HomeMy WebLinkAbout126 Main St - CofO (11)o
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HUNTINGTON BEACH
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CERTIFICATE OF OCCUPANCY 20(PA- - �a l
CITY OF HUNTINGTON BEACH -
DEPT. OF BUILDING & SAFETY APPLICATION
714/536-5241
(3rd Floor - Must Apply In -Person)
Business Address/ Z (o M rA %v1 5As 2e--t- ( 0 Zip Code q Z (oq rg
Business Owners.Name A.40av K P+1 Telephone No. '7 ('l - 37�i- Z S7 3
Business Name ku Xos� IAA .�e,f -� , XA Cr Bus. Phone 71 t% - S3 6 ?a s(
Business Type (2o.ko,i ( It
Property Owner Information (required) Tenant/Emergencv Contact (required)
Name Name AgAo"t h-,
Address Zoo Home Address 3 0o Ac kt .tom 4 0
City 14 • IS State/Zip L'tA 9 M2t-(g City 14-3 State/Zip CA- .
Telephone No. 7141 - 3 0 Q- 33S W Telephone No. i 14 •37 4 -a 3 7 3
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Buildingor X Existing Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner ❑Change of Occupant ❑Change of Use ❑Additional Occupant
■ Indicate former type of business �Ci t t
■ Are you requesting that the electricity be turned on? Yes NON"
■ Is the building sprinklered? Yes' • Non
■ Will operations produce dust/wood shavings or similar material? Yes . Noy
■ Will operations involve the repair or replacement of automobile parts Yes 0 No)( If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes El Nod(
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes E]No J
■ The following best describes my operation: ❑ Office Only ,Retail Sales ❑ Medical/Dental
❑ Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food
(describe process and end product) g7F—' �%l CAO OlcaSS �cu c
❑ Other (describe)
For Official Use Onl
Occ Group: M Area: --QO cb
Occ Group: Area: ro O
Occ Group: 5L-1 Area:
Total Sq FtOccupied: 'S(7 No. of Stories: d vt
Bldg. Permit # - Q Entitlement #:
Plnr Initialsz Date-'q Plan Chkr Initials:_
Conditions of Approval or Other Notes:
Inspection Date:
(G:Buildin gAdmin/webDocuments/CertificateofOccupancy)
Occ Load: S3
Occ Load: ^
Occ Load:
TIF Review: Y/ N
Zoning: 8 [)I T• 3�
Date: 3 q Insp Initials:� =C" Date: 6 • d?
1
" South Coast
I 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:.J6 A Sv lt' - 00A S eo 6- t T%A C
Property Address: J Z (o Vgc•k%A
City: 11I - Z Zip Code: Z 6 4
Contact Person: Aoaov\ Ta I Title: O W tn-e i-
Typeof Business: ?.)tcx't` (,lpj\NjWt,—C-,CtkS.Soft.2S Telephone: 71-eL-! 3Vo -7-9
Fax Number: J1q •- g065' e-m ' address:
Applicant (print name): Signature: / k:
A" O � 701t Date: 3 i'K / 0 5-
• Will the facility have any of the following equipment? Yes ❑ NoK
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❑ NoX
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 2003