HomeMy WebLinkAbout120 5th St - CofO (6)Ja
i
HUNF MON OVACH
6�0 106 nC�g31
CERTIFICATE OF OCCUPANCY - trza -
CITY OF HUNTINGTON BEACH
DEPT. OF BUILDING & SAFETY APPLICATION
714/536-5241
(3" 4 Floor --Must Apply In -Person)
Business License # 200 Date '4f l $116
Business Address /,�D _6 �+� �¢, +luvrl9 nQ11NI ':F3ryah- Zip Code g21p4K
Business Owners Name -Toro ��N Woyld wldr I Telephone No.gc(q-4t/0 -21310
Business Name.-r-1 0CM / WgAelWafig, A&eel cas i rx Bus. Phone gl4q - Nqo - 2log
Business Type �"'
Property Owner information (required) Te.nant/Einemency Contact (required)
Name C ! Name E9hM MW'=
Address 14V jbilOOGI Mud 9(.i7 Home Address _2z,2! - C=11z&d6d:E__
Cit3'LILOOd State/ZIP a' qoda Cityl&a State/Zip _ CA- Cl 27di;--
Telephone No.1323 - YU -tea Telephone No. 0741q-70-17
THIS USE WOULD BE DESCRIBED AS:
& Newly Constructed Building.-_ or ❑ Existing Building
CHECK ALL THAT APPLY:
Change of Property Owner Mange of Occupant [3Change ofUse OAdditional Occupant
■ Indicate former type of business— t,.J 0
Are you requesting that,the electricity be turned on? YesQ NoO
■ Is the building sprinldered? Yes® NoD
A Will operations produce dust/wood shavings or similar material? Yes❑ , Noll
l
d Will operations involve the repair or replacement of automobile parts YesQ Nod! If yes; Describe the
components repaired or replaced.
Does the operation involve the use of welding or open flame? YesQ No®
o Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes QNo 0
The following best describes my operation: IN Office Only ❑ Retail Sales 11 Medical/Dental
0 Warehouse /Manufacturing/Distribution C Restaurant/Take Out Food
(describe process and and product)
❑ Other (describe)
For O cial Use Only
Occ Group: `L � '> Area: ��� Oce Load: b
Oce Group: Area: Occ Load:
Occ Group: Area: Oce Load:
Total Sq Ft Occupied: No. of Stories: TIF Review: Y/ N
Bldg. Permit # ��� ` Entitlement #: Zoning: _
Plnr Initial . Date:3/a 0 PIan Chkr Initials: � Date,5 r'/' 'Ir,sp In
itials• Date.
Conditions of Approval or tither Notes:
Inspection Date:
rod: South Coast
Air Quality Management District
n.' 21865 Copley Drive, Diamond Bar, CA 91765-4182
(909) 396-3529 • http:// www.aqmd.gov
Air Quality Permit Checklist
California Government Code Section 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: —_FhY7GCF_Ani V_&V1d wi Af AM�tZtC4 S i LLC
Property Address: 12G 54", 15t� 2A, r(GO✓ ,
City: U JC CIS— Zip Code: 0l'Z(OyV
Contact Person: tflYCZ Title: QffiCe 5iAtfleVi,56L
Type of Business: i i + ,,, aA Pg0T Telephone:
Fax Number: 01�--- 411Q 2 I0 e-mail address: CK(AHiYC&V)y16C5M0H iCa-S - C61—(
Applicant (Print name): C ��I Yfzj Signature:
Date: 511191110
• Will the facility have any of the following equipment? Yes ❑ No
Charbroiler
Dry cleaning machine
Spray booth
Printing press (screen/lithographic/flexographic)
Internal combustion engine greater than 50 HP (excluding motor vehicles)
Boiler/combustion equipment (greater than 1 million BTU/hr. maximum input)
Abrasive blasting cabinet/room
Baghouse/cartridge-type dust falter/scrubber
Motor fuel storage and dispensing equipment
• Will any of the following operations be performed? Yes ❑ No Ifl
Application of paints or adhesives
Etching, plating, casting, or melting of metals
Molding, extruding, or curing of plastics
Mixing and blending of liquids and/or powders
Storage 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 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).
Revised November 2006