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124 Main St - CofO (2)
�.j o HUNTINGTON BEACH Business License ## Business Address_ Business Owners N Business Name Business Type CERTIFICATE OF OCCUPANCY 0200N - CITY OF HUNTINGTON BEACH - DEPT. OF BUILDING & SAFETY APPLICATION 714/536-5241' © (3'd Floor - Must Apply In -Person) 2--7 2c 2 l Date 12-,91 Me 1, 5�(- Ff Zip Code q 2 C le _ 04eu, Pryy e,,` )y ? i c. ( 13r,,. - 0k) Telephone No. 7 f Y -3'13 -T7 5 � �R:''ct. (4 -'- Bus. Phone -7(4(- 2 ti 3 -- 94-20P I c J' t . Property Owner Information (required) Tenant/EmerjZency Contact (required) Name OcPc ' _S d P ev+ce L/- C Name r3 ✓'".A" d Address 3c' /� t4' _Sl z'd31-W 5 c 'i if Home Address 4 M l Cti"V'CA 4"// %ice c.-H ter, City LA State/Zip l'G. City t-0, 4^ , State/Zip (c, ci 2, Telephone No. .Z (3 — 2 % 2, q 5n i Telephone No. % 14 3 c(3 rS 7 THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or 4Existing Building CHECK ALL THAT APPLY: ❑ Change of Property Owner 'Change of Occupant ❑Ch nge of Use ❑Additional Occupant ■ Indicate former type of business St,,.. i N. 5- �- rz-.- fN z ■ Are you requesting that the electricity be turned on? YesV^ No El ■ Is the building sprinklered? Yes NdEr ■ Will operations produce dust/wood shavings or similar material? Yes ' Not— ■ Will operations involve the repair or replacement of automobile parts Yes Q No T' If yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? YesQ Noft�'� ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? Yes QNo Lr ■ The following best describes my operation: ❑ Office Only , ❑4etail Sales ❑ Medical/Dental ❑ Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food (describe process and end product) ❑ Other (describe) Por Official Use Only 1 AW Occ Group: Area: _ _ Occ Load: J Occ Group: Area: P— Va Occ Load: 2 Occ Group: Area: Occ Load: Total Sq Ft Occupied: 2 O No. of Stories: _. TIF Review: Y Bldg. Permit # Entitlement #: Zoning: S P$ " C Plnr Initials:) Date:2"2. 01 Plan Chkr Initialsii_Date: " Insp Initials: Inspection Date: (G:BuildingAdmin/WebDocuments/CertificateofOccupancy) 5)06 Date: o 10 South Coast Air Quality Management District 21865 Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-3529 • http:// www.agmd.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: Alec Property Address: I City: 1-`- Contact Person: 01'0p.e,- -r -T �, , M CK It �\ S`l (--( 9 Zip Code: o� Type of Business: P'S k ).7 J''--1- Fax Number: �1 r-5�q r-4 Applicant (print name): r' �"` U�'` Signature: _ -- -�! 7 -��� W 211"C>1 '!� 2 �4�d Title: 1' NP5 j'-''"- Date: Telephone: 3 `13,- 5 %& bl- ?5-11 ' 1 ad ess: nd- Will the facility have any of the following equipment? Yes ❑ No Ey\ <--7 <q Charbroiler Dry cleaning machine Spray booth Printing press (screen/lithographic/flexographic) Internal combustion engine greater than 50 BP (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[:] Nola 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). -2- Revised June 2005 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: Or. P - 12c( FKa Z-, Property Address. City: j`-�g Contact Person: Sri t—c 6 Zip Code: �r.•"ot\ Type of Business: Fax Number: 0, j rf `9 - Applicant (print name): 0 (— &" ` (T Signature: _ Date: --—�! 7 �- 7 2( 2161 Will the facility have any of the following equipment? Yes ❑ No[? Charbroiler Dry cleaning machine Spray booth Printing press (screen/lithographic/flexographic) Internal combustion engine greater than 50 BP (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 Qi 2 C4-d1 i� Title:rPS► Telephoner <4 3 S `75(Y e-mail 71ess: �,�; o "k 0,A �,5 - Will any of the following operations be performed? Yes❑ Noll 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). -2- Revised June 2005