HomeMy WebLinkAbout15102 Bolsa Chica St - CofO (12)1
i
HUNTINGTON BEACH
Business Licen
Business Addrf
Business Owne
Business Name
Business Type
CERTIFICATE OF OCCUPANCY ( 020_ff - O
CITY OF HUNTINGTON BASH
DEPT. OF PLANNING & BUILDING APPLICATION
714/536-5241 �S ,��`a Floor — Must Apply In -Person)
Date
Zip Code
Telephone NoCT
Bus. Phone �dZ
Property Owner Information (required) Tenant/ mer e c Cont ct (required)
Name W, vv4zb Name 10
Address Home Address
City State/Zip City Lq_ I c ,r—�, ,-, State/Zip ?;
Telephone No. 771 _ 3 Telephone No. ��/e-j-l�l
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or Ptxisting Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner hange of Occupant ❑Change of Use ❑Additional Occupant
■ Indicate former type of business
■ Are you requesting that the electricityturned on? Yes[.] NOV'
■ Is the building sprinklered? YesV No❑ /
■ Will operations produce dust/wood shavings or similar material? Yes[] No
B'
■ Will operations involve the repair or replacement of automobile parts Yes[] No If yes: Describe the
components repaired or replaced.
■ Does the operat' n involve the use of welding or open flame? YesEl No
■ Will the busi ss be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes QNo
■ Will there be stora a racks, gondolas, or shelving exceeding 5fe t eight? Yes []No
■ owing best escn e— ation: ❑ Office O ❑ Medical/Dental
XWarehouse /Manufacturing/Distrib n ❑ Restauran
recess and end product) r I ,
Other (describe)
For O, jf cial Use Only
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied: I�Z
Bldg. Permit #
Occ Load: } O
Occ Load:
Occ Load.
TIF Review: Y
Zoning: L—
Plnr Initials: Date: Plan Chkr Initials: Date: 1 Insp Initials: Date: i3
Conditions of App�oval or Other No
KAAVLr t Uh C—/01ff kZh GrT7W
Area: i CDOO P
Area:
Area:
No. of Stories:
Entitlement #:
vS�(115Wrrr�
South Coast 1 - .
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: L Gcnoc
Property Address: 5 (O 2- f3 O'sa
P
City: ° Zip Code: C
Contact Person: Uj'QI Title:
Type of Business: I.l%� $; �2 G� 1 Telephone: 6I t)
Fax Number: e-mail address:
Applicant (print name): " l' Signature:
Date:
• Will the facility have any of the following equipment? Yes ❑ No
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-