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HomeMy WebLinkAbout120 5th St - CofO (8)Sent By: CPMC; ti 760 202 9074; Feb-10-09 18:39; Page 1 10 714/536-5271 CertiiiGate of Occupan-ey No. O200q.-06) '7S ��_= APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH - DEPT. OF BUILDING & SAFETY (Y4 Floor - Muvt Apply ln-Person) usines5 License # A 27 74o � Date z � /� _....�...............�.� �— 13ttsitless Address t,za s��7Fr',,..,... l a © "Lip Code G'.2. L—..�... Business Owners Name 4 C._ Telephone Nc�__3.r Z_ Business Name n/e r, y ( Bus. Phone Business Type X !'ropetty Owner Information (required) Tenant/Eme. rgcngv Contact -(required) Name Yyl G t'der Name G aer"e r � Address .,..- T , r............,,I -.,1lome Address / v'11�s�..GP City 4' ��State/'Lip ,.,.__ fir,, g City State/Zip - / / D Telephone Nu...._,��-:.,�_._���� ._� y` �d 'Telephone No. —��� W �P �• �" �".��... THIS USE WOULD BE; DESCRIBED AS: Newly Constructed Building or i::i Existing; Ouilding C TIEC:K ALL THAT APPLY: Change of Property Owner iJ Change of Occupant 0 Change of Use L., Additional Occupant M Indicate fornier type of business • _ _....... .., ■ Are you requesting that the electri-city be turned on'? YesQNon ■ Is the building sprinklered? Ves.?NoD ■ Will operations produce dust/wood shavings or similar materialT YesQNqp�- ■ Will operations involve the repair or replacement of automobile parts Yes QNo 1 Y If yes: Describe the components repaired or replaced.�� M Does the operation involve the use of welding or open flame? Yes QNo 0 w Will the busines's be. a drinking, dining or assembly use with an occupant lead of more than 50 persons'! Ye. r ii e.. r-,, No � .� ■ 'The following best describes my operation: n Office Only n Retail Sales ! 1 Medical/mental ZRestaurant/Take Out Food ri Warehouse /Manufacturing/Distribution (describe process and end product) _", (f /'*Zd-J7G�-sp Other (describe) For C ie ial Use Ural)'. Occ Oroup:— ►—., ...-......,Y Area: _�._. occ Load:..,.u. Ucc Group:_..,,.,..._........ Area: Ucc Load Ucc Group:_._.._,.._Area: Ucc Load•_ , w„ _ 'Total Sq Ft.Occupie:d:-­ 17V No. of Stories: a t sr► 'FIF Review: Y/ N - }31dg. Permit. t Entitlement t Zoning: �- qr Plnr Initials: _ _ Date: _ W ~ _ Plan Chkr initials: , �Date_ Aj 11sp Initials. � Date: Conditions of Approval or Other Notes: Inspection Date: kC;:nuildiligiFonns,,document id goes here,) Sent By, CPMC; 760 202 9074; t r `--'- Sot.lth Coast Air Quality Management District 21865 L, Copley Drive Diamond Bar, CA 91765-4182 (909) 396-3529 htpp,//www.agmd.gov Feb-10-09 18:39; Page 2/3 Air Quality Permit Checklist C ii-ilifornia (iuvernment Code 65850.2 prohibits cities from issuing a Certificate of occupancy to a business without c)earanee frorn the local air quality agency. This checklist will determine if you need to obtain clearance from the .riuwh Coast Air Quality Management District (AQMD). Company Name:arL............. Properiv ,Address: 'Lip Code: Contact Person: _ l9 � r�D ^T Title: _�f Lk4,C. iir :Pf 2s rz� Type of Business: e- A--, r%✓ Telephone: () _ r ll�.� •C� l' a� Appli(*ot: (print name) ....... �(,�.n`....k 6 � . Signature: -- ,\Vial the Facility have any of the following equipment? Yes 0No f�� Charbroiler Dry cleaning machine Spray Booth Printing Press (screen/lithographic/flexographic) Internal combustion engine (greater than 50HP) (excluding motor vehicles) Moiler/combustion equipment (greater than 2 million BTU/hr. maximum input) Abrasive blasting cabinet/room 13aghouse/cartridge type dust filter/scrubber Motor fuel storage and dispensing equipment WjH any of the following operations be performed'? Yes []No E-T Application of paints or adhesives Ftching plating, casting, or melting of metals M0141iRg and blending of liquids and/or powders `+too -age of acids, solvents, organic liquids or fuels Production of acids, solvents, organic liquids. or fuels Production of fumes, dust, smoke or strong odors If you answered "No" to both questions, 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 pt:nnits are needed, AQMD will assist you in submitting permit application(s) and then provide you with a clearance letter, Vou can call AQMD at their Small Husiness Assistance Office at (800) 388-2121,