HomeMy WebLinkAbout126 Main St - CofO (22)L CERTIFICATE OF OCCUPANCY 02010
CITY OF HUNTINGTON BEACH —
DEPT. OF PLANNING & BUILDING APPLICATION
HUN71NG70N BEACH 714/536-5241. S �P ' S2, ` r (3`d Floor —Must Apply In -Person)
Business License # A 227 0 z2 Date i LA 20 I U
Business Address 12 6 Me i h s-r tt ZO j Zip Code q'L 6 q 2
Business Owners Name (C� v;� zLnrv,, /h4;n S{,,� Come-, s Telephone No. 5(.z.-305• /yGG
Business Name Bus. Phone 7/y- r/ C g 000
Business Type RP.S�aurhr�
Property Owner Information (required) Tenant/Emergency Contact (required)
Name 'Z-e. i tk� w% �YC �e tr � i c5 Name Ke , ,,, A c%L rf.
Address 174S Q q"c201 Home Address l-q 15 4J,
City 0 rra.►1g tate/Zip Cat q 2 PZ>9 City N 13 State/Zip Cam,, qjZ(N g
Telephone No. 7 / `t 7q(, O q Z z Telephone No. qQ_ - 30 S- W 0 0
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or 9 Existing Building
CHECK ALL THAT APPLY:
0 Change of Property Owner Change of Occupant []Change of Use ❑Additional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity be turned on? Yes[] No%
■ Is the building sprinklered? Ye4 No❑
■ Will operations produce dust/wood shavings or similar material? Yes[] , No11
■ Will operations involve the repair or replacement of automobile parts YesQ NoA If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? YesN NOD
• Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes NNo ❑
■ The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑ Medical/Dental
❑ Warehouse /Manufacturing/Distribution W Restaurant/Take Out Food
(describe process and end product)
Other (describe)
For Official Use On f '4'r'Lj 4., O « /' J &_'�c✓/L
Occ Group: / r °r Area: 6 � ✓: Occ Load: t
Occ Group: Area: Occ Load
Occ Group: Area: 2, 5 Occ Load:
Total Sq Ft Occupied: a0 cr, f , No. of Stories: _I_ TIF Review: Y/
Bldg. Permit # Entitlement #: Zoning: srn -(A-
Plnr Initials: Date: 2`Z JVPlan Chkr Initials: ate: � �� '0 Insp Initials: `Date: �i lC^
Conditions of Approval or Other Notes:
S
5
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South Coast
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
0 r 0 ;. (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: -2, h cal �7 1 otw
Property Address: Iglu mc,;A S1 LL -42-0
City: fib Zip Code: I -LC q
Contact Person: ke,,.; V Uosev, Title: O1QA,:v
Type of Business: Telephone: s(-Z-'3a5- /#00
Fax Number: 71V 17CgO004 e-mail address:
Applicant (print name): + v.A Unso, Signature:
Date:
• 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 HP (excluding motor vehicles)
Boiler/combustion equipment (greater than I 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[] Nowd
Application of paints or adhesives
Etching,` plating, casting, or meltingof 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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