HomeMy WebLinkAbout15222 Connector Ln - CofOr
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HUNTINGTON EACF
CERTIFICATE OF OCCUPANCY 0201(P - 1J?71
CITY OF HUNTINGTON BEACH —
DEPT. OF PLANNING & BUILDING APPLICATION
Business Address i 522.2
Business Owners N,^,a�fm�ce 1�'I
Business Name P�
Business Type DJnnf5C
(3'd Floor - The Applicant Must Apply In -Person)
ate 0 S — O - Z4 i
Zip Code 2
Telephone No. ILq 932_0103
Bus. Phone 2
Pro a Owner Information (required) Tenant/Emereencv Contact (required)
Name Sa Name Mop riyi to r, NJCAc,- r n 1 I hC#_Ur_ {'1
Address I lj - Home ddress .fj2�fL G
City I State/Zip Cit v � WC1t h4 k�tate/L1p s ��, 7
Telephone No. 31U $3 / - J-S Telephone No. ID 1- g Z� /
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or )Rr Existing Building
IS THIS BUILDING FIRE SPRINKLERED? .a Yes ONo
CHECK ALL THAT APPLY:
❑ Change of Business Owner ISrChange of Occupant ❑ Change of Use ❑ Additional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity be turned on? ❑Yes )RNo
■ Will operations produce dust/wood shavings or similar material? ❑Yes ,8No
■ Will operations involve the repair or replacement of automobile parts? ❑Yes _.WNo If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? ❑ Yes J�Mo
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
❑ Yes 9 No
■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? Yes ❑No
■ The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑Medical/Dental
.EWarehouse /Manufacturing/Distribution ❑ Restaurant/Take-Out Food ❑ Other
■ Will any meat products including beef, poultry, and/or fish bee cooked or fried onsite? ❑ Yes _!NNo
If you answered yes, 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 O'No
For Q icial Use Only
Occ Group: 13
Occ Group: S- 1
Occ Group:
Total Sq Ft Occupied:
Bldg. Permit #
Planning Initials:_,,b_Date:
Conditions of Approval or Other Notes:
Area: OOW I t co
Area: - 10-4 de0
Area:
No. of Stories:
Entitlement #:
Occ Load: j o
Occ Load: -V- 1
Occ Load:
TIF Review: Y/ N
Zoning: It -
Building Reviewed By Initials: Date:
Grease Interceptor Verified Inspected By Initials: Date:
0[b --33 tiS
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
lSouth Coast Air Quality Management District (AQMD).
� Company Name: rs Ru 1 UVbf+s n_ rI C.
Property(Address: 1522Z(_) 0_y)0iecNO(- Lctne_
City: 4UBeQQ Zip Code:
Contact Person: G 1"eh oI n-p-r
Type of Business: bAdeSQ-le_ DI5-t • Telephone: �Iq - 41�(-5713.3
Fax Number: Q )q �qz-f-3 I U g e-mail address: YneOC4Sr2l qa ICU • Co rn
Applicant (print name): 0611MOd N adl in, gtap:1 H - N Date: _5wj�7
• 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[:] NoX
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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