTED BLDG. CHANGE OF OWNER ❑ CHANGE OF OCCUPANT
EXISTING BUILDING 4 q❑ CIgANGE (A USE ❑ ADDITIONAL OCCUPANT
ajl�,el�Li��4�/�
indicate former use, if any Occupancy Gr. Div.
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SQUARE FT. OF BUILDING TO BE OCC'1PIED 'The—IL37
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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 alectrical service will be released for any existing building until the service has been inspected and
certified safe. All applicants for occupancy in an existh,g uuilding are required to scher'ule an electrical
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'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 building or
premises in order to determine if a change may be made in the character of occupancy or use ofthe 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.
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4. Huntington Beach Fire Code Section 10.208 rc quires that building numbers must be a minimum of four(4)
inches in height with one half (1/2) inch stroke, •^ of a contrasting color from the backgrourd. 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):
TRAFFIC IMPACT FEE
DATE PAID
AMOUNT RECEIVED _. __ (FOR OFFICE USE ONLY)
NAME ZONING
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OCCUPANCY GROUP PLAN CHECK N0. NO PARKING SPACES
OCCUPANT LOAD PERMIT NG. A
HEALTH DEPT APPROVAL
NO. OF STORIES ► ADMIN ACTION
UTILITIES RELEASED I' 4
6.4� &Wa/u
7
6�Z�-1 CERTIFICATE OF OCCUPANCY FEE
(APPROVED BY DATE CHANGE OF USE OR OCCUPANCY FEE
TOTAL $ ;
7s-osaRev. vsr COMHiUNITY DEVELuTINIENT
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SUPPLEMENTAL WFORMATION
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1.
BUSINESS ADDRESS '5_13( -th !�
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2.
Person to contact in case of emergency.:_ Itj -�4r1 -
Telephone
g36c
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number:SGon Svl[�
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3.
Does the building in question have electricity?
�
�Yes
(a) If No, are you requesting that the electricity be
C No l
turned on?
Yes
CI No i
4.
The building is sprinklered?
IR Yes
5.
Operations will produce dust / wood shavings or similar
❑ No
material
❑ Yes
b.
Operations will involve the repair or re la
automobile p cement of
Cl No
❑Yes
parts?
No
If Yes:
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(a) Describe the components repaired or .replaced.
a
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(b) Does the operation involve the use of an open flame?
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❑ yes
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The business is drinking, dining or assembly use that
result, in
will
No
an occupant load of more than 50 persons.
Yes
8.
The following best describes my operation;,
Q No
Office Only
Retail Sales
.`
Warehouse
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Manufacturing / Distribution (describe process and end
product)
Restaurant / Take out Food
Me Kcal ental
Other (describe)
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$UPPLEMENTAL INFORMATION
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t1FPLEMfiNTAt__RMA_ INFORMATION (Continued)
Does
the operation involve any of the following materials? Cl Yes
ANo
r if
Yes, indicate quantities:
Material
r
Quantity
Flammable liquids
Class I -A
Class I-B
Class I-C ------
2.
Combustible liquids i
Class 11
Class III -A — }
3.
Cornbination flammable Vquids {
4.
Flammab16 gases
5.
Liquefied flammable gases -
6.
Flammable fibers - loose
7.
Flammable fibers - baled
8.
Flammable solids
g.
Unstable materials —
10.
Corresive liquids
11.
Oxidizing material - gp,es
12.
Oxidizing material - ,,quids
13
Oxidizing material, - solids--------
14,
Organic peroxides
15,
Nitromethane (unstable materials)
16.
Ammonium nitrate
17.
j
Ammonium nitrate compound mixtures
containing more than by
60% nitrate
weight
18
Highly taxis material and �
Poisonous gas
19•
Smokeless powder 1—
20.
Black sporting powder
I hereby certify that the above information is true and correct to
the best of my knowledge.
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— 6 b Q-)
Signature
Date
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South Coast
AIR QUALITY MANAGEMENT DISTRICT
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21865 E. Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-2000
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AIR QUALITY PERMIT IT CHECKLIST
for nonresidential buildings only
Company Name: S �n clz �! G(n U 0I; rn ifiQ�
Location ofPro ertS'� Fy l5 ! 3 ( ' fc-n 1-"el #r(23
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City: H (W(n1- m 13eoai
Zip Code 164 q
Contact Person: ',6 11 Hey,
— Title: _ 0 o ne r
Telephone Number: (014) 8 Q 2-- 6 3 _ Fax Number: 1
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Type of IndustryBusiness: S�
To apply for a nonresidential building permit, you must complete this checklist.
questions about completing this checklist, please call (800) 388-2121. If you have any
` 1. Will the facility have a charbroiler? YES NO
2. Will any internal combustion engine with greater than ] EX]
operate at the facility (excluding motor vehicles)? ]I
3. Will operations at the facility involve mixing, blending, or processing of
solvents, adhesives, paints or coatings? 1
4. WilI dust or smoke be generated at the facility? I ] E i
5. 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? 1�
7. Will any combustion, equipment rated greater than 2,000,000 BTU/hr be [ [�
operated at the facility?
8. Will any acids, solvents, motor fuel be used or stored at the facility? ]
9. Will any,organic liquids �2r gases be reacted orproduced?
10. Will any ovens be used to dry or cure products at the facility? ]
II. Will anCFC j
``y (Freon) re;.ycling machines. operate at the facility?
Applicant: iy 6-A t .0 61
Signature:
(Print name clearly) 1
4 If you have marked "NO" in all the boxes, an air quality permit is —t needed at this time,
and this checklist is your written release.
If you marked "YES" in any of the boxes, you must contact the South Coast Air Quality
Management district (AQMD). please read the requirements on the back of the checklist. {
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(800) 388-2121
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ACDITtONAL SUPPLEMENTAL INFORMATION
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