Loading...
HomeMy WebLinkAbout15331 Pipeline Ln - CofO (3)APPLICATION FOR CERTIFICATE OF 0(C&PANCY v C,ITY'OF AUi ITINGTON BEACH 1DEP RTINMNT OF BUILDING u SAYE T (3rc1 Fiao1'—11,sfppiy lay -Person) ' Business License st Date "�20 /-Address: 4;4-kMvn 9�6y �1 »�© i Tele hone Business i Tarim o �' Business Type v» 'eve a ►^ Prooerty Owner Information Bu�iness Owner dame ("1 C D r A P 2 U O T 1 CS _ Ntame ' e.n Ai 5 Addres34 � '� MA c-A4 T�U� (3L,yD A 343 Home Addre s yo - < a d-Qr City 3y{ W r�2i 3L�k Ch Tel. _ City`!5 . -d n i�v� _Tee 1 � y THIS USE WOULD BE DESCRIBED AS: ONewly Constructed Building or OExisturg Building CHECI£ 41L THAT APPLY: 'PChange of Owner Change of Occupant ElChange of Use ❑Additional Occupant Indicate fonner use, if any ' J Does the building have electricity? Yes' NOU I If moo, are you requesting that the electricity be turned orr? Yes No Tlie building is sprinldered? Yes NO Operations will product-dust/wood shavings or similar material? Yes ❑' No Operations will involve the repair or replacement of autonio6ile i;u is Yes` No J If yes: ascribe the coinpofients Te aired or replaced. Alt Does the operation involve the use, :' ;.ng or open wine? Yes No The business is drinidng, dining or a.,,, ; use that will result in an occupant load r ` of more than 50 persons. Yes U 1\T0 The following best describes my operation: Office Oril i ElRetail Sales ElMedical/Dental lCRestaurant/Take Out Food ❑Warehouse r, a ivlaiufacturing/Distribution (describe process and end product) Other �deseribe) CIO Gam.;.--•� s I ssoutil Coast Air Quality Management District 21865 E. Copley Drive Diamond Bar, CA 91765-4182 ( 909) 396-3529 htpp //wNvNv.agmd.,-ov Air Quality Permit Check -list California Government Code 65850.2 prohibits cities from issuing a Certificate of Occup ancy to a business without clearance from the local air quality agency. This checklist will determine if you need to obtain ciearance from the South Coast Air Quality Management District (AQMD). Company Name: Property Address: ? 1 "PC L.1 N` G LN City: l-1 �3Nz ti�otS Zip Code: 4 Title : d6vm Contact Person.: Type of Business: 0 r;o •t �- ` �iY� Telephone: { ���' Q%`S Applicant: (print name)1 Ii Signatur . Will the facility have any of the following equipment? Yes ® No Charbroiler Dry cleaning rnachine Spray Booth PrintincrPress (screen/lithographic/flexographic) Internal combustion engine (greater than 50HP),(excluding motor vehicles) 'onequipment eater than 2 million BTU/hr. maximum input) ' aombusti(� er/ Boil blasting g cab inet/room Baghouse/cartridge type dust filter/scrubber Motor fuel storage and dispensing equipment 0 �— ` Yes N v operations be performed? foll owing in ' an of the f g p Well Y Application of paints or adhesives Etching, plating,. casting, or melting of metals Molding and blending of liquids and/or powders Storage of acids, solvents, organicliquids or fuels Production 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 you: clearance from AQ)v • If you answered "Yes" to either question, you must contact AQIv1D to determine if air quality permits are required. If permits' are needed, AQ1II? will assist you in submitting permit application(s);and then provide you tance Office at (80t1) 388 aL1. with a clearance letter. 1'ou can call AQMD at their Small Business Assis v yh° Ft�x 3 r C y ) t€ t '+ta r.h� � t4 c p4. as .� r! X�"�.� �.- FORSTRUCI AT o 05PT, Or MU, COMA#Uh! 7Y G' E i (�i7MENT �fV, s GtTY OF HUN rNqG1 C�t�Ek,CN is P ° r 4" k 4 v ( j � k r.x ft PE S i c t 1S, 6.4� u �► W a� x. x ilk,� a �v t Tad M, aJ� ,�/ _ 5 4. �tJ (✓ fi. ze�Dt t D'` f �"w' fib} �� y a j�,,•k �{L �j ! j,' � t