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HomeMy WebLinkAbout101 Main St - CofO (64)qV(-M1q1n aJJ CERTIFICATE OF OCCUPANCY �,020— - CITY OF HUNTINGTON BEACH — DEPT. OF PLANNING & BUILDING APPLICATION HUNTINGTON BEACH 714/536-524I (3`d Floor — Must Apply In -Person) Business License # A® L,5'?— 3 d Date ­11-2O/l Business Address Qj M AIA)!5r AM .0 121 Zip Code Business Owners Name : A u. S sigg,,el s' LL. 6 ,Telephone No. '>,/V 536 Business Name 64f--UVfl Bus. Phone I lel 5;?C G l Business Type 9427;rG Property Owner Information (required) Tenant/Emergency Contact (required) Name A D C Name 2 A(, &LA C—UA 0T / Address Home Ad ress �z�f- C ()C—'.�iy/3 sme, City . C4 State/Zip 9 Z6 cj "J City State/Zip q Z 6 y(3 Telephone No. �11L/) _S-3� - (SS'6 7 Telephone No.y1�8 - w5�3 THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or ,?I-xisting Building CHECK ALL THAT APPLY: ❑ Change of Property Owner ❑Change of Occupant ❑Change of Use ❑Additional Occupant ■ Indicate former type of business/j /L _ ■ Are you requesting that the electricity be turned on? Yes Nair ■ Is the building sprinklered? Yesb"- No❑ ■ Will operations produce dust/wood shavings or similar material? Yes❑ Now ■ Will operations involve the repair or replacement of automobile parts YesEl Ng.' If yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? Yes E.1 Nqz' ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? Yes (]No P- ■ The following best describes my operation: ❑ Office Only Prietail Sales ❑ Medical/Dental ❑ Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food (describe process and end product) Other (describe) For Official Use 0 Occ Group: Area: 1� © ho Occ Load: 3(p� Occ Group: Area: Occ Load Occ Group: Area: Occ Load: Total Sq Ft Occupied: ®G -Pi No. of Stories: TIF Review: Y/ N Bldg. Permit # Entitlement #: Zoning: S's, _ G l: Plnr Initials:' Date: 31 t 1 1 �lan Chkr Initialste: 3q 11 I I Insp Initials: Date: Conditions of Approval or Other Notes: Inspection Date: 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: Property Address: f Q / /VglAj 5r /0 / City: 14 eVT tkjj, Zip Code: 2ZGq S Contact Person:,,) PIAL Type of Business:�- Title: _CjL Telephone: —Vqg- z//y3 Fax Number: e-mail address: Applicant (print name): / � Signature, y r Date: — // — ZD / / • Will the facility have any of the following equipment? Yes ❑ No 2' 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[] 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). -2-