Loading...
HomeMy WebLinkAbout10038 Adams Ave - CofOBusiness Licen Business Addrf Business Owne Business Name Business Type Certificate of Occupanev No. 0200vt = `" ` I APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH — DEPT. OF BUILDING & SAFETY (3r" Floor — Must Apply In -Person) Date 0%jZ Zip Code Telephone No. 3 Bus. Phone 49 3 Pro ertOwner Information (required) Tenan /Emer ene Contact (required) Name M11h `Q " Name AW Address Gl Home Address City ON State/Zip City Z,40 j,# State/Zip Telephone No. 71V-q67--71Telephone No.�57 THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or X Existing Building CHECK ALL THAT APPLY: ❑ Change of Property Owner ❑ Change of Occupant ❑ Chan e of Use ■ Indicate former type of business ■ Are you requesting that the electricity be turned on? YesQN0X \ ■ Is the building sprinklered? Yes []No`l�. \_ ■ Will operations produce dust/wood shavings or similar material? YesQN0X ■ Will operations involve the repair or replacement of automobile parts Yes QNoX components repaired or replaced. ■ Does the operation involve the use of welding or open flame? Yes QNo Additional Occupant If yes: Describe the ■ Will the business be a drinking, dining or assembly use with an occupant"load of more than 50 persons? Yes QNo ■ The foIlo ing best describes my o eration: ❑ Office Only ❑ Retail Sales ❑ ❑ Restaurant/Take Out Food Warehouse /Manufacturing/Distribution (describe process and end product ❑ Other (describe) For Official Use Onl Occ Group: Occ Group: Occ Group: Total Sq Ft Occupied: \® 4z Q Bldg. Permit # Area: o ©' Area: Area: No. of Stories: 6� Entitlement #: Medical/Dental Occ Load: Occ Load Occ Load: TIF Review: Y Zoning: CGr Plnr Initials: ),& Date: Plan Chkr I itials: J `M Date: 1 2- Insp Initials:76 Date: 3 z Conditions of Approval or Other Notes: U 1T ��1'js t�� 14sc{m.�D'av"[7�cL +.A y ��i. i'I l%3 �`1 f�QV'1�FrtC� e,11 Inspection Date: (G:Building/Forms/document id goes here) • J 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). Company Name: 4 -bl) Property Address: &Z�f AW9 � r° City: Zip Code: Contact Person: Title: Type of Business: Telephone: Applicant: (print name) �QkCIM • ` 0 (1YNC V SignatureMCNIkk Q Will the facility have any of the following equipment? Yes UNo� Charbroiler Dry cleaning machine Spray Booth Printing Press (screen/lithographic/flexographic) Internal combustion engine (greater than 50HP) (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 QWill any of the following operations be performed? Yes []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. ❑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.