HomeMy WebLinkAbout15131 Triton Ln - CofO (85)P u APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENTA CH
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1PRINT OR TYPE ONLYi DATE
Business Name"T /' r'� ,f-T
'Business Type �` �l Occ. Group
BUILDING OWNER BUSINESS OWNERIMANAGE
Name /JG S�F� f>
Itarne� t-rg" C'L�cVd.0
Address A (� r'1 _ VE Su jo Address 3Q? IAS6
5A 9 f'X, Tel City � 6"� Home Tel.
THIS USE WOULD BE DESCRIBED AS:
❑ NEWLY CONSTRUCTED SLOG ❑ CHANGE OF OWNER CHANGE OF OCCUPANT
EXISTING BUILDING CHANGE Or USE ❑ ADDITIONAL OCCUPANT
Indicate former use, i, any _C -? � a^� i tub ,,,..Occupancy Gr Div. —
SQUARE FT. OF BUILDING TO BE OCCUPIED ��
1.
BUSINESS ADDRESS .f `. / J✓ - i2��=". �/t
2.
Person to contact in case of emergericyR
Telephone number`
3.
_ Does the building in question have electricity?
8Yes
❑,No
(a) If No, are you requesting that the electricity be
17 -Yes
turned on?
❑ No
4.
The building is sprinklered?
Wyes,
171
5.
Operations will produce dust/ wood ,shavlogs or similar
No
material?
❑ Yes
IYNo
6.
Operations will involve the repair or replacement of
❑. Yes
automobile parts?No
If 'Yes:
(a) Describe : the components repaired or replaced.
(b) Does the operation involve the use of an open flame?
❑ Yes
7.
The business - is drinking, dining or assembly use that will
result in an occupant load of more than 56 persons,
❑Yes
N o
i 8
The following best describesmy operation;
Office Only
Retail Sales
Warehouse
Manufacturing / Distribution (describe process and end ),duct)
Restaurant) Take Out Food
Medical J Dental
Other (describe)1�-fi'"
4 IPR-EMENTAL €NFORNIAiON
Souk Coast
AIR QUALITY MANAGEMENT [DISTRICT r
21865 E. Copley Drive, Diamond Bar, GA 91765-4182 (909) 396-2000
AM QUALITY PEIUMT CEOECKLIST
for nonresidential buildings only
Company Name:f �S Chi
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Location of Property:/�
City._#tfll Zip Code: 67-44 4
T
Contact Person 0q l 'l'-,�, JG L Title-,' G �'7 ✓
Telephone Number:r/ Fax Number:
J
Type of Industry/Business: ," f"
To apply for a nonresidential building permit, you must complete this checklist. If you have any
questions about completing this checklist, please call (800) 388-2121.
YES NO.
1. Will the facility have a charbroler? [
2. 'ill any internal combustion engine with greater that- 50 horsepower
operate at the facility (excluding motor vehicles)?
3. Will operations at the facility involve mixing, blending, or processing of
solventa, adhesives, paints or coatings?
4, Will dust or smoke be generated at the facility? [
5. Will refining of any liquids or solids be done at the facility? [ ["
6. Will any plating or coating of rnate,-ials be done at the facility? [ ] [
7. Will any combustion equipment rated greater than 2,000,000 BTU/hr be
operated at the facility?' [ ] [
8. Will any acids, solvents, or motor fuel be used or stored at the facility?
9. Willany organic liquids or gases be reacted or produced?
10. Will any ovens be used to dry or cure products at the facility?
I I. Will any CFC (Freon) recycling machines operate at the facility? [ [ l
� 1
Applicant;:
.Gf/tS�f Signature,' ,
(Print name clearly)
f
sZ If you have marked "NO" in all the boxes, an air quality permit is not needed at this time, }
and this checklist is your written release,
If you marked "YES" in any of the boxes, you must contactthe South Coast Air Quality
nnagemrierst Disti iet (AQ 3). Please read the Requirements on the back of the checklist.
(800) 388-2121
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