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HomeMy WebLinkAbout15131 Triton Ln - CofO (134)r r I ;� • a 0 M • Reordortrom'Sand Dollar Business Forms, (714) 842.1148 `�' 9i AA APPLICATION FOR CERTIFICATE OF OCCUPANCY �o CITY OF HUNTINGTON BEACH % q DEPARTMENT OF COMMUNITY DEVELOPMENT j z-f tr rn>rrrc�aN (PRINT OR TYPE ONLY) DATE , aa L��� c Address 1 S '3 ! �� �d �V `� �) 1 a District / Q �, , Business Name j mu � �(�NC{) fit tZ�1 i�l CI Tel. % /`I — p 7 3 "" �7/aQ >� Business Type Occ, Group I BUILDING OWNER BUSINESS OWNER/MANAGER t Name _ Name_ i� Address Home Address City _ Tel. City Home TeL THIS USE WOULD BE DESCRIBED AS: ❑ NEWLY CONSTRUCTED BLDG. (� CHANGE OF OWNER t CHANGE OF OCCUPANT r❑ EXISTING BUILDING /�� CHANGE OF USE ❑ ADDITIONAL OCCUPANT Indicate former use, if any i w/ l /r ;Occupancy rr. —Div. O SQUARE FT. OF BUILDING TO BE OCCUPIED- � 5 sQ F� O�sP 7oUfF MdVACO^SP goo v 3 ,l NOTICE: 1. Occupancy of any building is prohibited and a business license will not be issued until the building has been s inspected and a certificate of occupancy is issued. 2. No electrical service will be released for any existing building until the service has been inspected and certified safe. All applicants for occupancy in an existing building are required to schedule an electrical 'fuse up' inspection in the Department of Community Development at the time this application is filed. } 3. Charr7e of occupancy or use inspection fee. Whenever it is necessary to make inspection of a building or u: premises in order to determine if a change may be made in the character of occupancy or use of the building F` or premises which would place the building in a different division of the same group of occupancy or in a different group of occupancy, a change of occupancy inspection fee of $ shall q be paid to the city. 4. Huntington Beach Fire Code Section 10.208 requires that building numbers must be a minimum of four (4) inches in height with one half (1/2) inch stroke, and of a contrasting color from the background. These numbers must be posted on your building in a location that is visible from the street. +` 5. Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection and distribution per the i National Fire Protection Association p m let 10 (see reverse side). / /J 411�� I TRAFFIC IMPACT FEE _ L! rNt S (GccE DATE PAID, X 1p 6L' :MOUNT RECEIVED NAME (F OFFICE USt ONLY) ~r SUPPLEMENTAL INFORMATION (�Q 2c,, ZONING OCCUPANCY GROUP - i, V� kq e- NO. PARKING SPACES PLAN CHECK NO/� OCCUPANT LOAD_ PERMIT NO. -- 4� l HEALTH DEPT_ APPROVAL No, OF STORIES ADMIN. ACTION UTILITIES RELEASED l . alyz CERTIFICATE OF OCCUPANCY FEE g - j )PROVED By AT - CHANGE OF NG USE OR OCCUPANCY FED g . TOTAL $_ a ,. 