HomeMy WebLinkAbout15081 Edwards St - CofO (11)J�
HUNTINGTON BEACF
Business License #
Business Address A
CERTIFICATE OF OCCUPANCY 0205 -
CITY OF HUNTINGTON BEACH —
DEPT. OF PLANNING & BUILDING APPLICATION
Business Owners Name �) �._� ��•�1t.�
Business Name R 11J,10 ^���.� o�,�LS ,g ►moo,
Business Type A— M-A ndd(A41CP
(3`d Floor — The Applicant Must.Apply In -Person)
Date
Zip Code
Telephone No.
Bus. Phone
Property Owner Information (required) Tenant/Emergency Contact (required)
Name'' Al ► e c.,-' Name L- �01114 4Cn1G—
Address!!E6'0 _ --rdvt Home Address
City w,4-bi �►,�,: ��9 .StatelZip q ZCo City State/Zip
Telephone No. \`7'/ATelephone No. � '7142 &q �— � q- o 2
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or CVExisting Building
IS THIS BUILDING SPRINKLERED? Yes No
CHECK ALL THAT APPLY:
Change of Business Owner ❑ Change of Occupant ❑ Change of Use ❑ Additional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity be turned on? PYes &Ko
■ Will operations produce dust/wood shavings or similar material? ❑ Yes Ml�o
■ Will operations involve the repair or replacement of automobile parts? ❑Yes M'No If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? ❑ Yes M No
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
❑ Yes ❑ No
■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 'nches in height? ❑Yes 4NO
■ The following best describes my operation: ❑ Office Only Retail Sales ❑Medical/Dental
❑Warehouse /Manufacturing/Distribution ❑ Restaurant/Take-Out Food ❑ Other_ 5 ✓ `C
■ Will the Food Service Establishment Generate Fats, Oils Greases? ❑ Yes ("No 1
■ Does the Facility Have a Grease Interceptor? ❑Yes Ej�No
For Official Use Only Q
Occ Group: �U
Occ Group:
Occ Group:
Total Sq Ft Occupied:
Bldg. Permit #
Planning Initials:�Date:i 2'Ij
Conditions of Approval or Other Notes:
Area:
Area:
2()
Area:
No. of Stories:
Entitlement #:
Occ Load:
Occ Load:
Occ Load:
TIF Review: Y/ N
Zoning:
Z
Building Reviewed By Initials: Date
Grease Interceptor Verified Inspected By Initials: Date:
J_
ro South Coast
wibi: Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
a' f 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:
Property Address: A �_O 9 ) EG( AznzY,�
City: Zip Code: Z G �--
Contact Perso -c— Title: U w Y,,y—
Type of Business: I ��'C:ci►�� lepho(-7
Fax Number: e-mail address: 14
Applicant (print name): P&z Signature: ij, Date:fN
• Will the facility have any of the following equipment? TesEl 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[:] NoEN�
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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