HomeMy WebLinkAbout15262 CONNECTOR - CofO41
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• CERTIFICATE OF OCCUPANCY 020 -
J� CITY OF HUNTINGTON BEACH -
DEPT. OF PLANNING & BUILDING APPLICATION
HUNTINGTON BEACH 714/536-5241 (3`d Floor — Must Apply In -Person)
Business License # A2oS 2-bo Date 7 h3113
Business Address 15 Zl' Z C0X31oc0--WiZ L.0 • Zip Code 9 2_ (, y 9.
Business Owners Name Tcfe�� U31 LKC36 . Telephone No. -71 K • 377. 7aOO
Business Name i'D v Bus. Phone
Business Type I Q-L-Aj5TQ_j AL
Property Owner Information (required) Tenant/Emergency Contact (required)
Name A tAZO LLC• Name __76Z, o 01 Lk1:S
Address 1 S Z,& Z ,,3t9cczv?_ Home Address 17c 3 ( 0/ZC1 AA-iLl) D12..
City 4 - State/Zip A �� g. City pJ�-� �- gc eFiState/Zip
Telephone No. `7/`i - 9/ y - 31?90 Telephone No. 71 q • 0-4—
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or Existing Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner Change of Occupant ❑Change of Use El Additional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity be turned on? Yes 0 No ❑
■ Is the building sprinklered? Yeses No
■ Will operations produce dust/wood shavings or similar material? Yes ❑ No$
■ Will operations involve the repair or replacement of automobile parts Yes 0 N9, 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 ONo
■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? YesANo ❑
■ The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑ Medical/Dental
❑ Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food
(describe process and end product) 'PL5t 1-7;)• t ZzoT -,7 YPtS
Other (describe)
For Official Use Onl
Occ Group: 5-1 Area: � 13-1 Occ Load: 6�
Occ Group: Area: -+6— g Occ Load:
Occ Group: Area: 15'17Occ Load:
Total Sq Ft Occupied: Z No. of Stories: 'L. TIF Review: Y/ N
Bldg. Permit # 6 13 - Entitlement #:
Plnr Initials:` Date: 13Plan Chkr Initials:
Conditions of Approval or Other Notes:
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
Property Address:
ID C72_00T.
�pr3 tjC° T�(� L t� .
I S7L
City: 14 ° Zip Code:
Contact Person: :jj i� °� t_►���►JS
Type of Business: 'P L-:"l C-7 v3 %)i Ct--S
Z�y9.
Title:
Telephone:
Fax Number: -1 t y ' 3� 9 - OOZ e-mail address:
Applicant (print name):3&_ZL-- Y G) Mature:
Date: 7h,_3 113,
• Will the facility have any of the following equipment? Yes ❑ No
Charbroiler
-74 37 �- 9do0
�r_M'F1
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).
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