75-o3e.,1/97 � [ .. COMMUNITY DEVELOPMENT t i SUPPLEMENTAL INFORMATION i 5 1. BUSINESS ADDRESS -3 —T(Ztvdo LU1—%-E is 2. Person to contact in case of emergency. ' Stomp G Telephone number: E59 0 — 0 l' 3. Does the building in question have electricity? pYes No (a) If No, are you requesting that the electricity be ❑ Yes turned on? ❑ No 4. The building is sprinklered? Yes C] No 5. Operations will produce dust/wood shavings or similar material? ❑ Yesl 0 No i 6. Operations will involve the repair or replacement of ❑ Yes automobile parts? No k If Yes: (a) Describe the components repaired or replaced. } 13 it (b) Does the operation involve the use of an open flame? ❑ Yes g No 7. The business is drinking, dining or assembly use that will result in an occupant load of more than 50 persons. O Yes ;B�No i 8. The following best describes my operation; g Office Only Retail Sales Warehouse Manufacturing / Distribution describe process and end product) E P1ym W G 0 �= tPrC Ef I N E A ITS Restaurant / Take Out Food Medical / Dental Other (describe) t SUPPLEMENTAL INFORMATION SUPPLEMENTAL INFORMATION (Continued) Does the operation involve any of the following materials? Yes i ,�. Ls No If Yes indicate' q intities: Material Quantity' 1. Flammable liquids Class I -A Class I-B Class 1-C 2. Combustible liquids Class II Class 111-A 3. Combination flammable liquids . Flammable gases ! 5. Liquefied flammable gases 6. flammable fibers - loose 7. Flammable fibers - baled ` 8. Flammable solids I 9. Unstable materials y 10. Corrosive liquids 11. Oxidizing material - gases 12. Oxidizing material - Liquids 13. Oxidizing material - solids 14. Organic peroxides 15. Nitromethane unstable materials 16. Ammonium nitrate r 17. Ammonium nitrate compound mixtures containing more than 60% nitrate by weight 18. Highly toxic material and poisonous gas 19. Smokeless powder 20. Black sporting powder I hereby certify that the above information is true and correct to the best of my knowledge. �Z)Ila e SiCure ure 1�--W Date as .._. q �i 3 a k South COCiSt jl AIR QUALITY MANAGEMENT DISTRICT 21665 E. Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-2000 Ij t 4 AIR QUALITY PERMIT CHECKLIST for nonresidential buildings only Company Name: CNG ; N ECG Location of Property: f City:y �4 I QSCQ Tdt � 1� �{} i _ Zip Code: Z� i Contact Person: Et� 57JMV Title: C, E.G Telephone Number: (71f) 5 `76 —d 763 Fax Number: Type ofIndustryBusines Pr i iitJaiNE� CoCATca it 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 charbroiler? 2. Will any internal combustion engine with greater than 50 horsepower operate at the facility (excluding motor vehicles)? [ ] [}] s 3. Will operations at the facility involve mixing, blending, or processing of solvents, adhesives, paints or coating? [ ]€ 4. Will dust or smoke be generated at the facility? [ ] [yg- 5. Will refining of any liquids or solids be done at the facility? 6. Will any plating or coating of materials. be done at the facility? 7. Will any combustion equipment rated greater than 2,000,000 BTU/hr be [ operated at the facility? [ j 8. Will any acids, solvents, or motor fuel be used or stored at the facility? [ ] 9. Will any organic liquids or gases be reacted or produced? 10. Will any ovens be used to dry or cure products at the facility? 