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HomeMy WebLinkAbout15262 Pipeline Ln - CofO (3)• CERTIFICATE OF OCCUPANCY 0201 - 00 IvCJ J�- CITY OF HUNTINGTON BEACH — DEPT. OF PLANNING & BUILDING APPLICATION HUNTINGTON BEACH 714/536-5241 (3`d Floor — Must Apply In -Person) Business Licen Business Addrf Business Owne Business Name Business Type Date �7- "�- - ( -7) Zip Code 07 2-6 cl Telephone.No. Bus. Phone 74h 373- '8r11r�- Property Owner Information (required) Tenant/Emer encv C1 ontact (required) Name Frte. [ ,y &dvs ah t Name RA 41'h C� i c-1L js U Address Ca /�'nc, Home Address 16 /�l �y�., nr rk CitySa State/Zip City • 13 _ State/Zip S'o� 4i cf Telephone No. Telephone No. -7 THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or &:Existing Building CHECK ALL THAT APPLY: ❑ Change of Property Owner ❑ Change of Occ u ant ❑ Change of Use additional Occupant ■ Indicate former type of business C—,-cvt (fp 'fav- ■ Are you requesting that the electricity be turned on? Yes0 NoZ ■ Is the building sprinklered? Yes , No❑ ■ Will operations produce dust/wood shavings or similar material? Yes❑ N RF ■ Will operations involve the repair or replacement of automobile parts Yes Now If yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? Yes O N6Z ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? Yes ONo ■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? Yes 'ONo ❑ ■ ollowing best describes my operation: )*OfftccOnly ❑ Retail Sales ❑ Medical/Dental Warehous /Manufacturing/Distribution ❑ Restaurant/Take Out Food (descn a process and end product) Other (describe) For Official Use Onl Occ Group: Occ Group: 5 1 Occ Group: Total Sq Ft Occupied: Bldg. Permit # Occ Load: �O4D Occ Load: 15 Occ Load: TIF Review: Y/ N Entitlement #: Zoning: 2 Plnr Initials: �f� Date. $-I 72 Plan Chkr Initials: Date: �3 Insp Initials: Date: N jy `J Conditions Hof Approval or Other Notes: Area: �O S 411 Area: Area: No. of Stories: Inspection Date: Tn BALL //y 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: sc k_ s cc U0-1 V lk 4ulo e3 . Property Address: /5_1(_Z f�l Pe �'� 114 City: �1 - 6 . Zip Code Contact Person: M&rry Kolte✓' Type of Business: 67 ekt - CGPrfyrL�c frv- 9,6 - i).l GIG �za C/5 Title: Telephone: Fax Number: e-mail address: _ Applicant (print name) b v Pbl&aSignature: Date: • Will the facility have any of the following equipment? Yes ❑ NoV- 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❑ Nob 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). M