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10056 Adams Ave - CofO (6)
l&l — 291 J� HUNTINGTON BEACH Business License # Business Address Business Owners T Business Name Business Type CERTIFICATE OF OCCUPANCY 714/536-5241 020 CITY OF HUNTINGTON BEACH - DEPT. OF PLANNING & BUILDING APPLICATION -�_Fctq(g (3rd Floor — Must Apply In -Person) Date Zip Code Telephone No. Bus. Phone Property Owner Information (required) Tenant/Emergency Contact (required) Name r Name _9 „► l�t2 j Address ! 14 3 'FI• Home Address/� M onrDwNV City : lii��State/Zip CA 97,(,( _l City���1i_r��State/Zip_C_,A ? •7T Telephone No. St IRS. -3 —7 j Telephone No. �J 14 Ll 12.-21 I THIS USE WOULD BE DESCRIBED AS: ewly Constructed Building oristing Building CHECK ALL THAT APPLY: ❑Change of Property Owner fRChange of Occupant �hange of Use ❑Additional Occupant ■ Indicate former type of business ■ Are you requesting that the electricit turned? Yes ❑ No ■ Is the building sprinklered? Yes � No ■ Will operations produce dust/wood shavings or similar material? Yes n No'�9 ■ Will operations involve the repair or replacement of automobile parts Yes Nonf yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? Yes[] NZ] ■ Wille business be a drinking, dining or assembly use with an occupant load of more than 50 persons? YTo ❑ ■ Will there be storage racks, gondolas, or she g exceeding 5feet 9 inches in hei ht? YesEl ■ The following best describes my operation: ffice Only Retail Sales jMedical/DentaP arehouse /Manufacturmg/Distribution Restaurant/Ta cee Out Food L_I escribe process and end product) Other (describe) For Official Use Only G v Occ Group: Z Area: Z� Occ Load: Occ Group: Area: Occ Load: Occ Group: Area: Total Sq Ft Occu ied: No. of Stories: Bldg. Permit t r�( Entitlement #: Plnr Initials `� Jute: V l 1gan Chkr Initials: Date: Conditions of Approval or Other Notes: �lz -1M Cates r �ta.►� tF7 CUP H - ©lam Occ Load: TIF Revie : Y/ N Zoning: Insp Initials: Date: Inspection Date: South Coast Air Quality Management District 21865 Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-3529 • 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: NC,►,,, bane S Property Address: r 00 ODD 5 City: t} G . Zip Code: 9 Z(- f Contact Person: PA v( g i r,e,� Title: Q LA/Ag, ► ` Type of Business: 240avrcm Telephone: -7) ^ LY Fax Number: e-mail address: „ Applicant (print name A u } tft; Signatur Date: (o -z-6 -- / V • Will the facility have any of the following equipment? Yes N� 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� 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-