11. Will any � CFC (Freon) recycling machines operate at th 'lity? [ ] [ Applicant: / L (--P—F T2, « Signature: (Print name clearly) If yot have marked "NO" in all the boxe., an air quality permit is not needed at this time, and this checklist is your written release. If you marke YES" in y of the boxes, you must contact the South Coast Air Quality Management Di (AQMD). Please read the requirements on the back of the checklist. (800) 388-2121 5 F'-6m M 9 k- �� `1 ti 55� cl�, -Izg29 C=-1364 ADDITIONAL SUPPLEMENTAL IMPORMAMOfu t (� Ff'R 09 ' 98 06: 49HM SCHUMD '90y dyb—ebbti ;:�a•., SOUTH COAST AIR QUALITY MANAGEMENTDISTRICT page l r, c ,y 21865 East Copley drive, Diamond Bar, CA 91765 F 21 829 ° PERMIT TO CONSTRUCT/OPERATE AIN 336779 This initial permit must be renewed ANNUALLY unless the equipment is moved, or changes ownership. If the billing for annual renewal fee (Rule 3011) is not received by the expiration date, contact the District. I i f LEGAL OWNER ID 114772 OR OPERATOR; KEN STUMP MACHINING, TRITON ENO, DBA 15201 'TRITON LN HUNTINGTON BEACH, CA 92649 Equipment Location: 15131 TRITON LN SUITE #118, HUNTINGTON BEACH, CA 92649 1 Equipment Description: SPRAY BOOTH NO. 1. KINKS, FLOOR TYPE, MODEL PAF-7.5-7-TLH, 8'4)" W. X 7-8" L. X 7'-0°' H., WIT14 TWO 36 X 90" ANDREAE TYPE EXHAUST FILTERS, AND ONE 1-HP EXHAUST FAN. Conditions: 1) OPERATION OF THIS EQUIPMENT SHALL BE CONDUCTED IN ACCORDANCE WITT•I ALL DATA AND SPECIFICATIONS SUBMITTED WITH THE APPLICATION UNDER WHICH THIS PERMIT IS ' ISSUED UNLESS OTHERWISE NOTED BELOW. ; 2) THIS EQUIPMENT SHALL BE PROPERLY MAINTAINED AND KEPT IN GOOD OPERATING CONDITION AT ALL, TIMES. i t. 3) THIS SPRAY BOOTH SHALL NOT BE OPERATED UNLESS ALL FXHAUST AIR PASSES THROUGH , FILTER MEDIA AT LEAST 2 INCHES THICK, a 4) A GAUGE SHALL BE MAINTAINED TO INDICATE„ IN INCHES OF WATER. THE STATIC PRESSURE DIFFERENTIAL, ACROSS THE EXHAUST FILTERS, IN OPERATION, THE PRESSURE DIFFERENTIAL SHALL NOT EXCEED 0.25 INCH OF WATER, f 5) T14E TOTAL QUANTITY OF VOLATILE ORGANIC COMPOUND (VOC) EMISSIOINS FROM THE USE OF COATINGS, THINNERS. REDUCERS AND CLEAN-UP SOLVENTS FRONT THIS FACILITY SHALL BE LESS THAN 667 POUNDS IN ANY ONE CALENDAR MONTH. 6) THIS EQUIPMENT SHALL BE OPERATED IN COMPLIANCE WITH RULES 1124 AND'I171 7) THE OPERATOR SHALL COMPLY WITH RULE 109 (RECORDKEEPING FOR VOLATILE ORGANIC COMPOUND EMISSIONS). 8) T11E OPERATOR SHALL KEEP ADEQUATE RECORDS FOR TMS FACILITY TO VERIFY CALENDAR MONTHLY VOLATILE ORGANIC COMPOUND (VOC) EMISSIONS IN POUNDS AND VOC CONTENT OF EACH COATING AS APPLIED (INCLUDING WATER AND EXEMPT COMPOUNDS). ALL RECORDS SHALL BE PREPARED IN A FORMAT WHICH iS ACCEPTABLE TO T iM DISTRICT. t ORIGINAL APR 09 198 08:49AM SCAQMD 909 396-2608 ;•„;, SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT Pagel P-2 21865 East Copley Drive, Diamond Bar, CA 91766 F 829 o PERMIT TO CONSTRUCT/OPERATE AIN 336779 a This initial permit must be renewd ANNUALLY unless the equipment is moved, or changes ownership. If the billing for annual renewal fee (Rule 301.f) is not received by the expiration date, contactthe District, t LEGAL OWNER ID 114772 OR OPERATOR; KEN STUMP MACHINING, TRITON ENG, D13A 15201 TRITON LN HUNTINGTON BEACH, CA 92649 Ci Equipment Location: 15131 TRITON LN SUITE #118, HUNTINGTON BEACH, CA 92649 `<6 a Equipment Description: ) y SPRAY BOOTH NO.1, BINKS, FLOOR TYPE, MODEL PAF-7.5-7-7,LH, T-0" W. X 7'-8" L. X 7•-0" H„ WITH ¢ TWO 36" X 90" ANDREAE TYPE EXHAUST FILTERS, AND ONE 1-HP EXHAUST FAN, Conditions: 1) OPERATION OF THIS EQUIPMENT SHALL BE CONDUCTED IN ACCORDANCE WITH ALL DATA? AND SPECIFICA`t IONS SUBMITTED WITH THE APPLICATION UNDER WHICH THIS PERMIT IS' ' { ` ISSUED UNLESS OTHERWISE NOTED BELOW.