HomeMy WebLinkAbout15131 Triton Ln - CofO (66)oft
714/536-5271
Business Licen
Business Addr(
Business Owne
Business Name
Business Type
CERTIFICATE OF OCCUPANCY 02010 - 005",
CITY OF HUNTINGTON BEACH
DEPT. OF PLANNING & BUILDING APPLICATION
(3'd Floor — Must Apply In -Person)
Date ) D — i !? . !C�
Zip Code a L•, ¢
Telephone No 7! 1$ g75!., ?.S"(,?
Bus. Phone -A-
Property Owner Information (r uired) Tenant/Emergency Contact (required)
Name �,q ." DA"g 12/c Name I)nl > SM tiM
Address � Home Address 6120 d 0 MUL1pe, p
City a State/Zip c��_City j State/Zip ay L7 1 P"
Telephone No. Telephone No.? lei, .4 Sr
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or K Existing Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner EX hange of Occupant 0 Change of Use A Additional Occupant
■ Indicate former type of business'
Are you requesting that the electricity be turned on? Yes0N9
■. Is the building sprinklered? Yes DNo❑
■ Will operations produce dust/wood shavings or similar material? Yes ONo 0
■ Will operations involve the repair or replacement of automobile parts Yes QNo 0 If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes [.]No ❑
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes ONo ❑
■ The following best describes m operation: ❑ Office Only ❑ Retail Sales ❑ Medical/Dental
❑ Restaurant/Take Out Food Warehouse /Manufacturing/Distribution
(describe process and end pro ct)
❑ Other (describe)
For Official Use Only
Occ Group: Area: Occ Load:
Occ Group: Area: Occ Load: --2
Occ Group: Area: Occ Load:
Total Sq Ft Occupied: 1*0 �,�, No. of Stories: _ TIF Review: Y/ ID
Bldg. Permit # Entitlement #: Zoning: (L
Plnr Initi s: • VDaf! :'� O Plan Chkr Initials:G��--Date: �� (1Io Insp Initials: �C- Date: lea Z2 tt�
Conditions of Approval or Other Notes:
Inspection Date:
(G:Building/Forms/document id goes here)
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 Quality Management District (AQMD).
Company Name:
Property Address: 7479j Z-&T d A9 4U / 0 �
City: Zip Code: q2.6 4
Contact Person: Title: t
Type of Business: ��T��/7 �'�u 6Zol r I Telephone: () 1,�L�
Applicant: (print name) ,J)n(p Signature:
Q Will the facility have any of the following equipment? Yes F1 No ❑
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
Q Will any of the following operations be performed? Yes []No)�
Application of paints or 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
Ulf you answered "No" to both questions, this checklist is your clearance from AQMD.
Q 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 (800) 388-2121.