HomeMy WebLinkAbout15000 Bolsa Chica St - CofOJ�
HUNTINGTON BEACH
Business License #
CERTIFICATE OF OCCUPANCY 020 /3 — 02Z G 5y
CITY OF HUNTINGTON BEACH —
DEPT. OF PLANNING & BUILDING APPLICATION
714/536-5241
A 200 S Cv 22
Business Address M 0 00 1;01XA CAt CFl 'gyp . A 1-i 6
Business Owners Name
Business Name C,-LEv-C7Kr1 NMArTVRI A" -TFCH PO L0a
Business Type
(3rd Floor — Must Apply In -Person)
Date
Zip Code 21'f9
Telephone No. 71y ff 2- /96 /
Bus. Phone
Property Owner Information (required) Tenant/Emergency Contact (required)
Name V .,S 8,4tJ14, Name jkm-3 L, - -R-1 L�
Address P,D. Bcw ? Ro4*4 R Home Address 512 AL-IAL-IA VON9 /-W C
City 5F- WM iS State/Zip 110 (,3 r7q _ City CO P-wJR State/Zip CA qZ& 4
Tele hone No. O44$
p /�, 3c�) 35� 3�-Y y Telephone No. CJ S I - � 3 LI —? 3 0
I q -22-7- 3zJ 1
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or ,?R Existing Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner 4Change of Occupant ❑ Change of Use ❑Additional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity be turned on? Yes NoXI
■ Is the building sprinklered? Yes. No
■ Will operations produce dust/wood shavings or similar material? Yes❑ , NO'<
■ Will operations involve the repair or replacement of automobile parts YesO NoK If yes: "Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? YesO No
■ Will the business be a drinking, dining or assembly use with an occupant load of more than SQ persons?
Yes ONO t&
■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? Yes ONO X
■ The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑ Medical/Dental
9-Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food,
(describe process and end product)
Other (describe)
For Official Use Only
Occ Group: Area: 6-7 M
Occ Group: Area: 2 Cti
Occ Group:
Total Sq Ft Occupied
Bldg. Permit #
Plnr Initials: CL� Date: 5 -J 3 IPlan Chkr Initials:, Date: i3
Conditions of Approval or Other Notes:
Area:
No. of Stories:
Entitlement #: _ Zoning:
Insp Initials: ,3�/ /(/Date:
Occ Load: 1
Occ Load: c,
Occ Load:
TIF Review: Y/ N
Inspection Date:
ti
South Coast
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 917654182
€ (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: ALE r^CuT r^A TL- kA"
Property Address: � Sp O U IDOUA GK (C4 P.
City: ROOT. y g'r-cN Zip Code: 1230
Contact Person:
Type of Business:
J R��
rr�; ev-kou '
Title: G'M
Telephone:
Fax Number: ' (I j bj L-015- e-mail addr ss: Jim � �j C� Fu: PDi
(� I Gt'7M
Applicant (print name): Signature: C�
��►�es C . 12 t LE� Date:
Will the facility have any of the following equipment? Yes ❑ No-KI
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[R
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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