Fillable CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT (City of Huntington Beach)

Fill Online, Printable, Fillable, Blank CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT (City of Huntington Beach) Form

Use Fill to complete blank online CITY OF HUNTINGTON BEACH (CA) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT (City of Huntington Beach)

On average this form takes 29 minutes to complete

The CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT (City of Huntington Beach) form is 4 pages long and contains:

  • 0 signatures
  • 94 check-boxes
  • 74 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Huntington Beach

BROWSE CITY OF HUNTINGTON BEACH (CA) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Page 1 of 5
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT
CERTIFICATE - OF - OCCUPANCY O20 -
INSTRUCTIONS: 1. All questions must be answered or designated not applicable (N/A) as appropriate.
2. Applicants are required to declare under penalty of perjury that the statements made herein are true.
3. Complete plans are required to identify all existing and new rooms and equipment. EXCEPTION: Office-to-office without any
tenant improvements.
PLEASE TYPE OR PRINT CLEARLY IN INK
GENERAL INFORMATION
Name of Business:
Business Address (including Suite #, if applicable):
Business Owner Name: Business Phone #:
Mailing Address (if different from above):
Building Type: Newly Constructed Building Existing Building
Reason for Occupancy Change (mark all that apply) : Change of Business Owner
Change of Occupant
Change of Use Additional Occupant to (Name of Primary Occupant):
CONTACT INFORMATION
Property Owner
Name: ________________________________________
Address: ________________________________________
________________________________________
Phone: ________________________________________
Emergency Contact
Name: ________________________________________
Address: ________________________________________
________________________________________
Phone: ________________________________________
BUSINESS OPERATION
Type of Business (mark all applicable): Retail General Office Medical/Dental Office
Assembly
Restaurant/Take Out Manufacturing Warehouse/Storage Automotive Other________________
Detailed Description of Business Operation: _____________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Building/Suite Size: Former Type of Business: Sprinklered: Yes No
Yes No Are you requesting that the electricity to be turned on? A fuse up permit is required if there has been
no electrical service for more than 30 days.
Yes No
Will you be making any improvements to the space,
including any mechanical, electrical, and plumbing
equipment/works? (e.g. new mezzanine, any industrial
ovens, walk-in refrigeration, spray booths, grinders or
metal cutting equipment, cooking equipment, etc.)
If yes, plans, permits and Huntington Beach
Fire Dept. approval is required.
Yes No
Is there a change in business use to a more hazardous
use? (i.e. assembly, manufacturing, warehouse, etc.)
If yes, plans, permits and Huntington Beach
Fire Dept. approval is required.
Page 2 of 5
Yes No Will operations produce dust, wood, plastic, or metal
shavings or similar material?
If yes, duct collection system and approval
from Huntington Beach Fire Dept. is required.
Yes No
Will you be using an existing mezzanine (e.g. for storage)?
Use/Occupancy:
If yes, please specify the use and occupancy of
the mezzanine.
Yes No Will operations involve the repair or replacement of
automobile parts? If yes, describe the components:
If yes, permits are required for lifts, spray
booths, electrical components and all other
related improvements.
Yes No Will the business be a drinking, dining or assembly use
with an occupant load of more than 49 persons?
If yes, plans, permits and Huntington Beach
Fire Dept. approval is required.
Yes No Will there be storage racks, gondolas, or shelving
exceeding 5 feet 9 inches in height?
If yes, plans, permits and Huntington Beach
Fire Dept. approval is required.
Yes No Will any meat products including beef, poultry, and/or
fish be cooked or fried onsite?
If yes, please proceed to the next question.
Yes No Does your facility currently have a grease control device
(i.e. grease trap or grease interceptor)?
If no, submit plans for a new grease control
device to the Building Department.
Yes No Will hazardous material(s) be stored or handled? If yes, Huntington Beach Fire Dept. review and
approval is required.
