HomeMy WebLinkAbout15061 Springdale St - CofO (16)r�
HUNTINGTON BEACH
CERTIFICATE OF OCCUPANCY 020 -
CITY OF HUNTINGTON BEACH -
DEPT, OF PLANNING & BUILDING APPLICATION
714/536-5241
(3M Floor — Must Apply In -Person)
Business License # (?L)IO Date /O /s // a
Business Address 15 o q.;- Zip Code 7z&q5
Business Owners Name Telephone No.
Business Name Zo n art CA, (`ems Bus. Phone
Business Type cs ?c r
Propertv Owner Information (required) T nant/Emer en Contact (requirep'j1'`ous
Name ejw00 Name P Z_0r1
Address !Q2-7—/S- Home A dress fo f2c 7v')_
City /(/ ��+� State/Zip'} rj'z 4 City State/Zip Q! 2(c/
Telephone No.gf - ,290 K Z 3 3 k(IN Telephone No.
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or KExisting Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner ,,Change of Occupant ❑Change of Use ❑Additional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity be turned on? Yes No
■ Is the building sprinklered? Yes' , Non
■ Will operations produce dust/wood shavings or similar material? Yes❑ Nol
■ Will operations involve the repair or replacement of automobile parts Yes No% If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes N
■ Will the business be a drinking, dining or assembly use with an occupant loaa of more than 50 persons?
Yes QNoy
■ The following best describes my operation: *Office Only ❑ Retail Sales ❑ Medical/Dental
❑ Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food
(describe process and end product)
Other (describe)
For Official Use Onl
Occ Group: L> Area: Oce Load: l
Occ Group: Area: Occ Load:
Occ Group: Area: Occ Load:
Total Sq Ft Occu ied: No. of Stories: TIF Revi w: Y/
Bldg. Permit # Entitlement #: Zoning:
Plnr Initials: Date: (b • 18, to Plan Chkr Initials :���pate: la I 1911,o Insp Initials: Date:
Inspection Date:
l��
South Coast
PSI,
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: $ ¢,O r o e h- C o r
Property Address: \66 k S
City:. Zip Code:
Contact Person: -C3 P-3
Type of Business: �t k 0Fax Number: t • �? �r e/$3�
Applicant (print name): Signature:
Date:
S ,j , kP-- 10"'t
12(1_cet
Title: DASLI
Telephone: 'I I \� 'S'l 4 -"8a 1
e-mail address:
to to
• 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❑ Nol�
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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