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HomeMy WebLinkAbout15317 Pipeline Ln - CofO (9)s J� HUNTINGTON BEACH CERTIFICATE OF OCCUPANCY 0200 - CITY OF HUNTINGTON BEACH - DEPT. OF BUILDING & SAFETY APPLICATION 714/536-5241 Business License # �+r'Z5 ? & 11 Business Address 15 31'1 1 62 ('Q21 (ei C j^ n Business Owners Name Cj lt1 c1.`(` l "_ S Business Name 2 V-'3 C- A -e -f S Business Type Property Owner Information (required) Tenant/EmergencyContact (reg wired) Name .. n 4",il Name h c't r ( t` e C C) (( 1 ti s Address 1 P • -e L v-*) Home Address 'R l 3 'S— fix, u c N City State/Zip , `� City R t3 State/Zip d Co [ Telephone No. a .. ' ` `i� d Telephone No. If- q 7 r 7 - 3-7 19 Q7 (3`d Floor - Must Apply In -Person) Date 1�1" (C ^ 09 Zip Code -A a- U 4. !l Telephone No. / V - v� 7(�q Bus. Phone - / THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or Existing Building CHECK ALL THAT APPLY: / \ ❑ Change of Property OwnerChange of Occupant ❑Change of Use ❑Additional Occupant ■ Indicate former type of business ■ Are you requesting that the electricity be turned on? Yes,, NOD ■ Is the building sprinklered? Yes I,, Non. ■ Will operations produce dust/wood shavings or similar material? Yes No ■ Will operations involve the repair or replacement of automobile parts Yes 0 No components repaired or replaced. ■ Does the operation involve the use of welding or open flame? Yes Q No ■ Will the busi ess be a drinking, dining or assemb y use with an occupant load of more than 50 persons? Yes ON( ■ The following best describes my operation: ffice Only ❑ Retail Sales ❑ Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food (describe process and end product) Other (describe) W �AjAjJ6 'r 4 1 �, f ,(. If yes: Describe the ❑ Medical/Dental For Official Use Ong Occ Group: Area: JC © Occ Load: 2 Occ Group: 61 Area: Occ Load: 4 Occ Group: Area: Occ Load: Of - Total Sq Ft Occupied:11, f No. of Stories: Z TIF Review: Yi Bldg. Penn it # Entitlement #: Zoning: Plnr Initials: Dater. -16' Plan Chkr Initials: Date: / 1XI Insp Initials: Date: Conditions of Approval or Other Notes: (G:BuildingAdn in/WebDocuments/CertificateofOccupancy) 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: City: ( V f4ip Code: Contact Person: Type of Business: 1 C `10 Ra�Q`i P-� Qf--� Fax Number: 6 =7l% e-mail address: CcC9--C (_0 PTTV qC�-Vs '� �(�'` Applicant (print name): Signature: !� Date: • Will the facility have any of the following equipment? es ❑ 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❑ , NX 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 Title: Telephone 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_ Revised June 2005 0 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 65950.2 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 l � ` i ( ^ City: ( 4ip Code: c`?) 4 1 ^ Contact Person: Title: 2wA QF1 Type of Business: 1 Telephone: ­ 7 / (-/ " --� f 7 - 379 �J Fax Number: .71 q 01(a6 il address: C�CCONN��tC�j'�Applicant (print name): Signature: C,� " L Date: 2 CT nq • Will the facility have any of the following equipment? es ❑ 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❑ NX 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). Revised June 2005