VERIFICATION
_________
Initials
I hereby acknowledge that I have read the application and state that the information I have provided is
correct and agree to comply with all City Ordinances, State Regulations, and the provisions and conditions
of any permit issued pursuant to this application.
_________
Initials
No Construction Certificate-of-Occupancy:
I certify, under penalty of perjury, that no Tenant Improvements have been or are planned for this
location including installing shelving over 5’-9” high or installing equipment.
Print Name: Owner Agent Other _______________
Signature: Date Signed:
*** FOR OFFICE USE ONLY ***
PLANNING
BUILDING
Entitlement #:
Building Permit #:
Use Permitted: Yes No
OCCUPANCY GROUP
AREA
OCCUPANT LOAD
Zoning:
Parking Meets Code (for use): Yes No
Max Occupancy (per Planning):
APPROVALS
PLANNING Approved by: Date:
FIRE Approved by: Date:
GREASE INTERCEPTOR Verified by: Date:
BUILDING
Approved by:
Date:
Conditions of Approval or Other Notes: _________________________________________________________________
_________________________________________________________________________________________________
Page 3 of 5
South Coast
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
Phone Number (909) 396-3529 http://www.aqmd.gov
Air Quality Permit Checklist
California State Law Code 65850.2 prohibits cities from issuing an occupancy permit to a
business without clearance from
the local air quality agency. This checklist will determine if you need to obtain clearance from the South Coast Air Quality
Management District (AQMD).
Company Name:
Property Address:
City: Zip Code: ___________________________________
Contact Person: Title:
Type of Business: Telephone:
Fax Number E-mail Address:
Applicant (print name): Signature: __________________________ Date:
1. Will the facility release air pollutants, including but not limited to, dust fumes, gas, mist, odors, smoke, vapor, or a
combination of these to the atmosphere?
Yes No
2. Will the facility result of fuel-burning equipment including, but not limited to, boilers, generators, and internal combustion
engines?
Yes No
3. Will the facility result of hazardous materials, including but not limited to, chemical, plastics, rubber, resins, solvents,
paints, and other parts cleaners?
Yes No
4. Will the facility have use of above or underground storage tank? Yes No
5. Will the facility consist of manufacturing, fabrications, finishing, or treatment of wood, metal or plastic products? Yes No
6. Will the facility result in the use of the equipment listed below? Yes No
(Select all that apply)
Abrasive Blasting Cabinet/Room Internal Combustion Engine (rated > 50 bhp; e.g. back-up generator)
Air Conditioning System (containing > 50 lbs of refrigerant) Mixing/Blending of Liquids and/or Powders
Application of Paints/Adhesive/Resins Molding /Extruding/Curing of Plastic
Baghouse/Dust Collector Pharmaceutical/Nutraceutical
Bakery Oven (gas fired) Plasma/Laser Cutter
Boiler/Water Heater (max. heat input = or > 1 million BTU/hr) Printing/Coating/Drying
Charbroiler/Smoker Production of Fumes/Dust/Smoke/Odors
Coffee Roaster/Afterbunner Refrigeration Systems (containing > 50 lbs of refrigeration
Deep Fryer (excluding equipment located at eating establishment) Soldering Oven
Dry Cleaning Equipment Spray Booth
Electrostatic Precipitator Storage of Acids/Solvents/Organics Liquids/Fuels
Fermentation Storage Silos (sugar, flour, etc.)
Gasoline Storage & Dispensing Equipment
If you answered “No” to any of the above questions and your facility will not have the following
equipment listed, this checklist is your clearance from AQMD. If you answered “Yes” to either question,
you must contact AQMD to determine if air quality
permits are required. If permits are needed, AQMD will
assist you in submitting permit
application(s) and then provide you with a clearance letter. You can call AQMD
at their Small
Business Assistance Office at 1-800-CUT-SMOG (1-800-288-7664).
HUNTINGTON BEACH FIRE DEPARTMENT
FIRE PREVENTION DIVISION
2000 MAIN STREET • HUNTINGTON BEACH, CA 92648
(714) 536-5676 • FAX (714) 374-1551
Page 4 of 5
Fire Only
File #:
FP:
FIRE PREVENTION – BUSINESS DATA SHEET
For new Certificates of Occupancy
Business Name: Start Date:
Business Address: ________________________________________________________________________________
Number Street Unit Zip Code
Billing Address: same as business__________________________________________________________________
