HomeMy WebLinkAbout15311 Pipeline Ln - CofO (12)e le
HUNTINGTON BEACH
CERTIFICATE OF OCCUPANCY 02040 -(I)D09-4
CITY OF HUNTINGTON BEACH -
DEPT. OF BUILDING & SAFETY APPLICATION
714/536-5241
Business License #
Business Address15
Business Owners Name
Business Name
Business Type.
Name
Address
City ,ft
Telephone No.
(P Floor - Must Apply In -Person)
Date O -D6 -'-�)Dlw
Zip Code
Telephone No. 9111 3bl- I aGI
Bus. Phone
C44 Tf�/ City OMAC state/Zip CA M', 25
Telephone No.
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or XExisting Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner ,Change of Occupant 0 Change of Use ❑ Additional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity be turned on? Yes Q N6K
■ Is the building sprinklered? Ye,,X No ❑
■ Will operations produce dust/wood shavings or similar material? Yes . Nox
■ Will operations involve the repair or replacement of automobile parts Yes NoX If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes El Nox
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes ONO W
■ The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑ Medical/Dental
g Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food
(describe process and end product)
XOther (describe) S no
For Official Use Onl
Occ Group: A - o u
Occ Group: 41 I��K�Nou lL
Occ Group:
Total Sq Ft Occupied: 2
Bldg. Permit #
Area: 100
Area: (S L
Area:
No. of Stories:
Entitlement #:
Plnr Initi q
Date 16 Plan Chkr Initials: Date:
Inspection Date:
Occ Load: 1
Occ Load: 5—
Occ Load:
TIF Review: Y/
Zoning: I L
Insp Initials: 4,11 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:
Property Address: 153 P p �i�ne� Lahe
City: IAUY1i1A&n BCOCk Zip Code: VICAq
Contact Person: fhnfe� VhOf Title: QQ
Type of Business: Telephone:
Fax Number: e-mail address:
Applicant (print name): Y1Ylei h Signature: _
Y-►IoPP Date: S
Will the facility have any of the following equipment? Yes ❑ NoK
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[] 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).
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