HomeMy WebLinkAbout15061 Edwards St - CofO (9)HUNTINGTON BEACH
CERTIFICATE OF OCCUPANCY 020 L7 - -D,f)(6
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION
(3'd Floor — The Applicant Must Apply In -Person)
Business Address i Sorm EAL a c' Date 1
Business Owners Name u a� utT Zip Code?_6 1* 3'
Business Name V t+xtoA: Co RP Telephone No. f 6 ! . s Rq - 6
Business Type Ipc"r- Bus. Phone G 61
Property Owner Information (required) Tenant/Emergency Contact (required)
Name C U Lk- Name CN-p 21.e!2; U &.-
Address i OG 1 -F-kop�k )9 QC _ Home Address
City i-;;N4r� ; _kWate/Zip�� City 4jTiN4-Cali State/Zip 0 Pk _ 4g
Telephone No. `7(c(-`7GG - 6 Lf " Telephone No. f y- 9 z ( Z_
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or �ist'ngBuilding
IS THIS BUILDING FIRE SPRINKLERED? Yes ONo
CHECK ALL THAT APPLY:
❑ Change of Business Owner ❑ Change of Occupant ❑ Change of Use Additional Occupant
■ Indicate former type of business M &&Vrn—i`
■ Are you requesting that the electricity be turned on? ❑Yes ONO
■ Will operations produce dust/wood shavings or similar material? ❑ Yes 9NO
■ Will operations involve the repair or replacement of automobile parts? ❑Yes EIXo If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? ❑ Yes No
■ Will the bust ess be a drinking, dining or assembly use with an occupant load of more than 50 persons?
ElYes C o
■ Will there be storage racks, gondolas, or shelvingexceeding 5feet 9 inches in height? ❑Yes VTo
■ The following best describes my operation: Office Only ❑ Retail Sales ❑Medical/Dental
OWarehouse /Manufacturing/Distribution ❑ Restaurant/Take-Out Food ❑ Other
■ Will any meat products including beef, poultry, and/or fish bee cooked or fried onsite? ❑ Yes o
If you answered yes, please proceed to the next question.
• Does your facility Curren ly have a grease control device (i.e. grease trap or grease interceptor)?
Check one: ❑ Yes No
For Official Use Onl
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied: _
Bldg. Permit #
Planning Initials 4_ Date:!0/ 1( 7
Area:
Area:
Area:
No. of Stories:
Entitlement #:
Use Permitted: Y / N
Occ Load:
Occ Load:
Occ Load:
TIF Revi / N
Zoning:
Parking Meets Code (for use): Y / N
Building Reviewed By Initials: Date:
Conditions of Approval or Other Notes: b- 'AA 6ffi e_
Grease Interceptor Verified Inspected By Initials: Date:
South Coast
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
P
(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: n 61 "WA-Oj✓ 5�_
City: Zip Code:
Contact Person: 4ur1 VA'4 Title:
Type of Business: Rk &Wi-- Telephone: hr. �9�_(L�Q,
Fax Number: e-mail address:
Applicant (print name):4�u Nj._ Signature: Date: 70/
• Will the facility have any of the following equipment? Yes ❑ No Eg/
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[:] Nop,//
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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