HomeMy WebLinkAbout101 Main St - CofO (63)CERTIFICATE OF OCCUPANCY 020a - S ( to O
CITY OF HUNTINGTON BEACH -
DEPT. OF PLANNING & BUILDING APPLICATION
HUNTINGTON BEACH 714/536- (3'a Floor - Must Apply In -Person)
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Business License # sS Date
Business Address IDI M- tjo 64� . 0 255 Zip Code G1
Business Owners Name T»nacmin aicllnii Telephone No.114-- -isle 1- 5 21
Business Name `Atioroav, VU®,/f yA6d9 AnjCKica5j I -LC Bus. Phone 714-33UI - 52-CO
Business Type
ELoRerty Owner Information (required) Tenant/Emer ency Contact (required)
Name Ahdf JMu-, i CO• , L-LC Name rqr/E'er --
Address -7575 '?-evvlAtlk hwr1G_ Home Address, l5
City jh4l t�h_State/I.ip 612bCity�(�s i�(1 State/Zip _
Telephone 140. Telephone No. -71 �Ffol - 52 I
TIUS USE WOULD BE DESCRIBED AS:
D Newly Constructed Building or l$#3xisting Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner [RChange of Occupant ❑Change of Use ❑Additional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity ge turned on? Yes No❑
■ Is the building sprinklered? Ye'sO No
• Will operations produce dust/wood shavings or similar material? Yes❑ Now
• Will operations involve the repair or replacement of automobile parts YesQ Nog' If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? YesQ Noe
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes QNoA/ _ -
■ The following best describes my oper tio& ffice Only__ . ❑Retail Sales D Medical/Dental
Warehouse /Manufacturing/Distribn -L I Restaucant/Take Out Food
(describe process and end product)
Other (describe)
For Official Use Onl
Occ Group: Area: — Occ Load: _
Occ Group:_ _ Area: Occ Load
Occ Group: _ Area: _ Occ Load:
Total Sq Ft Occupied: No. of Stories: TIF Review: Y/e 1 >
Bldg. Permit # ° Entitlement #: Zoning:��
Plnr Initials: 1� Date: �•�• t2.Plan Chkr Initials: Date: _ Insp Initials: Date: _
Conditions of Approval or Other Notes:
fi ''C£ ` _.�P.. fa9BJ eyy-.'zoo):_�. --- -
Inspection Date:
South Coast
Mil
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
' ®= (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: X vivioczavi Wot I a W i CIE AHL:V i CO'S t L_,LE
Property Address: I o 1 Maivi 5k . -W 2 26-
City: 'bPad1 . dip Code: 6)91i4b
Contact Person: v CoF-f1�5C Title: _
Type of Business: '71 q- $(ol -52m Telephone: _
Fax Number: t7 Iu) o l --/53 1 P✓Aerirez �Q i3Oyj&wP'W irad "dress: _
Applicant (print name): Signature: 4-
�✓ 1�OIM1✓QZ Date:
s
• 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 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❑ NN
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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