The URL can be used to link to this page

Home My WebLink About15175 Springdale St - CofO (9)APPLICATION FOR ITIFICATE OF OCCUPANCY CITY OF hUdTINGTON BEAD 4 WO.UICH DEPARTMENT OF COMMUNI' 71VELOPMENT DATE M671NMON (PRINT 08 Tyr Address L 2 5" 64 15*1 :5 R r II! +r-e-P4 District BusinessName- ,-7 1q. -7q q. -2,Ag, 7 Tel,. Business Type Occ. Group BUILDING OWNER BUSINESS OWNERIMANAGER Name )h2;,r lar Ake. Par4tjaf--S Name Home Address- Lo:; 10 Address 53 391 L4LVp—ply J%pe-1 City ry'%55('t2cJ W el )'0 City 1304Ara ki-14 All- q06DOLI Home Tel.j:�'l THIS USE WOULD BE DESCRIBED AS: E NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER 91'CHANGE OF OCCUPANT EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT Indicate former use, it any Sg'nn Occupancy Gr. e— —Div, SQUARE FT. OF BUILDING 1-0 BE OCCUPIED t TRAFFIC IF111PACT FtE AID DATE P1 fqo e, Lei oo AMOUNT RECEIVED NAVIE_____ (FOR OFFICE USE ONLY) ZONING — OCCUPANCY GROUP 13 PLAN CHECK NO NO PARKING SPACES OCCUPANT LOAD 19 PERMIT NO HEALTH DEPT APPROVAL NO, OF STORIES ADMIN. ACTION UTILITIES RELEASED 3M�3_ CERTIFICATE OF OCCUPANCY FEE $ _ (APPROVED BY DATE CHANGE OF USE OR OCCUPANCY FEE $ TOTAL $ 15-039 Rev. 1/97 COMMUNITY DEVELOPMENT 4- r SUPPLEMENTAL INFORMATION 1. BUSINESS ADDRESS l5175 Snr_,�cl4le�vF lEyul'i'ntafa�eG, L'x}-�ialoY`l 2. Person to contact in case of emergency, 30ye.rL NaLJC1-7— Telephone number: 3. Does the building in question have electricity? Yes q ❑ No (a) If No, are you requesting that the electricity be ❑ Yes turned on? ❑ No 4. The building is sprinklered? J Yes - Now , 5. Operations will produce dust / wood shavings or similar material? ❑ Yes l i No 6. Operations will involve the repair or replacement of ❑ Yes ` automobile parts? ® No V If Yes: ?( (a) Describe the components repaired or replaced. I (b) Does the operation involve the use of an open flame? ❑ Yes - ® No 7. The -business is drinking, dining or assembly use that will, result in an occupant load of more than _50 persons._ ❑ Yes i No 8. The following best ribes m o .ration; I C3�•FicearJ � Retail Sales j. Warehouse l Manufacturing / Distribution (describe process and end product) Sail ��iYsur hr'nta o '(r�,,11t0<i%I'5 M, t t.te11025tNq x Restaurant Take Out Food Medical / Dental Other (describe) ! t7 t h SUPPLEMENTAL INFORMATION t E r r _ I r SUPPLEMENTAL INFORMATION (Continued) Does the operation involve a:ny of the following materials? ❑ Yes Z'No If Yes, indicate quantities: Material Quantity q 1. Flammable liquids .-Class I -A x Class I-B F Class I-C 1 t 2. Combustible liquids Class 11 Class 111-A 3. Combination flammable liquids: 4. Flammable gases f5. Liquefied flammable gases 6. Flammable fibers - loose 7. Flammable fibers - baled 8. Flammable solids 4 9. Unstable materials 10. Corrosive liquids 11. Oxidizing material - gases 12. Oxidizing material - liquids 13. Oxidizing material - solids 14. Organic peroxides 15. Nitromethane (unstable materials) i 16. Ammonium nitrate 17. Ammonium nitrate compoundmixtures containing more than 60% nitrate by weight �. 18. Highly toxic material and poisonous gas 19. Smokeless powder 20. Black sporting powder ' hereby certify that the above information is true and correct to r the best_ of my knowledge. i r 4 , ignature Date k i t� l r C I i South Coast AIR QUALITY MANAGEMENT DISTRICT :F 21865 E. Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-2000 F AER QUALITY PE 1R21VIIT CH7ECKI,IST for nonresidential buildings only a Company Name: e ljlw, — Location of Property: _ 15L -Z E Sr�r; City: 400- ,`r,?a 2 1J Ise—CL C A- coxo y9 ` Zip Code: &q 9 Contact. Person: _�� e cL A . n 1a cz C Title: Telephone Number: ii Fax Number: Type of Industiy/Business:a n + e r s To apply for a nonresidential building permit, you must complete this checklist. If you have any t questions about completing this checklist, please call (800) 388-2121. 1• Will the facility have a charbroiler? YES No 2. Will any internal combustion engine with g greater than 50 horsepower operate at the facility (excluding motor vehicles)? 3. Will operations at the facility involve mixing, blending, or processing of solvents, adhesives, paints or coatings? 4• Will dust or smoke be generated at the facility? �I 1x1 5. Will refining of any liquids or solids be done at the facility? i 6. Will any plating or coating of materials be done at the facility? 7. Will any combustion equipment rated greater than 2000,000 BTU/hr be operated at the facility? 7 8• Will any acids, solvents, or motor fuel be used or stored at the facility? 9. Will any organic liquids or gases be reacted or produced? 10. Will any ovens be used to dry or cure products at the facility? 11. WilI any CFC (Freon) recycling machines operate at the facility? Applicant: GC.etld 5/ Ja �'� r5u)e!( Signature: d•- G] (Print name clearly) f ` If you have marked "NO" in all the boxes, an air quality permit is D-Qt- needed at this time, 7 I and this checklist is your written release. k � 4- , k If you marked "YES" in any of the boxes, you must contact the South Coast fair Quality Management District (.hiQMD). please read the requirements on the back of the checklist. (800) 388-212I ADDITIONAL SUPPLEMENTAL INFORMATION t ; NOTICE OF RE, QUIREMENTS Y OON4TERNMENT CODE SECTION 65850.2 (A.B3205) California State Law (Government Code 65850.2) prohibits the Building Departments from a issuing a final certificate of occupancy unless all requirements of the local air quality agency are met. All applicants are required to complete the air quality pen -nit checklist.,The checklist is si designed to aid the applicant for a nonresidential building permm only. If the answer to any of the questions is "Y� S,' the Building Department must obtain a writtenrelease from the local air quality agency verifying that the applicant is in compliance. 1. All nonresidential building permit applicants must complete this checklist. 1 2. If the answers to all questions are "NO," the Building Department can accept the checklist as the -written release. 3. If any questions are answered "YES," the applicant must contact the AQMD by calling (800) 388-2121 to determine whether air quality permits arerequired for any equipment � which may be operated at the site. if the AQ1\0 determines that air quality permits are . not required or that all requirements have been met, a written release will be issued. 3 If air quality permits are required and applications have not been submitted, the applicant fees before written must submit the necessary permit application(s) and appropriate a # release will be issued. AQ_NID is committed to expediting all clearance letter requests. However, it may take several weeks to verify compliance with all requirements, Therefore, you are advised to contact AQ1VID ' immediately after applying for building permits. (800) 388-212>! a, I 1 revised 8195 R N t 1 r ��r7 {