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Home My WebLink About10054 Adams Ave - CofO (4)CERTIFICATE OF OCCUPANCY 020� I - CITY OF HUNTINGTON BEACH DEPT. OF PLANNING & BUILDING APPLICATION (3'd Floor — Must Apply In -Person) Business License # Business Address 10 o S- 4 H a rr► s /1 J z kf %' CA-- 12% 6 4 Business Owners Name Tf�,j V" T-u o rt !j Business Name '114 M' (-, ?'iaA' j,9r S � Business Type Date Zip Code Telephone No. Bus. Phone M) U of 2 7 2 Property Owner Information (required) Tenant/Emergency Contact (required) Name Q, U Si Vu'S PKVfi �` Name -- Address Home Address I U, W. W tjS arm St, (LLu"t� City State/Zip City f\-(gAA State/Zip (' 02-(n7,"1 Telephone No. 7 f w 0 b 9 g 2-3 2— Telephone No. g t j Of 6 4 Z- ZCY THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or ❑ 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 O No ❑ ■ Is the building sprinklered? Yes ONo❑ ■ Will operations produce dust/wood shavings or similar material? Yes O No ❑ ■ Will operations involve the repair or replacement of automobile parts Yes ❑ No ❑ If yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? Yes ONO ❑ ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? Yes ONO ❑ ■ Will there by storage racks, gondolas, or shelving exceeding 5 feet 9 inches in height? Yes ❑ No ❑ ■ The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑ Medical/Dental ❑ Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food (describe process and end product) ❑ Other (describe) For Official Use Onl Occ Group: Area: �` Occ Load: Occ Group: Area: Occ Load: Occ Group: Area: Occ Load: Total Sq Ft Occupied: No. of Stories: TIF Review: Y/ N Bldg. Permit # Entitlement #: Zoning: Plnr Initials:-)?Tate:*-�P�hkr Initials: Date: p Insp Initia �- ate: - 12 Conditions of Approval or Other Notes: Inspection Date: 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 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:. M KA (� TtL . � O r S�w n Property Address: 10 D S_ 4 AJ 61 yn s Ay e. City: ftt L htN CV_b Li BL_e_ .0 j^ Zip Code: 1 Contact Person: T" `f a4„ T. ( U-0 K c\ Title: p u) �t Type of Business: I�P_�ti t-�` o c� c lb Ekg �1 elephone: () 7 q 7 Fax Number: email address: Applicant: (print name) TT��T�0�[�Signature: Date: 66 Lam— Will the facility have any of the following equipment? Yes NO k 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 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 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 AQNID 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 AQNID at their Small Business Assistance Office at 1-800-CUT-SMOG (1-800-288-7664). CERTIFICATE OF OCCUPANCY 020� I - CITY OF HUNTINGTON BEACH DEPT. OF PLANNING & BUILDING APPLICATION (3'd Floor — Must Apply In -Person) Business License # Business Address 10 o S- 4 H a rr► s /1 J z kf %' CA-- 12% 6 4 Business Owners Name Tf�,j V" T-u o rt !j Business Name '114 M' (-, ?'iaA' j,9r S � Business Type Date Zip Code Telephone No. Bus. Phone M) U of 2 7 2 Property Owner Information (required) Tenant/Emergency Contact (required) Name Q, U Si Vu'S PKVfi �` Name -- Address Home Address I U, W. W tjS arm St, (LLu"t� City State/Zip City f\-(gAA State/Zip (' 02-(n7,"1 Telephone No. 7 f w 0 b 9 g 2-3 2— Telephone No. g t j Of 6 4 Z- ZCY THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or ❑ 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 O No ❑ ■ Is the building sprinklered? Yes ONo❑ ■ Will operations produce dust/wood shavings or similar material? Yes O No ❑ ■ Will operations involve the repair or replacement of automobile parts Yes ❑ No ❑ If yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? Yes ONO ❑ ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? Yes ONO ❑ ■ Will there by storage racks, gondolas, or shelving exceeding 5 feet 9 inches in height? Yes ❑ No ❑ ■ The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑ Medical/Dental ❑ Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food (describe process and end product) ❑ Other (describe) For Official Use Onl Occ Group: Area: �` Occ Load: Occ Group: Area: Occ Load: Occ Group: Area: Occ Load: Total Sq Ft Occupied: No. of Stories: TIF Review: Y/ N Bldg. Permit # Entitlement #: Zoning: Plnr Initials:-)?Tate:*-�P�hkr Initials: Date: p Insp Initia �- ate: - 12 Conditions of Approval or Other Notes: Inspection Date: 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 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:. M KA (� TtL . � O r S�w n Property Address: 10 D S_ 4 AJ 61 yn s Ay e. City: ftt L htN CV_b Li BL_e_ .0 j^ Zip Code: 1 Contact Person: T" `f a4„ T. ( U-0 K c\ Title: p u) �t Type of Business: I�P_�ti t-�` o c� c lb Ekg �1 elephone: () 7 q 7 Fax Number: email address: Applicant: (print name) TT��T�0�[�Signature: Date: 66 Lam— Will the facility have any of the following equipment? Yes NO k 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 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 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 AQNID 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 AQNID at their Small Business Assistance Office at 1-800-CUT-SMOG (1-800-288-7664).