The URL can be used to link to this page

Home My WebLink About15052 Edwards St - CofO (10)Certificate of Occupancy No. 0200 10 r / APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH - DEPT. OF BUILDING & SAFETY (3rd Floor — Must Apply In -Person) Business License # Kai &p ) 3 3 Date 3 / 2 2-6 /6 Business Address) O; 2 EDWARD. Jr. HVAMAkAW MC)f Zip Code 90 Z it 7 Business Owners Name L i / i MarcA Telephone No,S6Z 03jG Z815-d" Business Name S h<�t r- O ci Sl S Bus. Phone %/4 991 393v Business Type Sg /o n an ri S P9 Property Owner Information (required) Tenant/Emergency Contact (required) Name \Al t" t L j am 0 - - -ha -S h a,w Name W PV 1144 _EK Address / :3 Z, 9A C-�oldenWesj" &r FHome Address 476 -vc_l)De.4w/< Ue City We m in i S f& State/Zips 9Z 9 3 City �}KcW��D State/Zip C 4 V 71� Telephone No. 7/4- 9.2 7858 Telephone No. 56 Z ¢ZS� 4-5-24. THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or 1Nr Existing Building CHECK ALL THAT APPLY: ❑ Change of Property Owner k Change of Occupant ❑ Change of Use ❑ Additional Occupant ■ Indicate former type of business `5AAal ■ Are you requesting that the electricity be turned on? Yes QNo[K ■ Is the building sprinklered? Yes SKNo❑ ■ Will operations produce dust/wood shavings or similar material? YesQNoN1 ■ Will operations involve the repair or replacement of automobile parts Yes QNo 2' If yes: Describe the components repaired or replaced. _ ■ Does the operation involve the use of welding or open flame? Yes DNo K ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? Yes ONo W ■ The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑ Medical/Dental ❑ Restaurant/Take Out Food ❑ Warehouse /Manufacturing/Distribution (describe process and end product) N Other (describe) Mg I V- S g o n «r" d Z! -1 Nay -91 For Official Use Only Occ Group: Occ Group: Occ Group: Total Sq Ft Occupied: V Bldg. Permit # Area: f/►O ✓: F , Occ Load: f (Q Area: Occ Load Area: Occ Load: No. of Stories: ( TIF Revie Y/ Entitlement #: Zoning: Plnr Initials:, Dater Plan Chkr Initials:�_Date: � > sp Initials: Date: 3 `� Conditions of Approval or Other Notes: Inspection Date: (G:Building/Forms/document id goes here) J. HAZARDOUS MATERIALS DISCLOSURE INFORMATION Huntington Beach Fire California Health and Safety Code requires the Fire Department to regulate businesses that handle hazardous materials. Motor oil, hydraulic fluids, gasoline, dry cleaning fluid, etc., are considered hazardous materials and must be disclosed. If you use, handle or store hazardous materials or waste materials equal to or in excess of the following basic quantities, your are required to disclose: • 55 gallons of liquid • 500 pounds of solid • 200 cubic feet of compressed gas • Any amount of radioactive materials • Any amount of Class A explosive • Any amount of chemicals known to cause cancer • Any amount of commercial pesticides • Reportable quantity of any chemical on EPA Extremely Hazardous Materials Substance List Disclosure is not required for the following: 1. Hazardous substances contained in food, drug, cosmetic or tobacco products. 2. Upon approval of the Fire Chief, hazardous materials contained solely in consumer products packaged for use by and distributed to the general public. However, pesticides, herbicides, and ammonium nitrate fertilizers over the required disclosure amounts are not exempt from disclosure. 3. The transportation of hazardous materials accompanied by shipping papers prepared in accordance with the provisions of 49 Code of Federal Regulations. 4. Infectious waste generated by health care facilities that are regulated under Title 22 of the California Administrative Code. Check one of the following: No chemicals are used, handled or stored at this business. Chemicals are used, handled or stored at this business, but do not meet the requirements for disclosure Chemicals are used, handled or stored at this business. Disclosure forms will be sent to you. Amounts will be verified by the Fire Department during annual inspections. It is unlawful for any person to knowingly violate any provision of this ordinance. I certify, under the penalty of perjury, that the above information is true and convect to the best of my knowledge. x Signature, Home Phone -06 Z 4 25 4-.SZ(v Date 3 % Z 2 o l O Please call 714-536-5676 ivith questions regarding the Hazardous Materials Program. 'j = South Coast Air Quality Management District 21865 E. Copley Drive Diamond Bar, CA 91765-4182 (909) 396-3529 htpp://www.agmd.gov Air Quality Permit Checklist 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 Management District (AQMD). Company Name: .,S h eat f d cgsis S-t /o i an,( Swea Property Address: 15'01 Z EDL,0660S -5 City: j j(jA)T)N 4 l a/J b EhC11 Zip Code: g 6 L 4 7 Contact Person: L.. I 1 %G(V�C' F- Title: Type of Business: a IV' e pa Telephone:() 7l4 Applicant: (print name) L / / i /V a 1^e%C Signature: ` [I Will the facility have any of the following equipment? Yes ONo S' Charbroiler Dry cleaning machine Spray Booth Printing Press (screen/lithographic/flexographic) Internal combustion engine (greater than 50HP) (excluding motor vehicles) Boiler/combustion equipment (greater than 2 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 CST Application of paints or adhesives Etching, plating, casting, or melting of metals 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 Ulf you answered "No" to both questions, this checklist is your clearance from AQMD. DIf 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 (800) 388-2121.