HomeMy WebLinkAbout15183 Springdale St - CofOAPPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON.BEACH - DEPARTMENT OF BUILDING & SAFETY���
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Business License } `L' i Dare
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Address_13 rCA[AL
Busin
ess Name G ' _ i�c Telephone 7t
Business Type
Proper�Owner Information imw Business Owner
Name1. �`7 A � V'. r� �'s�2' t 1 1252
Address er 4 _ l a , c S '`-,--, `Z 0 Home Address
City �< Stt �l t Tel . t City <
THIS USE WOULD BB DES - RTIRED AS;
i ONewly Constructed Building or existing Building
CHECK ALL THAT APPLY: �_,,,��
❑Change of Owner ❑Change of Occupant ❑Change of Use ��Additioual Occupant
_ v T Qf"l/riL��i y f-#Its
Indicate former use, if anyr-- &_ S(A i—_ _
Does the building have electricity? Yes' No❑
If No, are you requesting that the elec, city be turned on? Yes 0 No CJ
The building is sprinklered? Yes NoIJ
Operations will product dust/wood shavings or similar material? Yes No
Operations will involve the repair or replacement of automobile parts Yes NO'p
If yes: Describe the components repaired or replaced.
Does the operation involve the use of welding or open flume? Yes O No,l
The business is drirddng, dining or assemblyse that will result in an occupant load
of more than 50 persons. Yes IN0
e following best describes my operation:
ffice Ot�I ❑Retail Sa1:es �Arledical/Dental ❑Restatrant�Iake O�.ttFood ?Warehouse
Y
ivlanufacturinglDistribution (describe pruccss and end product)
Q Other (describe) ._
0f -Tice Use 0
71
t
Zoiuna Sq Ft Occupied; Oec Group: Ot a I,Vd:
1i T Stories. Parking Spaces: TIF Review: YIN Amt PaidS: 7'
i Paid BUME Final tnspecuon ._
' Bailding Permit 9 Entitlement'
Comments: M'
Plain er Initials: Bldg/Plan. Checker Luitials CofO rr `
South Coast
Aix Quality Management District
21865 E. Copley Drive
Diamond Bar, Cl-',; 91765-4182
(909) 396-3529 htpp:/hvww.agmd.gov
Air Quality Permit Checklist
California Government Code 65850.2prohibits cities from issuing a Certificate of Occupancy to abusiness
without clearance from the local air quality agency. This checklist will determine if you need to obtai-a
clearance from the South Coast Aii Quality Management District (AQMD).
Company NameG
Property Address: `- I! ' t
City:�c-- Zip Code: Z
Contact Person: Tit!-_: W tl
Type of Business: ~.. v r (-j S Telephone:
Applicant: (print name)--l��C �t�tct� j Signature: liu�
• Will the facility have any of the following equipment? Yes ❑ N
Charbroiler
Dry cleaning machine
Spray Booth
Printing Press (screen/lithographic/flexographic)
internal combustion engine (greater than 50HP) (excluding motor vehicles)
Boiler/combustion equipment (greater than 2 million BTU/hr. maximum input)
Abrasive blasting cabinet/room
Baghouse/cartridge type dust filter/scrubber
Motor fuel storage and dispensing equipment
a Will any of the following operations be performed? Yes INTO
Application of paints or adhesives
Etching, plating, casting, or mr:lting of metals
Molding and blending of liquids and/or powders
Storage of acids, solvents, organic liquids or fuels
Prcduedon of acids, solvents, organic liquids, or fuels
Prodaction of fumes, dust, smoke or strung odors
• If you answered "No" to both questions, this checklist is your clearance tom AQiv9D.
• if you answered "'Yes" to either question, you must contact AQN- M to determine if air quality permits are
required. If permits are needed, AQMD will assist yoi�. iri submittin permit application(s) and then provide you
with a. cle trance letter. You can call AQ1N,IIi at their Small Business Assistance office at (800) 388-2121.