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HomeMy WebLinkAbout15131 Triton Ln - CofO (101)SUPPLEMENTAL INFOftIVIATION 7 1. BUSINESS ADDRESS � C 1~ i ��� I L) r Z Person to contact in case of emergency_- C) Telephone number -non � _{ S. Does the building in question have electricity? Yes i ll `No (a) If No, are you requOsting that the electricity be i] Yes turned oh? El' No 4. The building is sprinkiered?' Yes } 0 10 a 5.. Operations will produce dust/wood shavings or similar materi.a: C7 yes F ONO, t. 6. Operations will involve the repair or replacement of 0 Yes automobile parts'?No If Yes: (a) Describe the components repaired or replaced. 4 El Yes (b) Does the operation involve the use! of an open' flame? No '. The - business is drinking', dining or assembly use that will result in an occupant load of more than 5v persons, CI Yes ` 12 No 8. The following best describes my operation; Y Office Only Retail Sales Warehouse ManufacturV t Distribution (describe process and end product) Restaurant I Take Out Food Medical l Dental �r E Other (describe) — 3 • t x . _ UPPLar M-TAL t F R "tO (Continued) Does the operation mvolve any of the I��S�)vving ateri � { A4 It Yes, indicate quantities: -� Material Quantity �„w...4,«....-,:......,...e..«,w ...,..�.„��..n--,•.r.....«....,.•......a.............,..,...w._•„_,...,«_...,_.r,. :. 1. —µ.me".•=dam...._~-.-..,"...—..._.•..•-:-.,,a.=.,. Flarnmable- liquids Ciao t- lass -1-8 Glass 111` Combustible liquids Class 11 ................ .. 'lass Iil-A ,_.. T Combination flammable liquids, 4. Flammable gases i igtietlett flammable gases 6. i�la.i�iiiable fibers loose Flammable fibers - baled 13. Flammable solids Ui stat)[e materials 10. Corrosive liquids 11, ' 01gNizirig material -:gases 12. Oxidizing material li Wds f 1S1 OgEIdWng material . Solids ,< 1 'Organic erodes E Nitromethane (unstable materials) -Arniri 16. ,rr;ii im nitrate 17 Ammonium nitrate compo nd mixtures i;ontainino more than 60% nitrate by weight is. Highly toxic material poisonous gas 19. Smokeleas powder < Black sport1rj 1?0 wder I hereby. certii'y that the abovi� information is true. and correct to the best of my knowledge. p { signature late e` K t South Coast AIR QUALITY MANAGEMENT DISTRICT 21865 E. Copley Chive, Diamond Bar, CA 91765-41,92 (909) 39e-2000 AM Q� rA,1TY PERMT C C IST for nonresidential buildings only 3 Company Name: _s _� i � 1 �i� � t ('A\ _ - � ())(-)C Z,�cation of Prop€rty: i11T`l_ City7----- Zip Code: , Contact Person, I�U)SQ =� Title:--1he�--_-1 I t Telephone Number:917�'k fl>fn Fax Number: Type of Industry/Business: IM =-Dl 0 To apply for a uonresider aa1 building permit? you most complete this cheCldiat. If you have any. ' questions about completing this checklist, please call (800) 388-2,121, YES NO ; t 1. WiII the facility have a clZarbroiler? 2. Will any internal combustion engine with greater than 50 horsepower operate.at the facility (excluding motor vehicles)? (� V] 3, Will operations at the facility involve mixing, blending, or processing ref solvents, adhesives, paints or coatings? r Will dust or smoke be generated at the facility? t Will refining of any liquids or solids be done at the facility?' is Will any plating or coating ofmaterials be done at the facllity? 7; Will any combustion equipment rated greater than 2,000,000 BTU/hr be operated at the facility?: (1 8. Will any acids, solvents, or motor fuel b� used or stored at the facility? 3. Will any organic liquids or gases be reacted or produced? j 10. Will any ovens be used to dry or cure products at the facility? 11 Will any Cl?C (Freon),recycling machines operate at the faciEty? Applicant. ��✓� V �Signatureq�jl (Print name clearly) If you have marked "NO" in all the boxes an air quality permit is not needed at this time, and this cheeldist'is your written release.. If you marked "YES" in; any ofthe boxes, you must contact the South Coast Air Quality Management District (A �I D). Please read the requirements on the back of the checklist, (800) 388-2121 4 •. r y ' A.l PLICAMON FOR CERTIFICATE OF OCCUPANCY GT (.�'�,�'Edot• �- t1�`tcs�.�Ipply�ta 1'c��#•a�� j i Business License Date. " 4 Address ,P�i,131 7"rrifK► n, ►: � „ Btt6ness Name i OW' Business Type Property tk�n�r Information Business C�c zr Name `+tamer t Add � :,�.��� Holme AN reas tc� , r City s ,� lei. �._ _ :_ City THIS USE 1 )UDD'BER DESCRIBED AS. >t QNIewly Constructed $,�. uilding or Fxisting Building r CHE.M ALL THATAPPLY: U Change of Owner CE'Ciaage of Occupavt C]Change of the O A Mtx0 :al Occupant Indicate former use, il"any Does the building have electricity'. Yes Nou 11 No, are you r4,qucst ng that the ole,00eity ib� turned on? yes '0 Isf o C s ,. The building is sprixiklored? Yes a€�.'J Operations will product dust/wood shavings or similar material"? Yes Q No Operations will involve the ropair tir replacei.ent of atitoinobile parts Yes C) 'fyes: Describe the components repaired or-repla.ced, F Does the: coeration involve the tine of weldingg or open flame? 