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HomeMy WebLinkAbout15081 Edwards St - CofO (12)APPLICATION FOR CERTIFICATE T ,t♦ jl �_. , 'ZCA. E O OCCCUPANCY CITY OF HUNTINGTON E-ZA.CH - DEPARTMIENT OF BJI'LDINC & SAFE' q4 0� Floor" — MUst Apply Xx-Persoll) t Business License #___._ Address_ ��%tl, �,, Date Business Larne �-- M'n r1,11: rr , I IL"�M, ..i.11 i .. Business Type .� ter �a-----,�.__._ ._._. Telepliot���`% :! ,.� ?f'J prOperty�Infar,,� Name , BttEin s CJ�v t Name t�.t rs �.t �� Addressv— city ` ,s ~— Home Address ._ . t t,� � 1 1.1 ► x'1111,!% ;*r;.t." _Tell _ THIS USE 3'DULD BF �);*~+"SCZtl[SiS*;13 ��� City t=tY2,xnew;�� t; a,� Tel. °'l t � �'jr °� # CINEwIy Constructed Building Or QExisting Building CHECK �ML THAT APPLY: Change of Owner C1Change o£Ocr_.pant ClChangs ofUse MAdditional occ t t pant Indicate fernier use, if any Does the building have electricity? Yes L N'oC 3 If No, are you requesting that the electricity be turned can? ices Lj No (� Tl'.e building is sprinklered? Yes �� NO© Operations wil4 product dust/wood shavings or similar material? Yes i..,l No Opere titans will inQ Novolve fine repair or replacement of automobile parts Yes o If yes: Describe the components repaired or replaced, Does the operation involve the use of welding or open flame Yes The business is drinldng, dining or assembl se that will result in an occupant load ofinore rliar. 50 persons. Yes Q NO The following best describes my operation. n Office Only QRetail Sales IJMedical/Dental CIR-estaurant/Talce Out Food Warehouse E]Mai),ufacturing,'LlistribtrtioiI (describe process and end product) Other (describe) AM Office Me fhzly; � .,..... Zotrrrg: Sq I~t Occupied:_ Stories: Parking Spaces: Building Permii, # Occ Group: �� Occ Load: TIT` Re YIN Anit Paid$. Paid 13CF0 YFtnniIiIS eCt�pii Bntitlerxlel:t Planner Initials: South Coast Air Quality Management District 21865 E. Copley Drive Diamond Bar, C.A. 91765.4182 (909) 396-3529 htpp://wNvvt.agmd,aov Air Quality JPer nit Cheeldist California Government Code 65850.2 prohibits cities from issuing a Certificate of Occupancy 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 M:;nagement District (AQMD), Company Name; Property Address; City: A-11 u 7'if u , jl1,1 11C / Zip Code: c,J. C�, Contact Person: Title:, Type of Business; � �1 � � ! 1�m � �1� � t��� Telephone;;,k Y111 Applicant; (print name)_t:(aah�;t�Signature; Will the facility he ve any of the following equipment`? 'Yes No Rzi Charbroiler Dry cleaning machine Spray Booth 11rinting Press (screen/lithograpliie/flexographic) Internalcombustion engine (greater than 50HP) (excluding motor vehicles) Boiler/corribustion equipment (greater than 2 million BTTJ/hr. maximum input) Abrasive blasting cabinettroom Baghouse/cartridge type dust filter/scrubber Motor fuel storage and dispensing equipment o Will any of the following operations be performed? `Yes 13 No � Application ofpaints or adhesives Etching, plating, casting, or melting ofineta;ls Molding and blending of liquids and/or powders Storage of acids, solvents, organic liquids or fuels Production 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 P aswered " "Y'eS" to either question, you must contact AQMD to determine if air quality permits are required. If permits are iieeded, AQMD will assist you in submitting permit application(s) and them provide you: with a clearance letter, YOU Min call AQAW at their Small Business Assistance Office at (800) 388.2121. 3 M + j � � '• to :i �i "r (ij Cl) hTIn � x.� �,.-. � o � � ", k• ��' M tit 1 1 N t7o NIn CO ON co 93co in t y 4� rx a ti 1 co