HomeMy WebLinkAbout101 Main St - CofO (61)HUNTINGTON BEACH
CERTIFICATE OF OCCUPANCY 0201D - 0 0 4i 20 q
CITY OF HUNTINGTON BEACH —
DEPT. OF PLANNING & BUILDING APPLICATION
714/536-5241
Business License # A A-7 -7 (p ;� 17
Business Address 10 1 IV) S�
Business Owners Name , , e 2 c h
Business Name /jj :-- c 4 I q
Business Type 'c e.
(3`d Floor - Must Apply In -Person)
_ Date WY 0) �
Zip Code o
_ Telephone No.%/W fob $ f
Bus. Phone`71atr �534 --33 41
ProDertv Owner Information (required) Tenant/Emergencyontact (required)
Name ; 'z v, q kM�' h (ern .4r Name: cfl
Addre F s ;! 1
-S C J' V Home Address 1 c i C Co et s
City 41k ni 4 k c , tate/Zip CA-1City . 'i vt vt, c ac tate/Zip A Lj/Ir
Telephone No. -1 q 6/ % Telephone o. 914 �- 1:1 _3
THIS USE WOULD BE DESCRIBED AS:
Newly Constructed Building or Existing Buildin
CHECK ALL THAT APPLY: _ �
Change of Property Owner Chan e of Occu an Change of Use Additional Occupant
■ Indicate former type of business 0 l C C-
■ Are you requesting that the elect ' 't be turned on? Yes o
■ Is the building sprinklered? Yes No
■ Will operations produce dust/wood shavings or similar material? Yes
■ Will operations involve the repair or replacement of automobile parts Yes No If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes o
■ Will tisiness be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes o
■ The following best describes my operation: Office Only Retail Sales Medical/Dental
Warehouse /Manufacturing/Distribution estaurant Take Out Food
(describe process and end product)
Other (describe)
For Official Use Only b5'0
Occ Group: Area: Occ Load:
Occ Group: Area: 400lOcc Load:
Occ Group: Area: Occ Load:
Total Sq Ft Occupied: No. of Stories: TIF Review: Y UN
Bldg. Permit # Entit ment #: Zoning: SPS —' Le
Plnr Initials )&:Date: Id Plan Chkr Initia Date: D Insp Initials: Date: �� V
Conditions of Approval or Other Notes: p _ _ _ _
Inspection Date:
L
yy 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: /vl :T- P A 8 �' �' 1 v1 C
Property Address: I ` h `�
City: �l u'J I h 0 ►n c-cicZip Code:
Contact Person: -IA"
" i � e �5-n-he a 1j
Type of Business: 0-cr i C e—
Fax Number: ^^
Applicant (print name): J �,q� ' Fe Signature:
Date:
Will the facility have any of the following equipment? Yes ❑
Title: C
Telephone: jLq- S36 -3 3 3
ail ad : �►'� i kee jyt i pp -8 ict 114Co
L p yle1
1►
Charbroiler I
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❑ No
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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