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Home My WebLink About15171 Springdale St - CofOa J� HUNTINGTON BEACH Business CERTIFICATE OF OCCUPANCY 020 CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION 'Poll Business Owners Name `i �[c� ��55/�U Business Name &_<ozc'4je Business Type C601 PLEteA !2W 0 eA-' (3rd Floor - The Applicant Must Apply In -Person) Date Zip Code Telephone No. Bus. Phone g4' Property Owner Information (required) Tenant/Emergency Contact (required) Name yo o In Q20 t Name Address 2 6 L/zt 0 L to Wa to LPG! q # 2 Home Address 2321 e. I/ � �7/ OL City r'Ol� l/if'7ZState/Zip el 2t; City _SG vj& Aua State/Zip JQ_401� Telephone No. q1/9 -3 /1�[- u 90 Telephone No. THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or L rExisting Building IS THIS BUILDING FIRE SPRINKLERED? aYes ❑ No CHECK ALL THAT APPLY: ❑ Change of Business Owner Change of Occupant ❑ Change of Use Additional Occupant • Indicate former type of business • Are you requesting that the electricity be turned on? ❑Yes Flo • Will operations produce dust/wood shavings or similar material? ❑ Yes N No • Will operations involve the repair or replacement of automobile parts? ❑Yes [VKo If yes: Describe the components repaired or replaced. • Does the operation involve the use of welding or open flame? ❑ Yes "0 • Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? ❑ Yes bd No • Will there be storage racks, gondolas, or shelving exceeding 5 feet 9 inches in height? ❑Yes �T No • The following best describes my operation: &Office Only ❑ Retail Sales ❑ Medical/Dental ❑ Warehouse/Manufacturing/Distribution ❑ Restaurant/Take-Out Food ❑ Other • Will any meat products including beef, poultry, and/or fish be cooked or fried onsite? ❑ Yes ❑ No If you answered yes, please proceed to the next question. • Does your facility currently have a grease control device (i.e. grease trap or grease interceptor)? Check one: ❑ Yes J]No Grease Interceptor Verified Inspected By Initials: Date: For Official Use On/y Occ Group: Occ Group: Occ Group: Total Sq Ft Occupied: Bldg. Permit # Planning Initialsal-) Date Conditions of Approval or Other Notes: Area: Area: Area: No. of Stories: Entitlement #: Use Permitted- ID N Occ Load: Occ Load: Occ Load: TIF Review: Y/ N Zoning: L' Parking Meets Code (for use): VN Building Reviewed By Initials: Date: 0 _Sc) 3S South Coast Air Quality Management District 21865 Copley Drive, Diamond Bar, CA 91765-4182 Phone Number (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: T S E b= ± 4 S S 0 C r a ` Property Address: 1 5 (7 1 DO"Via Ja Q C City: utli u rp lovlQ r (" Zip Code: 2 ZY Contact Person: a SSA uE& Title: D WU 'P�L Type of Business: (� aufL�eo 6p/20 eft- Telephone: 5a j — ,� Pt - C6 I — Fax Number: /) E-mail Address: L�ct�(� ,2! 55!!),UE4, /V e f Applicant (print name): E4 L(.c L lSSA L)L'"2 -Signature: 1�,.Z,4W4OM ' Date: 1� 1. Will the facility release air pollutants, including but of limited to, dust fumes, gas, mist, odors, smoke, vapor, or a combination of these to the atmosphere? ❑Yes but No 2. Will the facility r sult of fuel -burning equipment including, but not limited to, boilers, generators, and internal combustion engines? ❑Yes qNo 3. Will the facility result of hazardous materials, including but not limited to, chemical, plastics, rubber, resins, solvents, paints, and other parts cleaners? ❑Yes No 4. Will the facility have use of above or underground storage tank? ❑Yes V 0 5. Will the facility consist of manufacturing, fabrications, finishing, or treatment of wood, metal or plastic products? ❑Yes [ rNo 6. Will the facility result in the use of the equipment listed below? ❑Yes N4No (Select all that