HomeMy WebLinkAbout15182 Triton Ln - CofO (7)CERTIFICATE OF OCCUPANCY 0200 ,q ---Ott 3 03
CITY OF HUNTINGTON BEACH -
DEPT. OF BUILDING & SAFETY APPLICATION
714/536-5241
(3"a Floor — Must Apply In -Person)
Business License # A 2' D 7 Z IX Date 97. O 2. o
Business Address / -t�_ /Z- 4 A�0/,A 4 /0 Zip Code q Z 6 V p
Business Owners Name PIT YA'eO D e, /L YX �, X.tr � , Telephone No.
Business Name 0,P14 IAA N Bus. Phone 7/Y - ,&9Q ' 4 y 7S
Business Type a &.9 z;' /cam
Property Owner Information (required) Tenant/Emer enc Contact (required)
Name i5ve✓ e7 t Jahn _Aa L ayrzt, Name s S e Ore / e V/y 6 d c
Address Home Address 220 -,!g/ H,014 (-/c .
City lkirin Aan Arh State/Zip0 6y9 City H , RF, State/Zip P A
Telephone No. 7/Ri Q2 9 % Telephone No. 7/ Y - 7/ 7 - 4 9 1
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or p Existing Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner TChange of Occupant ❑Change of Use ❑Additional Occupant
■ Indicate former type of business 'l'/� �� : K✓ti v 1-e 4 /i G /z
■ Are you requesting that the electricity be turn on? Yes NOD
• Is the building sprinklered? Yes[] No®
■ Will operations produce dust/wood shavings or similar material? Yes❑ Noz
■ Will operations involve the repair or replacement of automobile parts Yes Q NoK If yes: Describe the
components repaired or replaced.
• Does the operation involve the use of welding or open flame? YesQ NoX
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 54 persons?
Yes QNo V
■ The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑ Medical/Dental
[K Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food
(describe process and end product)
❑ Other (describe)
For Official Use Only
Occ Group:
Area: 180G
Occ Group: F '(
Area: U /4
Occ Group:
Area:
Total Sq Ft Oc p'
`Bldg.
No. of Stories:
Pernut #—
Entitlement #:
Occ Load: 1.6
Occ Load: ci
Occ Load:
TIF Review: Y/ N
Zoning:
Plnr Initials: Date: Plan Chkr Initials: Date: Insp Initials:
Conditions of Approval or Other Notes:
Inspection Date:
(G:BuildingAdmin/WebDocuments/CertificateofOccupancy)
'j // ,
South Coast
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
(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: /V/65' 1-e Q/a / f, g 6)-f4, /W (—
Property Address: SI 2 �k'-�' 2,*'vr, '
City: 1Y , 86A 01t Zip Code: z b
Contact Person:._ 2 C- y/'c oG /)
Type of Business:
Fax Number: `7 / (e
Applicant (print name):.-. E Y V G o c v Signature:
Date:
Title: %/, 2.
Telephone:
1 e ail addre
?.Z -v
Will the facility have any of the following equipment? Yes ❑ No
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❑ NoM
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).
-2-
Revised June 2005