HomeMy WebLinkAbout15185 Springdale St - CofO (3)•
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HUNTINGTON BEACH
Business Lice
Business Addr
Business Own
Business Nam
Business Type
CERTIFICATE OF OCCUPANCY
714/536-5241
DEPT. OF PLANNING & BUILDING
02U�-
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(3rd Floor — Must Apply In -Person)
nse # 1k l Date • 7i� • f 7j
ess Zip Codeq-Ae 4CG
ers Name Telephone Nowt
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e LA — Bus. PhoneS- -7
• Prope= Owner Information (required) •- Tenant/Emergency Contact (required)
Named NameVn
j `rig
Address ,L �j� Home Add ess � C2
Cit }„t. � �cc��11 State/Zip G17%z�City Pt,�kavt.;rLj 1,. State/Zip
Telephone No. Telephone No. --7( CA- Y919t f., 12.1 ! j77
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or ❑ Existing Building
CHECK -ALL THAT APPLY:
0 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 Nod,
■ Is the building sprinklered? Yew- No❑
■ Will operations produce dust/wood shavings or similar material? Yes❑ No?
■ Will operations involve the repair or replacement of automobile parts Yes N64 If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? YeSO Now
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes ONo
■ Will there be storage racks, gondolas, or shel ee 5feet 9 inches in height? Yes ONO
■ The following best describes my opera ri :Office Onl ❑ Retail Sales ❑ Medical/Dental
0 Warehouse /Manufacturing/Distribution s urant/Take Out Food
(describe process and end product)
Other (describe)
For OiEzcial Use Only
Occ Group:
Area:
Occ Group: Area:
Occ Group: Area:
Total Sq Ft Occupied: No. of Stories: _
Bldg. Permit # Entitlement #:_
Plnr Initials: Date: Plan Chkr Initials: Date
of Approval or Other Notes:
6-F GO( I h_ t s PAVAs
M -.
Occ Load:
Occ Load:
Occ Load:
TIF Review: Y/
Zoning: I l—
Insp Initials: Date:
Inspection Date:
South Coast
Air Quality Management District
w 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:
Property Address: Lg V0 !j O,IVt2.Qrs��4pd_f_ � ,
City: � G � Zip Code: 01 2:(e k'`:7
Contact Person: Title:
r
Type of Business: Telephone:
Fax Number-A,045 1,zlv� e-mail address:
Applicant (print name): Signature:
!/47 lit xDate: `�l —
• Will the facility have any of the following equipment? Yes ❑ NoA
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❑ N09�
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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