apply) ❑Abrasive Blasting Cabinet/Room ❑Air Conditioning System (containing > 50 Ibs of refrigerant) ❑Application of Paints/Adhesive/Resins ❑Baghouse/Dust Collector ❑Bakery Oven (gas fired) ❑Boiler/Water Heater (max. heat input = or > 1 million BTU/hr) ❑Charbroiler/Smoker ❑Internal Combustion Engine (rated > 50 bhp; e.g. back-up generator) ❑Mixing/Blending of Liquids and/or Powders ❑Molding /Extruding/Curing of Plastic ❑ Pharm ace utical/N utraceutical ❑Plasma/Laser Cutter ❑ Printing/Coating/Drying ❑ Production of Fumes/Dust/Smoke/Odors ❑Coffee Roaster/Afterbunner ❑Refrigeration Systems (containing > 50 Ibs of refrigeration ❑Deep Fryer (excluding equipment located at eating establishment) ❑Soldering Oven ❑Dry Cleaning Equipment ❑Electrostatic Precipitator ❑Fermentation ❑Gasoline Storage & Dispensing Equipment ❑Spray Booth ❑Storage of Acids/Solvents/Organics Liquids/Fuels ❑Storage Silos (sugar, flour, etc.) If you answered "No" to any of the above questions and your facility will not have the following equipment listed, 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). CERTIFICATE OF OCCUPANCY - -,' CITY OF HUNTINGION BEACH .. 1. Address - �. -' - T If e - Dale Business Name qf! ' T S ' - i - - District . ..( C I T N 'c. BUslness Type PR F SS - �, Tell3_1B RG;_ ?ii ? i lr R ... BUILDING� OWNER. Occ. Group .. VOh"DER AHE PP.PTfrER5 Name . BUSINESS OWNER&ANAGER� .- - Address Name -TINA h.ARIE 1Ap!ES Home _ Ch fOc^ .. ,y IA MESA Tel. Address _FnFO a eArunnn CT' c - .. Conslmcllob - —�" _ -._ No. of Staries City F:P f 4 Home �— , '--'"-'�--�_, Tel 9 A R6S_p4 f . CONDITIONS OF APPgpygl .. O-ups m load 19 ... R _ Sprinklers -: --'--�-- yr: I4 4. J fl1�1f it �,�111 :. 4 "t S i, M x /�.nsl�ll r7P II -.'W t A .. _ `. This Certificate 'DEPARTMENT OF COMMUNITY DE\ cLOPMENT of Occua ti SHALL BE posted Ina [onspicuo splace on the . IPremises and shall not be removed except by the ,. Building Otficlal. COMMUNITYDEVELOPMENT a I i "- SUPPLEMENTAL INFORMATION h 15 —7 q n�Zf�c t. BUSINESS ADDRESS 1 2. 'Person to contact in case of emergency- E. - - .Telephone " number:" - ' " 3. Does the building- in question have electricity? es ,' ;, r: (a) if No. . are you requesting that the electricity . bes ❑No II `. r turned on? {kjI 1 " 4. The building is sprinklered:7. ❑ No t 5. " operations will produce dust / wood . shavings or similar ❑.Yes ij J material? 6. ❑ Yes Operations' will involve. the repair or replacement of .. Q-No_ ." automobile parts? - If .'Yes:. (a) Describe the components repaired, or replaced: �. ❑Yew(b) Does the .operation involve the use of rin open flame? !; 7. The business is drinking, dining or assembly use .,that will ❑, Y.es� result in am occupant .load of .more than. 50 persons.— g:' The following best describes": my.;, operation; t it ` �Oflloe�d:V p ' Retai Sales p.i f Warehouse MenUfacturing / Distribution (describe "process . and end—pro,duct) i '.i `Restaurant / Take Out r o00 " Medical? Dental Other (describe) 1 ., SUPPLIMENTAIJNFORMATIbN 0. I t: d j. I !I I1 I �: rA SUPPLEMENTAL .INFORMATION (Continued) Does the operation involve any of the following materials? �N s i !f Yes, indicate quantities: ouantit - Material - - 1. Flammable liquids Class I -A r -- Class I-B i - - - - Class I C 2.-.' Combustible liquids ' • - Class Class 111-A - 3. Combination flammable .liquids 4.. Flammable gases.- _ 5.. Liquefied flammable gases g; Flammable -fibers - loose- _7. Flammable fibers - baled - g. Flammable solids g• - Unstable materials - 10. Corrosive- liquids oxidizing material - gases �. material -.liquids- I- ..