HomeMy WebLinkAbout15182 Bolsa Chica St - CofO (28)3
DE€PFITf�ENT O U NIMUNiTY DEVELOPMENT
This Certificate ci Occupancy
Ve oremses and Shall not be rarr a Sri ur-
C9j7i by the Puiiding Ofi+,ti ial_ [ V m
FICATE OF OCCUPANCY
APPLICATION FOR CERTI
CITY OF HUNTINGTON BEACH
DEPARTNIENT OF COMMUNITY DEVELOPMENT
"INnNGTON MACH
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Iv n
Nati i,
THIS USE WOULD BE DESCRIBED AS:
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NOTICE: ,;t Ai, b:',<11 .d,,A 1, 1 will not ri,,jt%d xt4; the biji4l:ng Ims been
in541ected cilld -1 ceitificA',k,�
iCe W,fj rf
No electrical serv" inSjpevfd and
Citlf',e cam! app�),-',', ,of rv)q ;J2 !eq 4;itl io a'iedt;lr an eleclrie,0
fuo -,14) ,,rPefCt,iw In',fc Dep,i0n1_,lit is l0eo,
Change of occupancy or use inspection fee. Vvt.'tit i!� vnnko In--V f abij,l&), or
ri
r >nai!
q;ulirt of
1, be paid to tiio, city
inr
4! , K, f 4. Huntington Beach Fire Code Section !0 itviniumoffouA,
-t I inches I'l t1eight '49th wv t,lif -ke :xpi "J 'i J 1-�e hao,grwind. These
riunqers 11ust he posttd on ?ur
Huntington Be, ach cire Code Section A,,'
hx-1 kha
Nationcil Fire
jFOR OFFICE USE ONLY) -7
SUPPLEMENTAL INFORMATION I
N",
OF Occia),mircY sUl'PW-',MENT .
SO(JI-I ICOASTAIR OUALITY MANAGEMENT CISTRICT
PFFllv1,;TTlW'j (-,I IECKLIST
COhINIFERGIAL BUILDINGS ONLY
I Y N
c,
I I-* All (-"omBrjT IA14
PAINTS, Ol?
7 17
C7;"'.;L'Tll' Ally BusTs (-)R smaKF?
!-)-c)E,, YOUR !'ACILIT-Y ANY LDluIDS OR
SOLIDS? REC110m ;ltN"; METALS?
lX,)17S 7CUP. FACl1,1T*-,' 01R CC"ANYT14ING
DOES YOUR F'A C 1 L I T Y HAVE ANY COMBUSTION
EQUIPMENT (I. E. , bOILERS, Fl!�RNACES, BROILERS,
BAXING OVENS, ETC)
�ACILITY HANDLE OR STORE SOII.��ENTS 01-', DOES YOUP r
MOTOR FUELS?
DO i'OU USE OR STORE ANY KIDS?
9. DO YOU USE ANY CHEMICAL PROCESSES?
I DO YOU USE ANY �OLVENTS FOR CLEAN UP?
31. APE YOU A DRY CLEANERi RESTAURANT, BODY SHOP,
GASCLINE STATION, PRINTER, OR PART COATER?
IF YOU DO NOT KNOW THE ANSWER Irb A oUESTION, MARK IN Tfll; "Y"
COLUMN.
IF YOU HAVE MARKED ANY QUESTIONS IN THE I'Yll COLUMN YOU MUST
CONTACT THE SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT LOCATED
AT 93BO FLAIR DRIVE, EL MONTE CA, 91731. P-',EASE CALL PUBLIC
INFORMATION AT (83.8) 572-6283 OR CUSTOMER SERVICE AT (818) 572-
6347.
JOB ADDRESS:
DATA;: SIGNATURE: