HomeMy WebLinkAbout15131 Triton Ln - CofO (63)f
APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
3'17`RZ-
DEPARTMENT OF COMMUNITY DEVELOPMENT
HUNTINGTON BEACH
1ARIN7 OR TYPE ONLY)
DATE
Address /5�3I Tri�a�/ L�Fr'f� f/NrT /o! / If•13. C/¢ q�64
_ District
Business Name
TeIZI91175_`r
Business Type
Occ Group
UILDING OWNER BUSINESS VAXWOAIMANAGER
t Name Name t
ffo�Yl F��i.+s�rtth
Home AwW3009 F,�✓e7.4 Sf'
Address_~ 4-
Address
09
� � Tel __ City AM �
Nome Tel. #
.City
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THIS USE WOULD BE DESCRIBED AS:
❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER
CHANGE OF OCCUPANT
® ❑ CHANGE OF USE
❑ ADDITIONAL OCCUPANT
EXISTING BUILDING
1
Indicate former use, if any ----Occupancy Gr
Div
80p
SQUARE FT. OF BUILDING TO BE OCCUPIED
{
SUPPLEMENTAL iNFORMATION
s
i.
BUSINESS ADDRESS
2.
Person to contact in case of emergency
Telephone number: Zf art 3,4S7
N"YesNo
3.
Does the building in question have electricity?
(a) If No, are you requesting that the electricity be
Yes
No
turned on?
;.
4.
The building is sprinklered7
Ltd' Yes
❑ No
t.'
5.
Operations will produce dust /wood shavings or similar
p es
r
material?
[�'N0
6.
OperaErons will involve the repair or replacement of
0 Yes
, �o
uY
i
automobile parts?N
s
t
i
if Yes:
(a) Describe the components repaired or replaced.
L
—
(p) Does the operation involve the use of an open flame?�
�x
}
7.
The bushic- s is drinking, dining or assembly use that will
p Yes
i
-result in an occupant load of more than 50 persons.
M-No
�.
8.
The following best describes my operation;
1,
Office Only 757Ta
Retail Sales
i
Warehouse to Tv
Manufacturing / Distribution (describe process and end product)
rNbryi �lorfry s-,s,%atJt
f%r--------------
Restaurant /Take Out Food
Medical / Dental
Other (describe)
t
f
SUPPUMENTAL INN RMATION
� a
SOUTH COAST AIR QUALI 9uildin only) SkGmMNT DISTRICT
(Nonresidential 9 '®r
,: :' ibj ec
t Property:%
Location o,, - t �QeF 11/ g'}�one
Property Owner Name: naturz 1
x Ila= of the Person preparixng this form in P
tint and ssg
tSignature:
2'---��-' applying f o r
Name:.._.- arson
this form must bpolloWiarg questions regarding I
The Person preparing ect building. If YOU DO NOT KNOW
building ;permits. Please answer the i`
of the sub? M COLUM:
your props-3sed occupancy 4
THE ANSWEil To A QUESTION MARK IN THE YES YST
AQN FERX7L*1`TI CHECl(L YES NO !
}
✓
internal combustion
inter4
facility use any ------ '""_--
1. Does Your rester than 50-HP? blending, or
engines g involve miming, mints
2, Does Your facility adhesives, P solvents,
processing jinx
smoke7
or coatings7 create any dusts or /
3, Does your facility refine any liquids or solids
w
4 , Does Your facility ___----
or reclaim any metals?
our facility 'Plate or coat anything?
5, Does Y have any
combustion equipment ,
YOU facility baking ovens,
6 Does Y aces, broiler, R? --" ---�-
i.e. boiler, furn
etc.) rated greater than 2,000,0t#0 HTU/Fi
YOU
facility handle or st�sz® solvents or
7 , Does y
rotor fual7 acids?
8, Do you use or store any roCeSsr -----
9. Do You use any chemical p -----
clean-
ou any solvents for
use wi /
10. Do Y cleaner, restaurant th a ✓
11. Are You a dxybody shop, gasoline station, /-
charbcoiler> art coatOr?
printer, or p located within one
12. is the subject building ----�
thousand (1,000) feet of any school?
PROPERTY LINzn. TO PROPERTY LIND. ou do not need an Air �
a in all columns, Y ueStions in
.NO
If you have marked you ht Air Quality
marked any $
auali.tY permit at ouimtime.
ustcontactthe South Coas
the "YES Column Y
Management District located fit:
21865 E. Copley Drive
Diamond Bar, CA 91765-4182
Please call:.
Plan Check (714) 395-2000
11360d-2)
f
�.� City of Huntington Beach
y— 2000 MAIN STREET CALIFORNIA 52648
DEPARTMENT OF COMMUNITY DEVELOPMENT
Building �'_6-52.41 ;
Planning 53&-52e71
Housing 536-5271
Government Code Section 65850.2(b) requires the City of Huntington
Beach Building Division not to issue the final certificate of
occupancy unless the applicant has met or is meeting the
requirements of the South Coast Air Quality Management District t
(AQMD). The Building Division must obtain a written release from
AQMD to show the applicant has complied with this law. The check 1
list on the reverse side is designed to help the applicant and the
building division to meet these requirements.
1. The applicant (tie same person who appli.r permits from
es fo
the Building Division) must complete the checic list which
can be obtained either at the Building Division or at AQMD.
2. If all boxes in the list are checked "no", the Building }
Division can accept the check list as the release. ,
3 If ti,sre are any "yes" answers in the list, the applicant
must contact an AQMD engineer by calling ('714) 395-2000_e
find out whether air permits are required for the proposed ;
construction project,
are not required, the applicant will obtain
4. If air permits ; t
a written release from AQMD.
5. If air permits are required, the applicant must submit the
necessary permit applications before the release can be
issued.
Because of the time it may take for AQMD to qo through the above
procedures, the applicant is advised to contact AQ immediately
after 'applying for Building permits.
r
(1360D)
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