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15131 Triton Ln - CofO (25)
P ' Ja HUNTINGTON BEACH Business License # Business Address Business Owners N Business Name _ Business Type /YJ CERTIFICATE OF OCCUPANCY 020j_22_ - CITY OF HUNTINGTON BEACH - DEPT. OF PLANNING & BUILDING APPLICATION 714/536-5241 (3rd Floor — Must Apply In -Person) Date 3 &�i3 7 �' aiA4 2GY `7 Zip Code 9 Z 6 c/ 9 ie a S=4 Telephone No3/o-63 7-ij ?P--D z 4 Ta .r K Bus. Phone Property Owner Information (required) Tenant/Emer enc Contact (required) Name 44>/a/1- Name or- /L 1-= ia Address-Y/ ?— o/ v Home ddress 2-6 /g,-,G City • t 6f�.4State/Z �j 1-G''/�City -j ,ou%& a/Zip 7 2gp> Telephone No. 7 ''/ — 8 7 2 -- Z% 9 f Telephone No. �7 Yi- S�%' Ve/ Q THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or xisting Building CHECK ALL THAT APPLY: 4 ❑ Change of Property Owner 0(hange of Occupant ❑Change of Use ❑Additional Occupant ■ Indicate former type of business FA ■ Are you requesting that the electricity a turned on? Yes 0 0 ■ Is the building sprinklered? YesA , No❑ ■ Will operations produce dust/wood shavings or similar material? Yes❑ Np�-- ■ Will operations involve the repair or replacement of automobile parts YesIj N l If yes: Describe the components repaired or replaced. lL Y , ■ Does the operation involve the use of weldingKr open flame? Yes Q N ■ Will the b ness be a drinking, dining or assembly use with an occupant load of more than 50 persons? Yes QNo ■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? Yes ONo ■ T e following best describes my operation: ❑ Office Only ❑ Retail Sales ❑ Medica ental Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Foo�/o { (describe process and end product) r'►� .tiH of o7�'� .� �. Other (describe) M T- ell For Official Use Only Occ Group: Area: Occ Load: 3 Occ Group: = Area: 251-550 Occ Load : Occ Group: Area: Occ Load: Total Sq Ft Occupied: No. of Stories: TIF Review: Y/ N Bldg. Permit # Entitlement #: Zoning: ,y L-- Plnr Initials: Date 3? ; -1 Plan Chkr Initi Date:&-Sh Oinsp Initials: Date: Conditions of Approval or Other Notes: Inspection Date: • .• - SOUR Coast 0 0 1 t5 A -:�-Co 'a Air Quality Management District •. _ 21865 Copley Drive, Diamond Bar, CA 91765-4182 p (909) 396-3529 • http:// www.aqmd.gov Air Quality Permit Checklist California State Law Code 65850.2 prohibits cities from issuing an occupancy permit 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). ,65,- r Company Name: � Property Address: City: /� v o �`�+-• L Zip Code: Contact Person: 2 Title: ©L"A_A_Q_� Type of Business: A14 ►v % o�/� A� �"� � S Telephone: '_�� --6 3 Fax Number: 7 y �s'" �3 y e-mail ad es)'2s,�o Applicant (prin name): Signature: �)=iw Date: � • Will the facility have any of the following equipment? Yes ❑ No [� Charbroiler 1 Dry cleaning machine Spray booth Printing press (screen/lithographic/flexographic) Internal combustion engine greater than 50 HP (excluding motor vehicles) Boiler/combustion equipment (greater than 1 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❑ No Application of paints or adhesives Etching, plating, casting, or melting of metals Molding, extruding, or curing of plastics Mixing and blending of liquids and/or powders Storage of acids, solvents, organic liquids, or fuels Production of fumes, dust, smoke, or strong odors If you answered "No" to both questions, this checklist is your clearance from AQMD. 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 1-800-CUT-SMOG (1-800-288-7664). 6A