HomeMy WebLinkAbout15080 Edwards St - CofO (10)La- M
CERTIFICATE OF OCCUPAN Y 020a -
J� CITY OF HUNTINGTON BEA�M-
DEPT. OF PLANNING & BUAJZNNG APPLICATION
HUNTINGTON BEACH 714/536-5241 ( FFloor Must Apply In -Person)
Business License # Date
Business Address 't " o ('-. • Zip Code 9 9
Business Owners Name A �C�i��c,��a\��, Telephone No. -�,� 4n4
Business Name ��n l�P �� asp v� Bus. Phone -714
Business Type
Propelly Owner Information (required) Tenant/Emergency Contact (required)
Name cJ Name
Address) we t Home Addressl-7671 NQWa 5'-'-*)`6veWE
City we, 6in5te- r State/Zip (�t. yz 6 g City alnU' on 11 0-L6 State/Zip 52- 64 -1
Telephone No. 7I� 139 Telephone No.
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 []Additional Occupant
■ Indicate former type of businessyif
■ Are you requesting that the electricity be turned on? Yes[.]
■ Is the building sprinklered? Yes ❑ No ❑
■ Will operations produce dust/wood shavings or similar material? Yes ❑ . No19
■ Will operations involve the repair or replacement of automobile parts Yes El NoX If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes O Nod
■ 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? Yes ONo ❑
■ The following best describes my operation: ❑ Office Only Retail Sales ❑ Medical/Dental
❑ Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food
(describe process and end product)
Other (describe)
For Official Use Only
Occ Group: Area: �"Occ Load: �41
Occ Group: Area: Occ Load:
Occ Group: Area: Oce Load:
Total Sq Ft Occupied: No. of Stories: TIF RevieAw, Y/ N
Bldg. Permit # E tltlement #: 1 Zoning: (�
Plnr Initials: J- Date: 1 Ili Plan Chkr Initials: Dat `Q Insp Initial . Date: / 1
Conditions of Approval or Other Notes:
6AML C46 DrI.dntt'
` 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: :Uh S� Me LI" \_
Property Address: )5Q $ a -0t cva'CJS S�Y CA '4' L
City: )AuAAi n 'V\ P-),-PGrlZip Code: 926� j
Contact Person: c�c�Yho.`C (gyp cti `I (� Title: V w ►\ e `.-
Type of Business: Telephone: 3�a 6 6o6 2-
Fax Number: e-mail address: _
Applicant (print name): 5 j"- Lu i�kignature: ,tea cta c �,,c) rk 1Ll/e
Date: \ — � o — 2e i4
• Will the facility have any of the following equipment? Yes ❑ No R
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❑ Nog
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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