Business Contact: ________________________________ ________________ _______________________
Emergency Contact:_______________________________ ________________ _______________________
(24-hour) Name Phone Email
Description of Business:
Will there be any of the following uses on the premise?
Storage >6 feet Welding Special amusements (escape room or similar) Motor vehicle repair
If yes, describe:
Will there be any of the following equipment (E =existing equipment, A = adding or new equipment)
___ Dry cleaning – list solvent ___ Industrial oven – list fuel
___ Propane patio heaters – # of heaters, # of spares ___ Cooking equipment (fryers, ovens, pizza conveyor, etc.)
___ Backup generators – list fuel ___ Walk in refrigerators or coolers – list size, refrigerant
___ Spray booth or dipping tank ___ Tents or air supported structure
___ Grinding/milling equipment that creates ___ Fuel dispensing (including storage tanks)
combustible dust ___ Carbonated beverage system – list total pounds of CO
2
If yes, provide details (e.g., number, fuel, size, etc.) ________________________________________
Does the building have any of the following features (E =existing feature, A = adding feature)
___ Sprinkler system ___ Other fire suppression system
___ Fire alarm system ___ Smoke detectors
___ Other detectors (e.g, methane) ___ Other alarm system
___ Private fire hydrants ___ Battery systems
___ Fire pump ___ Methane barrier or other methane control installed
If yes, provide details
Does the business handle any of the following:
YES
NO
55 gallons or more of a liquid hazardous material or hazardous waste.
Compressed gas (or liquid/cryogenic equivalent) of 200 cubic feet or more
Inert compressed gas (e.g., argon, nitrogen, helium) of 1,000 cubic feet or
more.
500 pounds or more of a solid hazardous material or hazardous waste.
Extremely hazardous material or radioactive material
I certify, under the penalty of perjury, that the above information is true and correct to the best of my knowledge.
Signature: __________________________________ Title: ________________________________Date: ____________
✔
✔
✔
HUNTINGTON BEACH FIRE DEPARTMENT
FIRE PREVENTION DIVISION
2000 MAIN STREET • HUNTINGTON BEACH, CA 92648
(714) 536-5676 • FAX (714) 374-1551
Page 5 of 5
Fire Only
File #:
FP:
IMPORTANT INFORMATION
ABOUT HAZARDOUS MATERIAL DISCLOSURE
If you are subject to hazardous material disclosure there are important steps you need to take.
We encourage you to reduce your hazardous material inventory below disclosure amounts to avoid
fees and inspections. However, if your business requires hazardous materials equal to or in excess of
disclosure amounts, you must comply.
A Fire Department representative will contact you to verify the information you submitted for your
Business License. If you are subject to this program, you will need to:
Disclose online,
Businesses must disclose on-line either through either (but not both):
o Orange County ESubmit portal (https://www.esubmit.ocgov.com/home/)
o California Environmental Reporting System (CERS) (http://cers.calepa.ca.gov/)
Business must disclose information on the following forms:
o Business Activities
o Business Owner/Operator
Identification
o Chemical Description
o An Annotated Site Map
o Emergency Plan.
You are encouraged to proceed directly to either online disclosure system and begin the
disclosure process. Failure to disclose is a violation and subject to significant fines and
penalties.
Annually review and certify your online disclosure.
Update your Business Emergency Plan every three years.
Pay an annual HMDP fee. The fee is determined based on number and quantity of
hazardous materials handled at your facility.
Inform your landlord if you operate in a leased or rental property that you are subject to
hazardous material disclosure. These are done in writing and sample forms are available on
our web site.
Receive an inspection by the Fire Department’s Hazardous Materials Program Specialist, at
a minimum of once every three years.
If you have question or are unsure whether you need to disclose please call (714) 536-5469 or (714)
536-5676. You can also obtain additional information on the City’s website at www.surfcity-hb.org on
the Fire Department page under the section Fire Prevention.
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT (City of Huntington Beach)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 23 July 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document