'Yes No The bushit ss is drinking, dining or asse;nhly tasethat will result in an occupant load j of more than. 50 persons. Yes 0 No I The 1`iillowing `best describes any operation: C QC `ice Onty . keta Sales ClMe&al/Dernal IJRestaurant/TUe Out Food. ElWarebouse G ilui`ticluring0istribwlon t eseribe process and end product) "*A4 Other (describe) M tffice Use olrll. �. �Sq Ft routr: ! Cce oad; , r Stories. �. Barking Spaces: _. TIF Revs ;w, Y/ N A-wt Paid$. a P id sEFrtz5r i=»g: ,;p 400 } Building r et°niet Entitlement: . South Coast .fir Quality Management Disci 21865 E. Copley Drive Diamond Bar, CA 91765-4182 (909) 396-3529 htpp://www.agmd.gov Air. Quality Permit Cheeldist California Government Code 65850.2 prohibits cities from issuing a Certificate of Occupancy, to a business without clearance £corn the local air quality agency, This check::3t will determine if you steed to obtain clearance from the South Coast Air Quality Management District (A.QMD)- Company Name: � c rr property.A.ddress. A16M 1'5-13 1 2r2i-17 •+'!sue %r.�'� City. r %t.rt de-.4 Zip Code' Contact person: /*-Ar . t r,OA 4-0 Title; OWm--e 1— Type ofBusiness; a err-.•1i- &-te e hone ;Appl imt; (pant name) 14 sigrzatut e • Will the facility have any of the following equipment? yes ;lj NO Chaibroiler Dry cleaning machine Spray Booth Printing Press (screcti/lithogr:aphic/ilexographic) Intern combustion engine (greater thm 50l iP) (excluding motor vehicles) Boilerfeaml3ustiott zgt1ipment (gireater than 2 million BTLT/hr. rn imu in Abrasive blasting cabinet/room '8agbouse/cartridge type dust filter&crubber Motor fuel storage and dispensing equipment Will any ofthe follct Ang operations be perfibmed? Yes No L�1 Application of paints or adhesives Eic ijn ,plating, casting, or'melting 'of»metals Molding and bleadin o(liquids aho%r powders Storage of acids, solvents, organic liquids or fitels: Production cf acids, solvents; organic liquids, or fuels Production of!Vales,, dust, sirnoke ter strong odors s tym answered tVo," to both questions, this checklist is your clearance from 4QMD. If you anssveied �`�Ces" to either question., you must contact AQMD to deterrraine ifair quality permits, are requirad. lfpermits are Sleeded,. AQMD will assist you in submitting permit application($) and then provide you with a clearance letter, You can. cAl, AQND at their Small Business Assistance Office at (800) 388-2121. t 9vdinaa Typo Occ. Grail , a gun OING C»aNER oust ��ss crivrax n unrii n A va�stlq'[ „l A ral. - CityC_l � �t� �. _ a let, Nt$ tlSE WOULD BE OESCRICEQ AS! 13 -NEWLY CONSTFIUMED t3LGG. GHAT GE o �yLitlEf# 0CHANGE OF OCCUPANT 9."EXISTING $U)(10ING 0 CHANGE Or WE 0 AM11100AL OCCUPANt ndreate fatmcrtxse, rf ar.Y. ./IM...�f3wipiOGy G( �O#3ASE FT. O OUILO1tJG 3ODE c� UFIECI.. .W ����'� �{t o %A OPP$, ) NOTICE: ' 9.OccupancyofAnybuftdng;%prohtbiledandabpsrdsstce A ecroreWliinoiAe saueduntil itebuildtngfigs been ITIIS cic3 end i 2. No edercWcaf : ervIce will be reltas+ed tnr an� eaishng buffdipq until it ervfce has been In,spebled and. certified $afe, All appUcznts ft,r , upsncy in tun eaisling bpafding are requtred to schedule an u#sctrfcof SM r 'lust up' inspection In the OepArtm>rnf of CommUnfiy ©cuolopmea'at At the IIMO this appticatidn is"iifrtd. Chan4t dj occupancy or oa♦ Inspection fse. Whenever It fs necessary -to make inspection Olt bultding or pretrfsesinoriferiodetermine11achangeM4ybemadointhec;.dratterotoacvpnrtcyoru eofthgbuffdinl7 orpremi"s whith woptd plece the buflling Ina dtfterent division of Ih$ same group of occupAncy Orin A differed group of occupancy, a change of 00auparcylns9eclion fee of S shatG ., be paid to the city. t, hunt#ngton beach Fire Code Section 1$208 requlfes fhatbuifding numberx must be atntr tnaura}offerttr(a) InchkI In height with One halt (%j Inch stroke, and bt a cpnirasiinp potor from the b$ckgrAµ tt+d Theses numbers must be posled on your bull ing in a facstiorl that is vfsibte from the Street. d. Huntington besth fire Code $ectlon io.$Qi requires fife extinguis"NK set"lian and distribution per lino National Fite PrOledtion Adsoctattan pamphlet10 (see reverse sfds). LT t `j DATE AMQ .. Hof: tit f fnE USE ON .�.� .. xnNtc a i:UPANC1 (3A0UA.A PLAN CilfCK NO PARXING, SPA�E�� � �a dJp. 1. tag itCAt TH OEPT AP PRpVdT 4 t CEf111FiCAF:.BF40CifpY I•fE ' CtdM OP.U$E OR 0MUPANC`/ FED