HomeMy WebLinkAbout15131 Triton Ln - CofO (76);
AMPLICATiON FOR CERTIFICATE 0 O 0ANCY
CITY OF HUNT VGTQN BEACH 4 ", �3
DEPARTMENT OF DEVELOPMENT SERVICES
-... tiliNTINGTc9FY N6tCifi :. "'Prn' i'r+ , r "t. a',9•t"_ i DATE.
i
1dress _ _ _ D1S1tiCt
reastness Name—�' t �....•_._._ !et` Tit.
....Ausintess Type i l lc�''lii?l:��t1 _ Occ. r roup
8011 iIN6 OW ER 6JSEIVEfiS OWN;�R!-M��AVIAGER
it
Acres
CeFy—� Trt +ty i Lr� w x woe is
THIS USE WOULD BE DESCRIEED AS:
NEWLY CONSTR'UU,3 E}t.OG CHAriUE �. F 01AINER CHANGE OF OCCUPANT
L-7 EkiSTING (3UR i3 NG L 1 GHANGF OF USE ADLIMONAL OCCOPANT
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Sr'liAFi> t 'T O Rt1tt UrN€.: TO, 8F
NOTICE. Cret pa cy of any ht;bong a prc r,o wd < ark a wx"M s Name WM not be towed ,,nm the niusis mg has
been insper ea and a ceritficate of i<, 1t�
i n. No electrical service Cvitf be 'Meased Q any exi ttr a WkImi I unit t"lf s n64v_,ks-itd'::'.4?en itispe@ ted and �
cert fted 8ato,. A}t' appii.,,.iwls fo; f C a.Il:3Cf'v in af,, exisling 1'itltiang are requ4'ed to schedule an =Mcal t
`fuse? ,•p' ink Ction tr'! !hry Depi irtinort? of the nine this anpiication is filed,
:3Change of occupancy or use inSpeadon fee. ilt'enevt ")Fp HIion of a bullCittig
C Cr orerfwies pi rrder Fc dWermine if a change ay by ri idz? i; t th'� i'11,3f ct, r t�1 or may or use of the
!' btnP inn or ptemrn;,-ies v ,IC`; laE3tlitj f.face $he bud Ing in a diffi ient if V -9L)n of Ithe same group of occupancy
G« Ina ;tif8 en! LT-ouc 04, aws tit _lt cy, a &,inge fit i)cca . ncv im;:)eclion +Vt of
shail be pai0_to the city,
4.� Huntington Beach Fire Code Section , ^0P regii:res`that buitd nth a rrininium of four
(:; inches 4 }y, gv an t?" hat` Car:;t of a color lrt n the MckgrOur d! These
raumt fu s ir,ust te posted an yam 'bwWMg 0i a ;ocaiion that is vjsi y'ie froin tite Street
S. Huntington Beach Fire Code Sect«)n 10301 1 mquaes We exlinguish r sefeWbn and di5t6putlon per
Ple ijalicn%lt i^I ;° t••"olection ;ltllion pariat" filet 10 Pee rmfi e !•,t( O,
(FOR OFFICE use ONL`ij
SUPPLEMENFALINFOR44ATIOPE
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OCCUPANT LCaAf? t'atlT NO [i,_PT APPROVAL M "
NO OF STIOR FS m / �rAOMIN A;;?'."cif'.__ _ . _ 0TR tT;ES RFLEAaa`ED ._._,_..._....
Orr tit`> JPANCY eEE
t V'P tOV ? Y DATE CRAW, E r tf_ c3oE , iR OCC UP 10 FEE s __, .
TC�TAI. Sr i 4'
z
SJPPLB17ENTAT 7NPOW4ATTON
1.
BUSINESS ADDRESS 5- 3 i TRITD10 LIV 2 °1✓tr,7 /w?d al�
2.
Persnn to contact in case of emergency:
1
f
Telephone number: -.7 —S<0 76-32
i
3.
Does the building in question have electricity?
ayes 1
*
ONO a
a. if No, are you requesting- that the electricity be
0Yes
turned on?'
O'No
4.
The building is sprinklered?
Ayes
0140 i
5.
operations will produce dust,/wood shavings o s-miler
tataz' al?
Qyes
f
M No
6.
operations wild involve the repair or replacement of
Oyes
'PNO
automobile parts?
If yes:
(a) Describe the components repaired or replaced.;
H
(b) Does the operation involve the use of an openflame?
Oyes
ago
7.
The business is drinking, dining or assembly use that will
result in an occupant load of more than,30 persons.
Oyes
r
QNo
' 8.
The following hest describes my operation:
office only
Retail Sales
Warehouse
Manufacturinq/Distri.butipn (describe process and Cenci
product)
Restauran t/Ta e Out Foac��"
Medical/Dental
f
Otter (describe)
(4562D)
SUPPLEMENTAL iNFORMATION (Continued)
Does
the operation involve any of the fallowing materials? Wes
ONO
IF
Yes, in cate quantltles;
Material Cluantitt
1`.
Flammable liquids,
Class I -A
4
Class T-g
Class I_C �.
2.
Combustible liquids
Class 11
Class III -A
3.
combination flammable liquid
4.
Flammable gases
5.
Liquefied flammab:ases
6.
Flammable fibers —loose
7.
Flammable fibers - baled
8.
Flammable solids
9.
Unstable; materials ,
IG.
Corrosive ,Liquids
11`.
Oxidizing material -mac a�ses
12.
oxidizing material liquids
13.
Oxidizinq material solids
14.
Organic peroxides
15
Nitromethane (unstable materials)'
16.
,Ammonium nitrate
17
Ammonium nitrate compound mixtures
containing more than 60* nil -rate
by weight
18.
Highly toxic material and
_-
poisonous gas
19.
Smokeless powder
' 20.
Black sportiaowder
I hereby certify that the above informatinn i, true and correct to the
bent of my knowledge,
Signatore Date
(0562€)
t1Z,�8/t36)