HomeMy WebLinkAbout10035 Adams Ave - CofO (12)i!!
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CERTIFICATE OF OCCUPANCY 020 '2' '
CITY OF HUNTINGTON BEACH —
DEPT. OF PLANNING & BUILDING APPLICATION
(3`d Floor - The Applicant Must Apply In -Person)
Business Address I fi 7) 3 _�_ AbArAs A V L -41 C) 3 • Date .S - a 2� - /
Business Owners Name U c_ Tt 27-c R? ctn . Zip Code U6 y 4
Business Name Cud I A., & %,d 10 c ell Je w c /I ,2 c 'Telephone No. rl N x - d 316 16 6
Business Type T, n. 'I-e w t / e RBus. Phone 71 y - 9A
Property Owner Information (required) Tenant/Emer enc Contact (required)
Name CC. -" , � Name VA u t, 'T; -_ f,'- re- R 14 x
Address We, A lQ e �1 7l, o r- Home Address d D n t PM C'e //: n
+ City L9c cc State/Zip 5P AN q Sf .ZkCity..��� State/Zip CA 9/ 1�7
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Telephone No. E63 - y90 0 6 79 90 W Telephone No.
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or-Btxisting Building
IS THIS BUILDING FIRE SPRINKLERED? -21 Yes ❑No
CHECK ALL THAT APPLY:
_change of Business Owner ❑ Change of Occupant ❑ Change of Use ❑ Additional Occupant
■ Indicate former type of business_ fie.,vJ,_ Q
■ Are you requesting that the electricity be turned on? ❑Yes -2No
■ Will operations produce dust/wood shavings or similar material? ❑ Yes -Emo
■ Will operations involve the repair or replacement of automobile parts? ❑Yes,2No If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? ❑ Yeses No
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
❑ Yes ,O-No
■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? ❑Yes Ewo
■ The following best describes my operation: ❑ Office Only-,EMetail Sales ❑Medical/Dental
[Warehouse /Manufacturing/Distribution ❑ Restaurant/Take-Out Food ❑ Other
■ Will any meat products including beef, poultry, and/or fish bee cooked or fried onsite? ❑ Yes 4E'No
Ifyou answered yes, please proceed to the next question.
• Does your facility currently have a grease control device (i.e. grease trap or grease interceptor)?
Check one: ❑ Yes —2- No
For Official Use OnIY
Occ Group: M Area: 1c I1
Occ Group: Area: I c, t�
Occ Group: Area:
Total Sq Ft Occupi d: "La'7 \ No. of Stories:
Bldg. Permit # � Entitlement #:
Planning
Conditions of
tt;
or Other Notes:
Occ Load:
Occ Load: 61
Occ Load:
TIF Revie�y;, Y/ N
Zoning: 1
Building Reviewed By Initials: Date_ZZ(15
Grease Interceptor Verified Inspected By Initials: Date:
Q
South Coast '
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
(909) 396-3529 • http:// www.agmd.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: u &t , a,, j L U Ca, ; e,✓c 1e. K 5
Property Address:
City: Hun�jo r,
Contact Person: P 4 0 U Title:
V G.
Zip Code: V a 4 Y4
Type of Business: R f-I en -6 e w e1e k Telephone: :7( Y- 9 G U/ a 1 V
Fax Number: e-mail address:
Applicant (print name): FAo u 1 e2Teili c,. Signature: �..2_�i Date:
Will the facility have any of the following equipment? Yes ❑ No,0_
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[] N010-l",
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).
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