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Home My WebLink About15081 Edwards St - CofO (19).APPLICATION FOR CERTIFICATE 10F OCCUPA,iCY , 1, 1 & S 4k F, T AITY,-,,'..,-.,IETI-LiTliNGT-OlTBF-ACIT-T)EPART,��lE�TOFRU!fLDLN�� 0 , ,, CV4 Business License DateJA4-1 Address uLal q Business Name 6t- ell Busine-cs Type Pronerry %Vner Irf,-jrkT—iat1'0:- Business Q%vn� 4 'Name — -kh-L- -T= Warne VJ1,1 . A 11 Address Horn ddre6s City ocity THIS USE WOULD BE ,DESCRIBED AS: istirg Building ©newly Constructed Building, or X CHECK ALL THAT APPLY: whangeof&Wlier C]Changeofoccupari. QChancy,:;ofUse QAt'ditionalOccupant Indicate fernier use, ifany. Dloes the building have elootricitY? Yes Nou If No, are you vequesting that the elect-icity be turned on? Yes No The building is sprinklered? Yes �k Nod yes No Operations will Product di;,st/,vvood sliavings or SiMilav material? j Operations will involve the repair or replaceineait ofam.tomobile Pitts Yes 0 No If yes: Describe the coim)orleftts repalued or replaced. . . . .......... 1v flaine? Yes 0 No Does he op -,ration involve the use of welding opert The 1.)usiness is drinldllg, diningor assembly that vAll restitt in an occupant load of r.jore tlian 50 persons, Yes 0 NO j k The following best describes any operatio- C2Retajjsales Q11viedical[Dental Chestaavant/Take Out Food ChVareliouse C31viculufacturiiig/l)istrib'.'*,.-loit (describe process and end product) *70-th7e,�� (describe', I , . "I "., QTICC Use Only Sq�tocoupied. IZOO occ G"Ou'o.. d:—, --:�R, Oc, T-OL, T4 Stories; — \ r BBuildingPe*-*nlit I�'. comer,tq, Pm lamier T,,dl Parking Spaces: TIF R�evie',V: Y,� N' /2oLl Bldg P%m C mm k� vSouth Coast Air QaalityManageinent District 21,65 B. 0,;,lcy Drive Diamond Bar, CA �.1.765-4182 (999) 396.3529 hipp:J/w�v-,v.agmd.gov Air Quality Permit Cheekiist, California Govertu c;tt Code 65850.2 prohibits Qities from issuing a Certif sate of Occupancy to a business without clearance from the',ocal air quality agency. This checklist w"ll determine if you need to obtain clearance from the South Coast Air au^lity Matiagernent District (,A,C�ItTI?), CompanyNamet Property Address: City: zip Code; Contact Person: i ilk I'rt��t: i''# r, 'Title: Type ufBusiness; .._ ►�� i L. C'fl) f )I" .I -__ ,� Telephena» i�/, �'� Signature:---�-�--- "' Applicant; (print name). '_}_.. .,�1 k:.L.__. 2' • Will the facility Dave any of the following equipment" Yes 0 No Charbroiler Dry cleaning machine Spray Booth Printing Press (screen/li,thogt-aphic/ile.<ographic) Internal combustion engine (greater than 5OHP) (excluding, motor vehicles) Boiler/combustion equipment (greater than 2 million BTU/hr, maximum input) Abrasive blasting cabinet/room Baghoitse/cartridge type dust filter/scrubber Motor fluel storage mt ;i dispensing equipment w Will any of the following operations be performed? Yes ❑T Application of paints or adhesives Etching, plating, casting, or melting of metals Molding and blending of liquids and/or powders Storage of adids, solvents, organic liquids or fuels Production of acids, solvents, orgz;,c liquids, or fuels Production of fumes, dust, sir:^,ke or strong odors • If you anawerad' Wo" to both questions, this checklist is YOU clearance from AQMD• �► If you answered "Yes" to either qnestion, you must contact A.Q1vID to determine if air quality permits are required. Sfpermits are needed, AQIMD will assist you to submittinE "mil applications) and than provide you �ttcc office at (Rd0) 333»212I, with a clearance letter. You can call AQTN1D at their Small Business � ��.