HomeMy WebLinkAbout15061 Springdale St - CofO (42)r • o� CITY OF HUNTINGTON BEACH CERTIFICATE OF OCCUPANCY 020 -
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DEPT. OF PLANNING & BUILDING APPLICATION
HurmNGTON BEACH 714/536-5241 (3rd Floor —Must Apply In -Person)
Business License # Date kf 2-0l Z01 1
Business Address i SO(,l spgzcm j oA [-r-- sr bE / o 3 Zip Code cf a.t. 4 q
Business Owners Name LArz(zg &o-r;-LxN H�,�,�,e Telephone No. 714 - (w� -o9ti 1
Business Name 72. [rorrc airs - 1,rt . .i c, Bus. Phone _7-Iti - 0g (a - 34 bK
Business Type O P Tc>m r-_Tay o r-f-sc_F
, Property Owner Information (required) Tenant/Emergency Contact (required)
Name s f on���xx�� �201�►= TiG S .� C_ Name L 0+12-0-1/ 6r-C>r 1 C-T- Z
Address k Z Z q (3r-rz e-N sr 1 S 6 Home Address _/ to uS 1 slL t G /11
City NrwPo2-r 13u-i State/Zip 6A G 2�42a City H- a State/Zip C-4 q Li
Telephone No. cl tj el - ZSo- clTelephone No. /y K gp, . sLiT-Z
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or KExisting Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner VChange of Occupant ❑Change of Use ❑Additional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity be turned on? Yes 0 No ❑
■ Is the building sprinklered? YesX No ❑
■ Will operations produce dust/wood shavings or similar material? Yes , NoK
■ Will operations involve the repair or replacement of automobile parts Yes NoX If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes 0 NoA
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes ONo`0-
■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? Yes ONo 9
■ The following best describes my operation: ❑ Office Only ❑ Retail Sales gMedical/Dental
❑ Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food
(describe process and end product)
❑ Other (describe)
For Official Use Only
Occ Group:_ Area: y� Occ Load:
Occ Group: Area: Occ Load: o
Occ Group: D Area: Occ Load:
Total Sq Ft Occupied: No. of Stories: TIF Review: Y/ N
Bldg. Permit # En ' lement #: l Zoning:
Plnr Initials: Date: - Plan Chkr Initia Date: r . Isp Initials: Y=� t- Date:-
1- 1AA/'- 3
Conditions of Approval or Other Notes:
y �!
v< South Coast .
Air Quality Management District
21865 Copley Drive, Diamond% Bar, CA 91765-4182 r
(909) 396-3529.• http:// www.agmd.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: D rl . (rd-rTLvr-4'� - I7It_ A'A" � P%vo
Property Address: / SOev
City: M . (3 Zip Code: 9 2-4, ct
Contact Person: &1w,_q Title: i)lLr-S.
Type of Business: a P i o 04 a - TA Y— Telephone: / `-f ' 3 y
Fax Number: --I Lt - 8 4 q- e-mail address:
Applicant (print name): TNy Signature:
Date: 7-12,t, / z v r
• Will the facility have any of the following equipment? Yes ❑ Nog]
Charbroiler
Dry cleaning machine
Spray booth
Printing press (screen/lithographic/flexographic)
Internal combustion engine greater than 50 BP (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 j
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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