HomeMy WebLinkAbout10172 Adams Ave - CofOa
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HUNTINGTON BEACH
CERTIFICATE OF OCCUPANCY
VIE
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION
(3nd Floor — The Applicant Must Apply In -Person)
Business Address 101;��'
m ;�— -412 33 Date
Business Owners Name Zip Code
Business Name hn �f tK c q Su,-f ; { S ,/� Telephone No t'g,49) E60-2g2-4
Business Type Bus. Phone
Pronertv Owner Information (regquired) Tenant/Emergency .Contact (required)
Name ass times Pa ' r:h �k i(S `' Name c ' Ca. < x S
Address -4 2S i ar ►rna Address
City ., Fra.>ct'sc o State/Zip_ga 7q /04 City o RWc4 Statemp �.
Telephone No. Telephone No. .494) 2B0 ;24 Z4
I .. i ,1
THIS USE WOULD BE DESCRIBED ASi,
O Newly Constructed Building, or S�
, . Existing Building
IS THIS BUILDING FIRE SPRIMak#.ED3 O Yes '*No
CHECK ALL THAT APPLY:
❑ Change of Business Owner Change of Occupant O Change of Use ❑ Additional Occupant
• Indicate former type of business
• Are you requesting that the electricity be turned on? OYes ❑ No
■ Will operations produce dust/wood shavings or similar material? ❑ Yes _VNo
• Will operations involve the repair or replacement of automobile parts? ❑Yes J�No If yes: Describe the
components repaired or replaced.
• Does the operation involve the use of welding or open flame? ❑ Yes ` No
• Will the business be a drinking, dining or assembly use with an occupant load of more: than 50 persons?
❑ Yes XNo
• Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? ❑Yes Alo
• The following best describes my operation: O Office Only ❑ Retail Sales Amedicai/Dental
OWarehouse/Manufadeuring/Distribution ❑Restaurant/Take-OutFood ❑Other
■ Will any meat produc6ihcluding beef, poultry. and/or fish bee cooked or fried onsite? ❑ Yes iq)<No
If you answeredyes, 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 )irNo
For Official Use Onl
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied: 2-
Bldg. Permit #
Planning Initials: W Date: 1216
Occ Load:
Occ Load:
Occ Load:
TIF Review: Y/ N
Zoning: U--1
Parking Meets Code; (for use): Y / N
Building Revieded By lnidals: b --Date: % 1L i&
Conditions of Approval or Other Notes: T_ � (cf
Area: 2,223 5F
Area:
Area:
No. of Stories: 1
Entitlement #:
Use Permiueds-' N
ease Interceptor Verified Inspected By Initials: Date:
At/Al—
.,.- South Coast
Q Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
(909) 396-3529 • http:// www.aqmd.gov
1 .
Air Quality Permit hecktist
California State Law Code 65850.2 prohibits cities ftoin issuih� an ccu lacy Oermit.to a
business Without clearance from the foetal air qualit ag�n� . This'cheC 's`E will determine 4f you
need to obtain clearance from the South Coast Air Quality Manag ' nt I .tstrict (AQM13).
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Company Natin3e: ctrl on�T, nc� rDRAL St11 CiTw .Srrtr u
Property Address: 16172 AtL AJc Nt&; �2
City,: i » :, _ Zip Code: �"92 64 4
i � , .
Contact Person: a r. UaA elI i'�r"Title: 0'a n c r
Type of Business: Derma j N(ice Telephone:: (944i 286 - 2424
Fax Number: -mail address: q Y441 • co
Applicant (print name): C6uec{{ Cnrison Signature: Date:'
• Will the facility have any of the following equipment? Yes ❑ N6X
Charbroiler
Dry cleaning machine
Spray booth
Printing press (screen/lithographic/flexographic)
Internal combustioningine 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!�'uel storage and dispensing equipment
• Will any of the following operations be performed? Yes[] No;
. ,C 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
applications) and then provide you with a clearance letter. You can call AQMD at their Small
Busindss Assistance Office at 1.800-CUT-SMOG (1-800-288-7664).
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