HomeMy WebLinkAbout15329 Pipeline Ln - CofO (4)� R
1�b
He
HUNTINGTON BEACH
CERTIFICATE OF OCCUPANCY 020 - (to
CITY OF HUNTINGTON BEACH —
DEPT. OF PLANNING & BUILDING APPLICATION
(3rd Floor — Must Apply In -Person)
Business License #���
tu
ine5 s'Address 15 �' 2Q I v+ Lan-e 14 E
'6ss Owners Name �PA«.1 «l��
Bu ss Name
sine Type i b i_�
714/536-5241
Date ? -15<- 11
Zip Code
Telephone No. S yl - 9L1L1- SS-7Z-
'_Bus�hore
Property Owner Information (required) Tenant/Emergency_Contact (required)
Name s ,,+ c, 14 ` (1� Name aL'j A h l ✓A 1L_
Address 213 cn (u I Ir) , Home Address c
City R c.lboai 51t„mod State/Zip C A q2 G�� City y� J(u d State/Zip � g7S 61
Telephone No. 0149 7 % - 1 So U Telephone No. Sal 94g - SS-72r
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or Wfixisting Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner b&hange of Occupant ❑Change of Use ❑Additional Occupant
■ Indicate former type of business NL. _G 1011f,a Q,,,,.,
■ Are you requesting that the electricity be turned on? Yes0_ NOD
■ Is the building sprinklered? Yeses No
■ Will operations produce dust/wood shavings or similar material? Yes . No.�
■ Will operations involve the repair or replacement of automobile parts Yes$W No El If yes: Describe the
components repaired or replaced. LqAbb �i n k—. /-I x C w,
■ Does the operation involve the use of welding o open flame? ❑
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes QNoCt9','
■ The, following best describes my operation: ❑ Office Only ❑ Retail Sales ❑ Medical/Dental
,,dWarehouse /Manufacturing/Distribution ElRestaurant/Take Out Food
escribe process and end product) ,
L62-
Other (describe) S .i-n -t /_/11 A 2, I C ,..,, IA -i o rl h1lan C.ct.Ue
For Official Use Onl
Occ Group: Area:Occ Load:
Occ Group: Area: Occ Load: 2—
Occ Group: Area: Occ Load:
Total Sq Ft Occupied: No. of Stories: TIF Revije Y/ N
Bldg. Permit # Entitlement #: Zoning: 1,
Plnr Initiaj& V,Date:O` Plan Chkr Initials:ate: 5/"A 1 Insp Initials: ZL_ Date: l l l
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).
o 'Name:
Property Address: 5 `
City: _A Zip Code:
Contact Person: _ AL,,L
Ln.
Title:
Type of Business: H6 b7 51 ° IY Telephone: 5 y 1-
Fax Number: e-mail address:
Applicant (print name): Signature: �_ 4
Date: 2_-ZSr- )!
Will the facility have any of the following equipment? Yes ❑ NoLg�,
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[l NcCj
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-