HomeMy WebLinkAbout15262 Pipeline Ln - CofO (2)J�
HUNTINGTON BEACH
CERTIFICATE OF OCCUPANCY 020
CITY OF HUNTINGTON BEACH —
DEPT. OF PLANNING & BUILDING APPLICATION
714/536-5241
(3'd Floor - Must Apply In -Person)
Business License # A) i & / -6 Date 6 Z$—( I
Business Address .1,E-61 1 S ZAS -2 QI�FLU h)E- Zip Code C) 7-6 0Business Owners Name E-W 1 �' -S Telephone No. '714 3 7 3 n �6
Business. Name Uy-os G AJ,!ST INC . C Bus. Phone
Business Type RC- sm fi vTta!_ CeNTRAC1be- I -
Property Owner Information (required) Tenant/Emergency Contact (required)
Name PaWK A tN44emS Name LONN I E � �A�.k(cTS►S
Address 161 SI .SAN7A p&AAA . L/V Home Address 1GI51 -5 4 GAQUA LA/
City -1=�N State/Zip CA 12,6�-cl City 14,q State/Zip Ck. 12641
Telephone No. _ '714 $ If6 4797 Telephone No. 71 ii- 34r. 42 7
THIS. USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building . or Existing Building
CHECK ALL THAT APPLY:
❑ Change, of Property Owner Change of Occupant ❑ Change of Use 5eAdditional Occupant
■ Indicate former type of business %09 I_ cow-imcfia
■ Are you requesting that the electricity a turned on? Yes El N
■ Is the building sprinklered? YeW . No❑
■ Will operations produce dust/wood shavings or similar material? Yes❑ No5iRe"
■ Will'operations involve. the repair or replacement of automobile parts Yes Q No,Z' If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? YesO
• Will the business be a drinking; dining or assembly use with an occupant load of more than 50 persons?
Yes ONo)K
■ The following best describes my operation: )l Office Only El Retail Sales ❑ Medical/Dental
Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food
(describe process and end product)
---- "Other (describe)
For Official Use Only
Occ Group: �^ r
Occ Group: _ Area: (o_ omz' Occ Load :y
Occ Group: Area: —� Occ Load:
Total Sq Ft Occupied: 2, o�c No. of Stories: j TIF Review: Y/ N
Bldg. Permit # Entitlement #: Zoning:
Plm• Initials:_ Date: Plan Chkr Initials ate Insp Initials- Date: 4 2—
Conditions of Approval or Other Notes:
U YZGN�C tz; VS-C w ,vrlT�tLYJ .
Inspection Date:
Area: 6" OV-4 Occ Load: 2
South Coast g
& I
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
k@D (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: GPtLVCLS C)ONS r
Property Address: 15 26Z P P&L( w F
City: I-Z-22 Zip Code: 01 Z6� 9
Contact Person: PRAWV- 14kAIL --4-7--V-3� Title: OW (VIE-2
Type of Business: GEv62A- cAV?WbL- Telephone: Il�Y -571, $'s4S
Fax Number: 7 �t e- dress:
Applicant (print name): x-\ -SIKIE Signature:
Date:
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 50 HP (excluding m6tor 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). ' � - .
-2-