HomeMy WebLinkAbout119 Main St - CofO (7)r .
CERTIFICATE OF OCCUPANCY 020JL - 3
CITY OF HUNTINGTON BEACH
DEPT. OF PLANNING & BUILDING APPLICATION
(3''d Floor -Must Apply In -Person)
Business License # � �.:-10 62
Business Address 1`1-M/3 /N S T
Business Owners Name V 000- f} SW
Business Name l+DAc-Ti QtJ <G c-
Business Type �'' .r C -0S"27 XL y-, e- S,. C rt •S
Date 6-/o-2-610
Zip Code 9_U0q -Ii�7��-5��
Telephone No. ti49- 2-3-1-14-17'
Bus. Phone 1 `f S- is'Y-/ 2 3 9
Property Owner Information (required) Tena t/Emergency Contact (required)
Name _ y��C�Al i a,Qy D Name ��y/Jit 5��, a�•1
Address � : r ck� � j j �vv 1� Home Address -7 tJt mr)sQ2
Cit} des+ �115 'State/Zip �P. _ � - CityOEWcy►-T 1RtE� H State/Zip 6/� l ei Z to O
Telephone No. t �•'10D- 0533 JTelephone No. 'q f 7 - 29 n - Li 7 7 2
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or (" Existing Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner ❑ Change of Occupant ❑ Change of Us DAditional Occupant
■ Indicate former type of business
• Are you requesting that the electricity be turned on? YesE]NoX
■ Is the building sprin1dered? Yes ONo❑
■ Will operations produce dust/wood shavings or similar material? YesONo�
■ Will operations involve the repair or replacement of automobile parts Yes ONo If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes 0Noy
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes ONo)>(
■ The following best describes my operation: ❑ Office Only C eta�Sales❑ Medical/Dental
❑ Restaurant/Take Out Food ❑ Warehouse /Manufacturin ism
(describe process and end product)
❑ Other (describe)
.43 pKe✓rw-f)
For Official Use Only
Occ Group: to
Occ Group:
Oce Group:_
Total Sq Ft Occupied:
Bldg. Permit #
Area: �{v�
Area:
Area:
No. of Stories:
Entitlement #:
C 5p1-A e
Occ Load: go
Occ Load :
Occ Load:
TIF Review: Y/
Zoning: % ('� C
Plnr Initials: t Date -Co I • 6 Plan Chkr Initials: Date: I l l' Insp Initials: FJ� Date: 1- Z. ro
Conditions of Approval or Other Notes:
Inspection Date:
(G:Building/Forms/document id goes here)
South Coast
Air Quality Management District
21865 E. Copley Drive
Diamond Bar, CA 91765-4182
(909) 396-3529 htpp://www.agmd.gov
Air Quality Permit Checklist
California Government Code 65850.2 prohibits cities from issuing a Certificate of Occupancy 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:
City:
Contact Person:
Type of Business:
%J0I T 1 mA jr'V C=12iI7�c
/Cj 5%
N T/NG TON S Zip Code: C Z4 V 9
Sco (T Si offJ Title: 4c600),j 1 1NlI
CDC/15AC r�-S
Applicant: (print name) S c4> TI` 5'/n-1 or/
Telephone:() -/z3 '
Signature:
Q Will the facility have any of the following equipment? Yes []No d
Charbroiler
Dry cleaning machine
Spray Booth
Printing Press (screen/lithographic/flexographic)
Internal combustion engine (greater than 50HP) (excluding motor vehicles)
Boiler/combustion equipment (greater than 2 million BTU/hr. maximum input)
Abrasive blasting cabinet/room
Baghouse/cartridge type dust filter/scrubber
Motor fuel storage and dispensing equipment
Q Will any of the following operations be performed? Yes ONo
Application of paints or adhesives
Etching, plating, casting, or melting of metals
__..._ Molding_and blending of_liquids_and/-or-powders
Storage of acids, solvents, organic liquids or fuels
Production of acids, solvents, organic liquids, or fuels
Production of fumes, dust, smoke or strong odors
QIf you answered "No" to both questions, this checklist is your clearance from AQMD.
QIf 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 (800) 388-2121.