-' 2 THIS EQUIPMENT SHALL BE PROPERLY MAINTAINED AND KEPT. IN GOOD OPER ATING CONDITION AT ALL TIMES. ` 3) THIS SPRAY BOOTH SHALL NOT BE OPERATED UNLESS ALL EXHAUST AIR PASSES THROUGH FILTER MEDIA AT LEAST 2 INCHES TICK, 4) A GAUGE SHALT. BE MAINTAINED TO INDICATE, IN INCITES OF WATER, THE STATIC PRESSURE DIFFERENTIAL ACROSS THE EXHAUST FITTERS, IN OPERATION, THE PRESSURE DIFFERENTIAL- SHALL NOT EXCEED 0.25 INCH OF WATER, 5) THE TOTAL QUANTITY OF VOLATILE ORGANIC COMPOUND (VOC) EMISSIONS FROM THE USE OF COATrNGS, THINNERS, REDUCERS AND CLEAN-UP SOLVENTS FROM THIS FACILITY SHALL BE LESS'rHAN 667 POUNDS IN ANY ONE CALENDAR MONTH. 6) THIS EQUIPMENT SHALL BE OPERATED IN COMPLIANCE WITH RULES 1124 AND '1171• 7) THE OPERATOR SHALL COMPLY WITH RULE 109 (RECORDKEEPING FOR VOLATILE ORGANIC COMPOUND EMISSIONS). • E 8) THE OPERATOR SHALL KEEP ADEQUATE RECORDS FOR THIS FACILIrf TO VERIFY CALENDAR MONTHLY VOLATILE ORGANIC COMPOUND (VOC) EMISSIONS IN POUNDS AND VOC CONTENT OF EACH COATING AS APPLIED (INCLUDING WATER AND EXEMPT COMPOUNDS). ALL RECORDS SHALL BE PREPARED IN A FORMAT- WHICH IS ACCEPTABLE TO THE DISTRICT. • i ORIGINAL � APR 09 198 08:49RM SCRUID 909 396-2608 F SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT page 2 P. 3 21865 East Copley Drive, Diamond Bar, CA 91765 Petmic No, F12829 .: PERMIT TO CONSTRICT/OPERATE A/N 336779 f i . o /o PERATE RMIT TO C TRUCT 0 CONTINUATION FPEN 5 9) WITHIN 14 CALENDAR DAYS AFI E_ "i4E END G EACH MONTH, THE OPERATOF. SlsesLL TOTAL, x I AND RECORD VOC EMISSIONS FOR THE MONTH FROM ALL EQUIPMENT COVERED•BY THE MONTHLY LIMIT. THE RECORD SHALL INCLUDE^ ANY PROCEDURES USED TO ACCOUNT FOR CONTROL DEVICE EFFICIENCIES AND/OR WASTE DISPOSAL. IT SHALL BE SIGNED AND CERTIFIED FOR ACCURACY BY THE HIGHEST RANKING INDIVIDUAL RESPONSIBLE FOR COMPLIANCE VATH DISTRICT RULES, 10) THE OPERATOR SHALL MAINTAIN A SINGLE LIST WHICH INCLUDES ONLY THE NAME AND ADDRESS OF EACH PERSON FROM WHOM THE >; ACILI" ACQUIREDMOC-CONTAINING MATERIAL REGULATED BY THE DISTRICT THAT WAS USED OR STORED AT THE FACILITY DURING THE PRECEDING 12 MONTHS. ` 11) THE OPERATOR SHALL RETAIN ALL PURCHASE INVOICES FOR ALL VOC-CONTAINING }}` MATERIAL USED OR STORED AT THE FACILLITi', AND ALL WASTE VOC-CONTAINING 3a MATERIAL REMOVED FROM THE FACILITY, FOR 36 MONTHS, V 12) ALL RECORDS REQUIRED BY THIS PERMIT SHALL BE RETAINED AT THE FACILITY FOIL 36 MONTHS, AND SHALL BE MADE AVAILABLE TO ANY DISTRICT REPRESENTATIVE UPON ; REQUEST. �i 13) COATINCIS, ADHESIVES, REDUCERS, THINNERS, AND CLEAN-UP SOLVENTS USED IN THIS EQUIPMENT SHALL NOT CONTAIN ANY COMPOUNDS IDENTIFIED AS CARCINOGENIC AIR CONTAMINANTS IN RULE 1401 AS AMENDED DECEMBER 7,1990. I 14) MATERIAL, SAFETY DATA SHEETS FOR ALL COATINGS, AND SOLVENTS USED AT THIS FACILITY SHALL BE KEPT CURRENT AND MADE AVAILABLE TO DISTRICT PERSONNEL UPON REQUEST. NOTICE IN ACCORDANCE VIT H RULE 206, THIS PERMIT TO OPERATE OR COPY S HALL BE POSTED ON OR i WITHIN 8 Ml