HomeMy WebLinkAbout15061 Springdale St - CofO (35)J�
HUNTINGTON BEACH
Business License #
CERTIFICATE OF OCCUPANCY 02007
CITY OF HUNTINGTON BEACH -
DEPT. OF BUILDING & SAFETY APPLICATION
714/536-5241 4ti 51, /
. P?s 3 Y
Business Address ISC
Business Owners Name
(3rd Floor - Must Apply In -Person)
Date �� % zo69
Zip Code (P
Telephone No. S-9-WD,- 56�
Business Name Bus. Phone 5Q Nvt�
Business Type jCOM-
Property Owner Information (required) Tenant/Emergency Contact (required)
Name n, ;4; Name i a COurd -
Address j J r) 0 1152 resn Z net d C-7 4$ Home Address 67e' l
City �1}a .-P-4 c9 h Lek S tate/Zip M N 5 S 3 j -city K)c u. -. l k_ State/Zip C A- aCo�
Telephone No. �15a 7 / a-! 3 -L/`itf Telephone No. _ - qN --5T `/
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or xisting Building
CHECK ALL THAT APPLY:
❑ Change of,Property Owner hange of Occupant ❑Change of Use []Additional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity be turned on? Yes Q No
■ Is the building sprinklered? Ye§1 , No❑
■ Will operations produce dust/wood shavings or similar material? Yes ❑
■ Will operations involve the repair or replacement of automobile parts Yes
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes 0 Nol
■ Will the bu iness be a drinking, dining or assembly use with an occupant 1�
Yes ❑ No
NoSZ
No If yes: Describe the
of more than 50 persons?
■ The folio ing best describes my operation: Yqestaurant/Take
ffice Only ❑ Retail Sales ❑ Medical/Dental
❑ Warehouse /Manufacturing/Distribution Out Food
(describe process and end product)
❑ Other (describe)
For Official Use Only 3 y
Occ Group: Area: Occ Load: 24
Occ Group: Area: Occ Load:
Occ Group: Area: _ Oce Load:
Total Sq Ft Occupied: �_ �, No. of Stories: L TIF Review: Y/ N
Bldg. Permit# 23ro Entitlement #: Zoning: 0 Ga
Plnr Initials: �%G v' j_ Date: I j-15~' / lan Chkr Initials: —Date: Vd `jInsp Initials: 4eDate: �®
Conditions of Approval or Other Notes:
Inspection Date:
` South Coast
4' Air Quality Management District
21865 Copley Drive,' Diamond Bar, CA 91765-4182
Sul; (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: Q j g r 7/1 (, /1%Qv
Property Address: I'5Dca ` PR
City:
a rjh-{�n9!' V A '-A- cKZip Code: C'�'D04&
Contact Person:
� o;F
Title: ` d� _G, Air
Type of Business: (0fn pCA jf& l1 ajjC>wapTelephone: pLTa.,-� t �_-3S CD
Fax Number: �% �� 3- 75Do e-mailaddress: emu, 001 i oh..
r)u,v-,ot—TAcoo-ell;
Applicant (print name): 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 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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