--•. " ...13, 'Oxidiiingmateriai--solids - . i j4. Organic -peroxides: _ 15. Nitromethane (unstable materials) i j6. Ammonium nitrate 17. Ammonium nitrate compound -mixtures _ containing more. than 60% nitrate by weight 16. Highly toxic. material and - poisonous. gas Smokeless... powder+ 20. Black sporting powder I.,`hereby certify that the above information is true and 'correct to �! ' i t of my knowledge. _ 1 Date Signature # t If ° fi l y tl I _ i t l � : your proposed occupancy of thesubject building.. IF YOU DO NOT "YES" KNOW . THE ANSWER TO A QUESTION MARK IN THE COLUMN. {' '•` �`" .''_¢ - AQMD. PERMITTING CHECKLIST _ YES NO: 1.. Does your facility use any internal combustion engines greater than 50-HP? -- ✓, _ _ 2. 'Does _your facility involve mixing, blending', or - processing any solvents, .adhesives, paints- .'; or coatings? - 3. Does your facility create any dusts.. or smoke?�� - - 4.Does your facility refine any liquids or solids - -. or reclaim any -metals? - -'- !; 5.' Does -your -facility plate.orcoat anything? -_ : �� '•" - 6. Does your facility have.any combustion' equipment - � �'• • i.e.. boiler,: 'furnaces, broiler, -:baking ovens> '. _ - �� --- .� `� etc.:), rated greater than'2,066,000 BTU/HR7..- - 7. Does your. Facility. handle 'or store solvents or - - ,'; - motor fuel? 8. ;Do you useor .store any acids?.- 9.- Do .you use any chemical process?. —• - •` . .: '..: .. 10:. 'Do you use any solventsfor. clean-up?` - 1' 11. Are 'you a dry 'cleaner, restaurant with .a. - charbroiler, boly_shop, gasoline' station, - „.. . ''-.�• .. :•{.' printer, or. part' coater7 - - ,. •.:� ;. 12. Is the subject building 'located within one -' -- -' - thousand''(1,00,0) feet of any school? z. :j AD PROPERTY LINE TO PROPERTY LINE.GRADES K'.-12.. ' . If you have marked "NO" in.all columns, you do not need an Air Quality permitat this time. If you have: marked any questions. in - - -. .the "YES" Column you must contact the South Coast Air ,Quality 7 -Management District located at:- 21865 E. Copley Drive -` Diamond Bar, CA 91765-4182 .Please call: Plan.Check (714) 396-2000 - t - - -- - r R 1 { 1 3 V ) r City of Huntington Beach 2ma0: MAIN:STBEE7 CALIFORNIA 92698 �Cg ! DEPARTMENT OF COMMUNITY DEVELOPMENT BulldIng 536-5211 - - - Planning 536.5271' - - - . Housing 536-5271 - - .. Government Code Section 65850..2 (b); requires the City of Huntington 'Beach BuildingDivision not to issue the final certificate of.-?- - occupancy -unless the .applicant has met or ismeetingthe - -- . 'requirements of the South Coast Air Quality. Management District - (AQMD). The Building Di Vision'mustobtain a -written release from AQMD to. show theapplicanthas complied with this. law. The check _ list on the reversesideis designed to help the applicant and the building division to meet these requirements. 1. The'applicant (t;he same Person who applies for 'oermi g; from the Building Division) must complete t.he.check list which : i..- can be be obtained either at the Building .Division or atAQMD.' 2. If all boxes in the List are checked "no", .the. Building: !' .Division can accept the check list as the 'release. f 3. If thereareany "yes" answers in the list, the applicant must contact an AQMD' engineer.by calling (114) 396-2000 to �. find out whether air permits are requited for the proposed construction 'project: ' - 9. If -air permits are not required the applicant: Will obtain I a written release from AQMD. .' a � � 5. If .air permits are required, the applicant 'must submit -the 'necessary permit applications before the release can be - issued. I ' 'Because of the time it may.take .for AQMD to g Q go through the above procedures, the applicant.is . advised ' to contact: AQwM immediately' - -: after applying. for Building permits. -. t (1360D) - - ' f I r e 1 d L