T ERS OF THE EQUIPMENT. ORIGINAL 1 r :I APR 09 '98 03:50AN SCAQMD (309 396-2608 ;:- SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT page x 21865 East Copley Drive, Diamond Bar, CA 91765 Penti t No' S F23009 PERMIT TO CONSTRUCT/OPERATE A/N 336780 ., This initial permit must be renewed ANNUALLY unless the equipment is meved, or changes ownership. If the bitting for annual renewal fee (Rule 301.f) is not received by the expiration date, contact the District. I" LEGAL. OWNER ID 114772 OR OPERATOR: KEN STUMP MACHINING, TRITON ENO, DBA 15201 TRITON LN HUNTINGTON BEACH. CA 92649 CC 1 Equipment Location. 15131 'TRITON LN SUITE #118, HUNTINGTON BEACH. CA 92649 l Equipment Deaeription: SPRAY BOOTH NO', 2, RINKS, FLOOR TYPE, 7'-10" W. X 7'-8" L. X V-0" H., WITH TWO 50" X 86" 13LANKET- TYPE PU FILTERS, SIXTEEN 20" X 20" X 15" POCKET -TYPE FMTERS, EIGHT 24" X 24" X 12 FINAL HEPA FILTERS AND ONE 7 1/2-HP EXHAUST FAN. t: - Conditions: I) OPERATION OF THIS EQUIPMENT SHALL BE CONDUCTED IN ACCORDANCE WITH ALL DATA AND SPECIFICATIONS SUBMITTED WITH THE APPLICATION UNDER WHICH THIS PERMIT IS ' ISSUED UNLESS OTHERWISE NOTED' BELOW, 2) THIS EQUIPMENT SHALL BE PROPERLY MAINTAINED AND KEPT IN GOOD OPERATING CONDITION AT ALL TIMES, 3) THIS SPRAY BOOTH SHALL NOT HE OPERATED UNLESS ALL EXHAUST AiR PASSES THROUGIi ALL THREE STAGES OF FILTERS. 4) A GAUGE SHALL BE MAINTAINED TO INDICATE, IN INCHES OF WATER, THE STATICPRESSURE DIFFERENTIAL ACROSS i BLANKET -TYPE AND POCKET -TYPE EXHAUST FILTERS. IN OPERATION, THE PRESSURE DIFI ERENTIAL ACROSS THE FILTERS SHALL NOT EXCEED 0.25 INCH OF WATER, 5) A GAUGE SHALL BE MAINTAINED TO INDICATE, IN INCHES OF WATER, THE STATIC PRESSURE DIFFERENTIAL ACROSS THE HEPA FINAL FILTERS. IN OPERATION, THE PRESSURE DIFFERENTIAL ACROSS THE HEPA FINAL .FILTERS SHALL NOT EXCEED 1.0 INCH OF WATER. i 6) THE TOTAL QUANTITY OF VOLATILE ORGANIC COMPOUND (VOC) EMISSIONS FROM THE USE OF COATINGS, THINNERS, REDUCERS AND CLEAN-UP SOLVENTS FROM THIS FACILITY SHALL BE LESS 11HAN 667 POUNDS IN ANY CALENDAR MONTH. 7) THIS EQUIPMENT SHALL BE OPERATED IN COMPLIANCE WITH RULES 1124 AND 1171, ORIGINAL APR 99 '98 08:50AM SCAQMD 909 396-260��� SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT Pala 2 P. 6 21865 East Copley Drive, Diamond Bart CA 91766 Pl=t No, PERMIT TO CONSTRUCT/OPERATE � 3�b7go r j CONTINUATION OF PERMIT TO CONSTRUCT/OPERAME 8) THE STRONTIUM CHROMATE CONTENT OF MATERIALS PROCESSED IN THIS EQUIPMENT SHALL NOT EXCEED 10%BY WEIGHT. 9) THE TOTAL QUANTITY OF COATINGS CONTAININNG STRONTIUM CHROMATE USED IN THIS EQUIPMENT SHALL NOT EXCEED 125 GALLONS IN ANY ONE YEAR. 10) EXCEPT AS NOTED IN CONDITION NOS. 8 AND 9, COATINGS, ADHESIVES, REDUCERS„ I THINNERS, AND CLEAN-UP SOLVENTS USED IN THIS EQUIPMENT SHALL NOT CONTAIN ANY COMPOUNDS IDENTIFIED AS CARCINOGENIC AIR CONTAMINANTS IN RULE 1401 AS AMENDED DECENMER 7, 1990. si 1 i) MATERIAL SAFETY DATA SHEETS FOR ALL COATINGS, AND SOLVENTS USED AT THIS FACILITY SHALL BE KEPT CURRENT AND MADE AVAILABLE TO DISTRICT PERSONNEL UPON REQUEST. 