Loading...
HomeMy WebLinkAbout15319 Pipeline Ln - CofO (6)L + 714/536-5271 Business Licen Business Addrf Business Owne Business Name Business Type Certificate of Occupancy No. 0200 6t -- ,Sp APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH — DEPT. OF BUILDING & SAFETY Q Floor_Must Apply In -Person) Date'? l?- , 2! v9 2 Zip Code cl-941 I Telephone No. 6aG ci 7�-- 9D o Bus. Phone . 06 ?7r- el-/ © Property Owner Information (required) Tenant/Emergency Contact (required) Name /�yvr>[ (��T— Name C-��i'ICeS ge-g 4�. Address I/ ,P11 �� Ave- -- Home Address , City Mrm-62e�K State/Zip a4y7City ,(1 � State/Zip 6V,9- 4717y Telephone No. i �� `� ZS= I -IS Telephone No. 67/ - J0 7 % 7� THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or Existing Building CHECK ALL THAT APPLY: ❑ Change of Property Owner 0 Change of Occupant ❑ Change of Use ❑ Additional Occupant ■ Indicate former type of business ■ Are you requesting that the electrici�y)de turned on? Yes QNo ■ Is the building sprinklered? Yes QNo❑ ■ Will operations produce dust/wood shavings or similar material? Yes ONo ■ Will operations involve the repair or replacement of automobile parts Yes oNo If yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? Yes ONo IV ■ Will the busiWSs be a drinking, dining or assembly use with an occupant load of more than 50 persons? Yes ❑No ■ The following best describes my operation: 13' Office Only ❑ Retail Sales 0 Medical/Dental ❑ Restaurant/Take Out Food ❑ Warehouse /Manufaetu�ing/Distribution ( scribe process and end product) Other (describe) _ _ � ' c-- --7- T- For Official Use Onl Occ Group: Area: /44y Occ Group: . Area: Occ Group: Area: Total Sq Ft Occupied: _ No. of Stories: _ Bldg. Permit # Entitlement #: Plnr Initials: Date 1 (� Plan Chkr Initials: Date Conditions of Approval or Other Notes: Inspection Date: Occ Load: / Occ Load: Occ Load: TIF Review- L / N Zoning: Insp Initials: 1L;,.,f---'Date: 2' 1 (G:Building/Forms/document id goes here) South Coast Air Quality Management District 21865 E. Copley Drive Diamond Bar, CA 91765-4182 (909) 396-3529 htpp://www.agmd.gov Air Quality Permit Checklist California Government Code 65850.2 prohibits cities from issuing a Certificate of Occupancy 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: �T 111M Awe- 1 v City: ,� ,l�Tl ✓ 4-2D 220440H , Zip Code: V/01 Contact Person: Title: Pj402l'Ial(?�4 j Type of Business: to pp� Ty �'Y A4ft!n/I et, I Telephone:() Applicant: (print name) jUl o &d L01itlow Aludwq—.— Signature: 0 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 50HP) (excluding motor vehicles) Boiler/combustion equipment (greater than 2 million BTU/hr. maximum input) Abrasive blasting cabinet/room Baghouse/cartridge type dust filter/scrubber Motor fuel storage and dispensing equipment Q Will any of the following operations be performed? Yes NO ❑ Application of paints or adhesives Etching, plating, casting, or melting of metals Molding and blending of liquids and/or powders Storage of acids, solvents, organic liquids or fuels Production of acids, solvents, organic liquids, or fuels Production of fumes, dust, smoke or strong odors QIf you answered "No" to both questions, this checklist is your clearance from AQMD. DIf 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 (800) 388-2121. South Coast wo 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: Vp W 5—ko M Property Address: V � c3 1 I ? fit' E L1 N E City: 1JJN} tr tToN i ,�tp� . Zip Code: Contact Person: l-1�A Type of Business:>Jic��pDN�DQ Fax Number: Applicant (print name) Signature: -rAb Ii.tA- Date: La- . 9 26 41 Title: D-WER Telephone: C5-62.) z R, 36 4cl 1 e-ma' ad ss: • Will the facility have any of the following equipment? Yes 2' No ❑ Charbroiler Dry cleaning machine Spray booth Printing press (screen/lithographic/flexogmphic) 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? Yes9' 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-