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HomeMy WebLinkAbout10001 Adams Ave - CofO (4)�. �"a'00j6oDLIy0L-_1 Co Certificate of Occupancy_.Nd. �0� J 714/536-5241 APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH -- DEPT. OF BUILDING & SAFETY RncinPec T.irPneP"# � � � I � v v (3rd Floor — Must Apply In -Person) Business Address ( S # ' Business Owners Name 4 MAe <_n Business Name !:22?, �JGS G@► , Business Type Date lo[40[0!P Zip Code ! jf 2lv,44- Telephone No. Bus. Phone Property Owner Information (required) Tenant/Emergency Contact (required) Name eo{MLcy Name �CRfL�'fyNfila COt; Address LJ4_ AO CAA_ Home Address City SM ID Q State/Zip CA g7jV, City0 044W4 State/Zip ( . Telephone No. « t%6,?) _()09 Telephone No. 424.1`700 THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or X Existing Building CHECK ALL THAT APPLY: ❑ Change of Property Owner XChange of Occupant ❑ Change of Use ❑ ■ Indicate former type of business S R1!((J1 ■ Are you requesting that the electricity be turned on? Ye TO ■ Is the building sprinklered? Yes Q N 0 • Will operations produce dust/wood shavings or similar material? YesQNd ■ Will operations involve the repair or replacement of automobile parts Yes QN6X components repaired or replaced. ■ Does the operation involve the use of welding or open flame? Yes QNo ■ Will the bu iness be a drinking, dining or assembly use with an occupant load of more than 50 persons? Yes QNo° ■ T e following best describes my operation: 0 Office Only /Retail Sales ❑ Restaurant/Take Out Food ❑ Warehouse /Manufacturing/Distribution (describe process and end product) ❑ Other (describe) For Official Use Onl Additional Occupant If yes: Describe the Medical/Dental Oce Group: As, $ Area: c` �y1 Occ Load: y Occ Group: Area: Occ Load: Occ Group: Area: Occ Load: Total Sq Ft Occupied:_ 8 Ct y No. of Stories: TIF Review: Y/ N Bldg. Permit # Ul_ — I-AL10(,� titlement #: Zoning: Plnr Initials:r„!)e-- Date: 10/1 41a Date: Insp Initials: Date: Conditions of Approval or Other Notes: J)- 2zoq -3 1 In Inspection Date: (G:Building/Forms/document id goes here) . - `Z 0 1 South Coast Air Quality Management District 21865 E. Copley Drive Diamond Bar, CA 91765-4182 (909) 396-3529 htpp://www.agmd.gov Air Quality Permit Checklist California Government Code 65850.2 prohibits cities from issuing a Certificate of Occupancy 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). w Company Name: S'iR0lar�s Property Address: 1 c©cs� 1 AD AW, City: Vh"hff W WC4 Zip Code: q 2646 Contact Person: 13 WD"1 mot.., Title: C4)NV7t . �fZ Type of Business: A! > Telephone: () 1 C7 Applicant: (print name) -T0M �' Signature: Q Will the facility have any of the following equipment? Yes ONO Charbroiler Dry cleaning machine Spray Booth Printing Press (screen/lithographic/flexographic) Internal combustion engine (greater than 50BP) (excluding motor vehicles) Boiler/combustion equipment (greater than 2 million BTU/hr. maximum input) Abrasive blasting cabinet/room Baghouse/cartridge type dust filter/scrubber Motor fuel storage and dispensing equipment Q Will any of the following operations be performed? Yes 0 No Application of paints or adhesives Etching, plating, casting, or melting of metals Molding and blending of liquids and/or powders Storage of acids, solvents, organic liquids or fuels Production of acids, solvents, organic liquids, or fuels Production of fumes, dust, smoke or strong odors Q If you answered "No" to both questions, this checklist is your clearance from AQMD. Q 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 (800) 388-2121. �. �"a'00j6oDLIy0L-_1 Co Certificate of Occu .Nd-- J 714/536-5241 APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH -- DEPT. OF BUILDING & SAFETY (3rd Floor — Must Apply In -Person) RncinPec T.irPneP'# R'�_ A I b y v nntP lofiiOlDi/ Business Address S AW# ' Zip Code ! jf 2lv,44- Business Owners Name 4 MAe <_n Telephone No. Business Name !:22?, �JGS G1a , Bus. Phone Business Type Property Owner Information (required) Tenant/Emergency Contact (required) Name eo{MLcy Name �CRfL�'�yNfila COt; Address LJ4_ AO CAA_ Home Address City SM ID Q State/Zip CA g7jV, City0 044W4 State/Zip ( . Telephone No. S%- q6,?) ...� 0 Telephone No. ;%! •1a06 THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or X Existing Building CHECK ALL THAT APPLY: ❑ Change of Property Owner XChange of Occupant ❑ CChange of Use ❑ ■ Indicate former type of business S R1!((J1 ■ Are you requesting that the electricity be turned on? YeTo ■ Is the building sprinklered? Yes QNo • Will operations produce dust/wood shavings or similar material? Yes QNd ■ Will operations involve the repair or replacement of automobile parts Yes QN6X components repaired or replaced. ■ Does the operation involve the use of welding or open flame? Yes QNo ■ Will the bu iness be a drinking, dining or assembly use with an occupant load of more than 50 persons? Yes QNo° ■ T e following best describes my operation: 0 Office Only /Retail Sales ❑ Restaurant/Take Out Food ❑ Warehouse /Manufacturing/Distribution (describe process and end product) ❑ Other (describe) For Official Use Onl Additional Occupant If yes: Describe the Medical/Dental Oce Group: As, $ Area: c` �y1 Occ Load: y Occ Group: Area: Occ Load: Occ Group: Area: Occ Load: Total Sq Ft Occupied:_ 8 Ct y No. of Stories: TIF Review: Y/ N Bldg. Permit # Ul_ — I-AL10(,� titlement #: Zoning: Plnr Initials:r„!)e-- Date: 10/1 41a Date: Insp Initials: Date: Conditions of Approval or Other Notes: J)- 2zoq -3 1 In Inspection Date: U (G:Building/Fonns/document id goes here) . South Coast Air Quality Management District 21865 E. Copley Drive Diamond Bar, CA 91765-4182 (909) 396-3529 htpp://www.agmd.gov Air Quality Permit Checklist California Government Code 65850.2 prohibits cities from issuing a Certificate of Occupancy 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). w Company Name: Ic->—S Property Address: 1 C>06� 1 AD AW, City: Zip Code:�(� Contact Person: 13 WD"1 mot.., Title: CWW7 . �fZ Type of Business: A! > Telephone: () 1 C7 Applicant: (print name): T0M �' Signature: LID Q Will the facility have any of the following equipment? Yes Q NO Charbroiler Dry cleaning machine Spray Booth Printing Press (screen/lithographic/flexographic) Internal combustion engine (greater than 50BP) (excluding motor vehicles) Boiler/combustion equipment (greater than 2 million BTU/hr. maximum input) Abrasive blasting cabinet/room Baghouse/cartridge type dust filter/scrubber Motor fuel storage and dispensing equipment Q Will any of the following operations be performed? Yes Q No Application of paints or adhesives Etching, plating, casting, or melting of metals Molding and blending of liquids and/or powders Storage of acids, solvents, organic liquids or fuels Production of acids, solvents, organic liquids, or fuels Production of fumes, dust, smoke or strong odors Q If you answered "No" to both questions, this checklist is your clearance from AQMD. Q 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 (800) 388-2121.