12) THE OPERATOR SHALL COMPLY WITI-I RULE 109 (RECORDKEEPING FOR VOLATILi ORGANIC r` COMPOUND EMISSIONS). # 13) THE OPERATOR SHALL KEEP ADEQUATE RECORDS FOR THIS FACILITY TO VERIFY CALENDAR MONTHLY VOLATILE ORGANIC COMPOUND (VOC) EMISSIONS IN POUNDS AND VOC CONTENT OF EACH COATING AS APPLIED (INCLUDING WATER AND EXEMPT COMPOUNDS). RECORDS' SHALL ALSO BE MAINTAINED TO PROVE COMPLIANCE WITH CONDITION NO. 9. ALL RECORDS I SHALL BE PREPARED IN A FORMAT WHICH: IS ACCEPTABLE TO THE DISTRICT, � 14) WITHIN 14 CALENDAR DAYS AFTER THE END OF EACH MONTH, THE OPERATOR SHALL TOTAL AND RECORD VOC EMISSIONS FOR THE MONTH FROM ALL EQUIPMENT COVERED BY THE MONTHLY LIMIT. THE RECORD SHALL INCLUDE ANY PROCEDURES USED TO ACCOUNT FOR CONTROL DEVICE EFFICIENCIES AND/OR WASTE DISPOSAL. IT SHALL BE SIGNED AND CERTIFIED FOR ACCURACY BY THE HIGHEST RANKING INDIVIDUAL RESPONSIBLE FOR COtiIPLIANCE WITH DISTRICT RULES. 15) THE OPERATOR SHALL MAINTAIN A SINGLE LIST WHICH INCLUDES ONLY THE NAME AND ADDRESS OF EACH PERSON FROM WHOM THE FACILITYACQUIRED CQUIRED VOC-CONTAINING MATERIAL REGULATED BY THE DISTRICT THAT WAS USED OR STORED AT THE FACILITY DURING THE PRECEDING 12 MONTHS. 16) THE OPERATOR SHALL RETAIN ALL PURCHASE JNVOICES FOR ALL VOC•CONTAINING MATERIAL USED OR STORED AT THE FACILITY, AND ALL WASTE VOC-CONTAINING MATERIAL REMOVED FROM THE FACILITY, FOR 36 MONTHS, ' I 17) ALL RECORDS REQUIRED BY THIS PERMIT SHALL BE RETAINED AT THE FACILITY FOR 36 MONTHS, AND SHALL BE MADE AVAILABLE TO ANY DISTRICT REPRESENTATIVE UPON REQUEST. E i 4 ORIGINAL 4-4 California Health .an,d Safety Code requires the Fire Department to regulate businesses that handle hazardous materials. Motor oil,;hydraulic fluids, gasoline, dry cleaning fluid, etc., are considered hazardous materials and must be disclosed. If you use, handle or store hazardous materials or waste materials equal to or in excess of the following basic quantities, your are required to disclose: • 55 gallons of liquid • 500 pounds of solid • 200 cubic feet of compressed gas • Any amount of radioactive materials Any amount of Class A explosive .any amount of chemicals known to cause cancer « Any amount o�`corruraercial pesticides • Reportable quantity of any cheT1ical on Ep?A Extremely Hazardous \,iaterials Substance List Disclosure is zot required for the following: 1. Hazardous substances contained in food, drug, cosmetic or tobacco products.; 2, Upon approval of tb Fire Chief, hazardous materials contained sol ;ly in consumer products pcel�aged for use by and distributed to the general public. However, pesticides, herbicides, and aatmoninm nitrate fertilizers over the required disclosure amounts are roti exempt from=disclosure. 3. The transportation of hazardous materials accompanied by shipping papers prepared in a;;cordance with the provisions of 49 Code of Federal Regulations 4. Infectious waste generated by health care facilities that are regulated under Title 22 of the California Administrative Coder eck one of the following: rlo chemicals are used, handled or stored at this business. Chemicals are used, handled or stored at this business, but do not meet the requirements for disclosure Chemicals are used, handled or stored at this business. Disclosure dorms will be suit to you. Amounts will be venified by the Fire Department during annual inspections. It is unlawful for any person to knowingly violate any provision of this ordinance. I :citify, uncle: ' e analty of perjury, that the above information is true and correct to the best of xny' knowledge. Os Signardre Di+te Y Horne P n Please call 714-536-5676 with questions regardin►o the Hat,,rdous ai�aterials Program. 