HomeMy WebLinkAbout118 Main St - CofO (3)V1 9 -g �
HUNTINGTON BEACH
CERTIFICATE OF OCCUPANCY 020 jj- 4 22Ip
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION
(3'd Floor — The Applicant Must Apply In -Person)
a 26U $ .
Business Address (($ MQ1n Skeet A-D-n c� Date 0 06 -1'l
Business Owners Name Zip Code R 20A 8
Business Name SAIR Lb4 EIN-e s's <74 is C'�ev� �Y . Telephone No. 562 — (DJG-3 149
Business Type 'RekrLp Bus. Phone MA
Property Owner Information (required) Tenant/Emergency Contact (required)
Name DAay,,Q 2)� . Name
Address ( t 9, t-An.,IA (?AYppi Home Address ( C1
CitB - State/Zip Q 26 4 g City—� CO- State/ p CC�_ QO Sb4
Telephone No. v� 1 L� ` 5 3('� I gb3 • Telephone No.
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or Existing Building
IS THIS BUILDING FIRE SPRINKLERED? Yes ONO
CHECK ALL THAT APPLY:
❑ Change of Business Owner
■ Indicate former type of business,
■ Are you requesting that the electricity be turned on? ❑Yes gNo
■ Will operations produce dust/wood shavings or similar material? ❑Yes ,ANo
■ 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 XNo
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
❑ Yes XNo
■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? ❑Yes XNo
■ The following best describes my operation: ❑ Office Only )< Retail Sales ❑Medical/Dental
❑Warehouse /Manufacturing/Distribution ❑ Restaurant/Take-Out Food ❑ Other
■ Will any meat products including beef, poultry, and/or fish bee cooked or fried onsite? ❑ Yes 'KNo
If you answered yes, please proceed to the next question.
• Does your facility currently have a grease control device (i.e. grease trap or grease interceptor)?
Check one: ❑ Yes qNo
For O•(Lcial Use Only
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied:
Bldg. Permit #
Planning Initials: jDate:�7� 7
Area: A00
❑ Change of Occupant ❑ Change of Use g Additional Occupant
Occ Load: U ",
Occ Load:
Occ Load:
TIF Review: Y/ N
Zoning: SPS- G
Parking Meets Code (fo'ru e): / N
Building Reviewed By Initials:_gr--_Datei
Conditions of Approval or Other Notes to SF1
Area:
Area:
No. of Stories:
Entitlement #:
Use Permitted: W N
Grease Interceptor Verified Inspected By Initials: Date:
F South Coast
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:
Property Address:
City:
Zip Code:
Contact Person: \✓ ` Title: 6.l `
Type of Business: ��� Q Telephone: 5-(0 2 ' 3� 9
Fax Number: e-mail address: -T2 h�
Applicant (print name): Signature: Date: 0'1 _06
• 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❑ NoJ4
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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