HomeMy WebLinkAbout15179 Springdale St - CofOL
CERTIFICATE OF OCCUPANCY 020_la.- a -a>3
CITY OF HUNTINGTON BEACH
DEPT. OF PLANNING & BUILDING APPLICATION
(3'd Floor — Must Apply In Person)
Business Licen
Business Addri
Business Owne
Business Name
Business Type
Date `/ —,-'v 1o2i
Zip Code (��L�j
Telephone No. ,?,,�2V —A0%--Q9�
Bus. Phone k
Property Owner Information (required) Tenant/Emer enc Contact (r
Name VDA Name
Address Home Address
Ci to/Zip City A State/Zip
Telephone No. 9 7` % U — 16 rf D Telephone No. 0/�1-- e —
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or XExisting Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner Change of Occupant ❑ Change of Use ❑ Additional Occupant
■ Indicate former type of busines
■ Are you requesting that the electricity be turned on? YesONo)L
■ Is the building sprinklered? YesNo ❑
■ Will operations produce dust/wood shavings or similar material? YesONM
■ Will operations involve the repair or replacement of automobile parts Yes ONO If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes ONo
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes ONox
■ The following best describes my operation: Office Only ❑ Retail Sales ❑ Medical/Dental
❑ Restaurant/Take Out Food � Wareho e /Manufacturing/Distribution
(describe process and end product)
❑ Other (describe)
For Official Use Only
Oce Group: Area: H I O
Occ Group: Area: p p
Occ Group: Area:
Total Sq Ft Occupied: { Q No. of Stories:
Bldg. Permit # Entitlement #:
Plnr Initia V ` Date*
ateL 11D,
Plan Chkr InitialsC-�.
Conditions of Approval or Other Notes:
Occ Load:
Occ Load:
Occ Load:
TIF Review: Y/ N
Zoning:
Date: o Insp Initials: Sr Date: t �Z
5� � '���Z- T�'ZAw,.�lr AttA�t1�A Chn�cao FL.r. �i.cr,.z'�-ati w1Ttd Gc�' o�
Inspection Date:
F
South Coast
Air Quality Management District
21865 E. Copley Drive
Diamond Bar, CA 91765-4182
(909) 396-3529 htpp://www.agmd.gov
Air Quality Permit Checklist
California Government Code 65850.2 prohibits cities from issuing a Certificate of Occupancy 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 Qu
Company Name:
Property Address:
City:
Contact Person:
Type of Business:
Applicant: (print naj
0 Will the facility have any of the following equipment? Yes LJ N o
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
Will any of the following operations be performed? Yes 0 No
Application of paints br adhesives
Etching, plating, casting, or melting of metals
Molding and blending of liquids and/or powders
Storage of acids, solvents, organic liquids or fuels
Production 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.
D 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 AQNM at their Small Business Assistance Office at (800) 388-2121.