HomeMy WebLinkAbout15192 Triton Ln - CofOJJ
HUNTINCTON BEACH
CERTIFICATE OF OCCUPANCY 0203 -IVY j
CITY OF HUNTINGTON BEACH —
DEPT. OF PLANNING & BUILDING APPLICATION
714/536-552441
IN
Business License # n4
Business Address_ 15
Business Owners Name try n1
,*Business Name R 44cip
(3rd Floor — Must Apply In -Person)
Date (� •28- I�i
Zip Code 97. q
Telephone No. it 42.3YRj
Bus. Phone 'TJ2 _?Y&v
B ' ess Type L
Property Owner Information (required)t—renant/EmergencyContact (required)
Male Wk' bbw' -r� �W h Name 1 lk QA4a.J1}
Address 5 L%'L Ook4t 51 C711 t'Xj Home Address 211 y tAoa ,+
City State/Zip GR q Ib iq City CRjrt6r, State/Zip 1%
Telephone No. R(� Telephone No. 1 7Z�
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or 2 Existing Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner /Change of Occupant ❑Change of Use ❑Additional Occupant
■ Indicate former type of business rM
■ Are you requesting that the electricity be turned o .Yes NOD
■ Is the building sprinklered? Yes❑ Nod
■ Will operations produce dust/wood shavings or similar material? Yes ❑ NOV
■ Will operations involve the repair or replacement of automobile parts Yes No[?/
If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? YesE1 No
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes ONo 2'
■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? Yes ONO I�
■ The es . n. El Office Only ❑ Retail Sales ElMedical/Dental
War' mnsr—/Manufacturinh/Distribution Restaurant/Take Out Food
describe process and end product)
For Official Use Only
Occ Group: Area: Occ Load: 2 (7
Occ Group: Area: Occ Load: 33
Occ Group: Area. ZQQ Occ Load: '
Total Sq Ft Occupied: S-0 No. of Stories: TIF Review: Y/
Bldg. Permit # 1 Entitlement #: Zoning:
s
Plnr Initials: an Chkr Initials: -Date:-- �/$nsp Initials: Date:
of Approval or Other Notes:
R1 I 0 0i4m1 ft - USC
Inspection Date:
«.� UP any
4-
South Coast
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
(909) 396-3529 • http:// www.agmd.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).
Company Name: p.�r �G✓� �� �� p
Property Address: IS I q1 _P- 110'j �O
City: Zip Zip Code:
Contact Person: f*nervyA) RVAI ley
Type of Business: dE'M
Fax Number:
Title: Av
f
Telephone: 1 N . "z . "s Ioo
e-mail address: Mel 0
Applicant (print name): 0o•\) MU-14L Signature:
• Date: 27�
• Will the facility have any of the following equipment? es ❑ No
Charbroiler
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).
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