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HomeMy WebLinkAbout126 Main St - CofO (30)S • CERTIFICATE OF OCCUPANCY' - f �J � CITY OF HUNTINGTON BEACH - DEPT. OF PLANNING & BUILDING APPLICATION HUNTINGTON BEACH 714/536-5241 (3'd Floor - Must Apply In -Person) Business License # P, -X-� © S- (O oti Date -7 is 2.012 Business Address `'Z(o Mp,ttii e;-r Zip Code of,1694; Business Owners Name ft tv F��('-,L'tunl Telephone No.7iy �G/-7-g319 Business Name Sy P EYZE VVE-yLo� s C any o W t c_N L� Bus. Phone --7►y & Z- j?zZ Business Type Property Owner Information (required) Tenant/Emergency Contact (required) Name Z-C;T 0 A.tN ,p(LD Q[2Ti LC Name �� N % is t_ is /-1 L/ /44 Address o Home Address -11 d t_`.�w fy� D i2 City _ (� , tatep = ��City El , g , State/Zip C.A- o� y Telephone No. '� �-{ too Telephone No. 114) -701'7 _ of 3 / aj THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or )<Existing Building CHECK ALL THAT APPLY: ❑ Change of Property Owner ❑Change of Occupant I-hange of Use ❑Additional Occupant ■ Indicate former type of business SPrr, U - CAA gas y G7 F2.owt Qup-L hoc �a�t-Y -Fo -T,u N iDL^I— ■ Are you requesting that the electricity be turned on? Yes El NOD ■ Is the building sprinklered? Yew' , No ■ Will operations produce dust/wood shavings or similar material? Yes ❑ NOX ■ Will operations involve the repair or replacement of automobile parts Yes No'A If yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? YeSO No ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? Yes ONoy, ■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? Yes ONo)< ■ The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑ Medical/Dental ❑ Warehouse /Manufacturing/Distribution XRestaurant/Take Out Food (describe process and end product) SpsN�j�',� 'CO (ail - Other (describe) For Official Use Onl Occ Group: Occ Group: Occ Group: Total Sq Ft Occupied: Plnr Initials: Date: % 26-1 L Plan or 01ther Notes: Area: Area: Area: No. of Stories: Occ Load: Occ Load: Occ Load: TIF Review: Y/ N Entitlement #: Zoning: Initials: Date: Insp Initials: Date: i 1 i3 — 1 Z - X:3041 CA chi _ — ?1L6/I0'5c.V 9A9 rA15 Sv, lif tk l02 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: sov-- ��� Property Address: �Z�o Chi City: ktrF(ej(sT M qw-4 Contact Person: OAr11,-1- Gq MA Type of Business: `) c- I Sri N G -0 «er-F—S Si ::A-it>4 Zip Code: Ci a�lv'-} puyl.Jep� o! e."c�cL�� Title: -114 101-1-1131ci Telephone: FaxNumber:14 3�py �I-414 AJ6AuA1/&4M(--Uf9-mail address: _ Applicant (print name): Da*►TZL- 6AUNA'Signature: s Date: '7�Zo I rL • Will the facility have any of the following equipment? Yes ❑ Nox 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[-] NoP( 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- t