7 AYPLICA ON FOR CERTIFICATE OF OCCUPANCY 1 CITY OF HUNTINGTON BEACH - DEFARTN.? �,NT OF BUILDING & SAFE T v- 4 (3 d Floor; -Mist Apply ln-.r ersoli Business License J� --�� j'�1'►�" �� Date t,�ddress , Itj � Business Name P t ,nr- li Telephone, T- _ 3usinv�s Type ',�`�c�6�1�i1 C,S `--lC�:�111�4�1��C� l)�� �c'�'►t�t�-t prorerry Owner Information A Business Ottillcr \1 qi amee t11 cress t - Home zddrss City Tel. C City Q Tel._ THISUSE WOULD BE DESCRIBED' AS; ❑Nev ly Constructed Building Or)aExist=_ng Building CHECK ALL. THAT APPLY: U Change of Owner 4�hanae or Occupant !—I. Change of Use ❑ ? ddztional Occupant G, I'�;o.:. flu-c.Itvrs�ig that thr e:ct:ici:; b� turned on? Yes i� fro ` _ OLe-- - ":u%a�C Gi b✓Zti:� t1� ..h�a:11123 c:_ imila: rnale4al? Yes N .� O ar?' ct. t4Z C1 *ri ;"vI� -i r. r t}: ie , c f%e r +7i 22t0 013it� fin. u v- 5 crJm'nor z repaired or,replaced. Does the operation 4.-volve the use of welding or open flame? Yes L�. N'c- o The business is drinking, dining or assembly u-sa that will result in an occupant load of more than 50; persons. Yes ❑ N 1 e following best describes my operation: ffice Only EIRetail Sales ❑N edical/Dental ORestatlrant/Take out Food QWarehouse i Ianufacturing/Distribution (describe process and end product) Oth..r (d scnbe, , Off; 2 Use Only:!_��` Occ Load:� Zoning: ��.--- S4 Ft Occupied: �©s "" _ Occ Grouu;_ ? ➢: �, TIF Review: Y/ N Amt PaidS., ' ]i zr Stories: Parking Spaces: Px d &fir"GRF �in�l i u�:t ion � M Entitlement T: Building Permit r f 7 S �A a CC)Illlllent5: CofO . s i` Planner Initials: !�'�3� B1dalPl�tn Cl ecl~zr lnit als _ � ;;, R , ��� South Coast Ass Quality Marta, District 21865 E. Copley Drive Diamond Bar, CA 91765-4182 (909) 396-3529 htpp://w�vw.agmd.gov Air Quality Permit Checklist California Government Code 65850.2 prohibits cities from issuing a Certificate of Occupancy to a business with 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:- Prope*tyAddress:�� �( f City: -EIt L Zip Code: Contact Person:�� �l��(l�Q (�Q Title: C G Type of Business: i �? Telephone:' Yr Applicant: (print naive) � �}1 16�RI Signature • Will the facility have any of the following equipment? Ye No t Charbroiler 1 Dry cleaning machine Spray Booth . i Printing Press (screen/lithographic/flexcgraphic) 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 Will any of the following operations be performed? Yes Application, of paints or adhesives lHtching, 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 i : If you answered "No" to both questions, this checklist is your clearance from AQMD. i • If you answered "Yes" to either question, you must contact AQ,110 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 i with a clearance letter. You can call AQNT D at their Small Business Assistance Office at (�3Qt3) 3$8�212i. h