HomeMy WebLinkAbout10120 Adams Ave - CofOb(DZ9��
• CERTIFICATE OF OCCUPANCY "020- -
CITY OF HUNTINGTON B -
DEPT. OF PLANNING & BUILDING APPLICAT
HUNTINGTON BEACH 714/536-5241 (3d Floor — Must Apply In -Person)
Business License # t� c Date `4 (1 81 it
Business Address 1 O 1 X0 Naam5 A-,fuv-, Q- Zip Code 9, 4, F (.
Business Owners Name VCod-t\e r ; n e 0+-- - Telephone No. "l LIt-S 3o- 85 oo
Business Name m C-w: cs U—> ck k GCent' er5 Bus. Phone
Business Type �� .h sr.cLQ �c,,,,�Q1, ti F, t�e_intti l- t�,vo l Sv�S
Property Owner Information (required) Tenant/Emergency Contact (required)
Name s sb.e 15 Name loo)
Address 3 G Home Address
City State/Zip J City j'- State/Zip _e"�o
Telephone No. 6149 ) '014 o90D Telephone No. 3�q —3,g�
L&& +er- C • 6M L&I I
THIS USE WOULD BE DESCRIBED AS-
0 Newly Constructed Building or [3 Existing Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner [(Change of Occupant ❑Change of Use ❑Additional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity be turned on? Yes NOD
■ Is the building sprinklered? Yes NoR"
■ Will operations produce dust/wood shavings or similar material? YesE� No❑
■ Will operations involve the repair or replacement of automobile parts Yes NOV If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? YesO No
■ Will the busi}ess be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes QNo Ei'
■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? Yes 8'�o ❑
■ The following best describes my operation: El Office Only 91' etail Sales ❑ Medical/Dental
❑ Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food
(describe process and end product)
Other (describe)
For Official Use Onlx
Occ Group: Area:
Occ Group: Area:
Occ Load:
Occ Load:
Occ Group: Area: Occ Load:
Total Sq Ft Occupied: No. of Stories: TIF Review: Y/
Bldg. Permit # Entitlement #: Zoning: C-0-
a�I1CA
Plnr Initials: Date: I Plan Chkr Initials: Date: ��I�s� Initials: Date:
Conditions of Approval or Other Notes:
A rtl'al / sipiLES 'rLQ YlL-trK=p rp2 C,6\
Inspection Date:
South Coast
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
(909) 396-3529 9 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: 5iYrGe. C5 L� Cav�k GP�5
Property Address: t O t a-0 N4-0J-y-5�
City: Zip Code: A
Contact Person:
Type of Business:
Fax Number:
Applicant (print name):
taut ko
Title:
Telephone:
d-mail
address:
Signature:
Date: 19 ( 1 k
Will the facility have any of the following equipment? Yes ❑ No EV
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 filter/scrubber
Motor fuel storage and dispensing equipment
Will any of the following operations be performed? Yes❑ No[�r'
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).
-2-