HomeMy WebLinkAbout15161 Triton Ln - CofOJ� 0
HUNTINGTON BEACH
Business Address_
Business Owners N
Business Name
Business Type
CERTIFICATE OF OCCUPANCY
020
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION
(3`d Floor — The Applicant Must Apply In -Person)
Date j r, 11-3,
Zip Code
Telephone o.
Bus. Phon
Pro w er Information (required) Te t/E er c Contact required)
Name Name
Addr s IJ Home Address 1
City 1 State/Zii� CA 014,effl City State/Zip
Telephone No. A — v/�� Telephone No.
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or isting Building
IS THIS BUILDING FIRE SPRINKLERED? es ❑No
CHECK ALL THAT APPLY:
❑ Change of Business Owner ❑ Change of Occupant ❑ Change of Use �<A dditional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity be turned on? ❑Yes o
■ Will operations produce dust/wood shavings or similar material? ❑ Yes VNO
■ Will operations involve the repair or replacement of automobile parts? ❑Yes XNo If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? ❑ Yes , No
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
❑ Yes kNo
■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? )Yes ONO
■ e following best describes my operation: Office Only ❑ Retail Sales ❑Medical/Dental
Ware /Manufacturing/Distribution ❑Restaurant/Take-OutFood ❑Other
■ Will any meat products including beef, poultry, and/or fish bee cooked or fried onsite? ❑ Yes No
If you answered yes, please proceed to the next question.
• Does your facility currently have a grease control device (i.e. grease trap or grease interceptor)?
Check one: ❑ Yes ,<No
For Official Use Only
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied: 7 9
Bldg. Permit #
Planning Initials:)�Date:_' ''
Conditions of Approval or Qther N
10/7-7 5
Area: Z`{ %
Area:
Area:
No. of Stories:
Entitlement #:
Use Permitted:
Occ Load:
Occ Load:
Occ Load:
TIF Review: Y/ N
Zoning:
Parking Meets Code (for use): ON
Building Reviewed By Initials: 1�Date4 �
Grease Interceptor Verified Inspected By Initials: Date:
0 C'&^ ► l6 / 1, 'i-lS S-r- a+% Ct uAzrvT SP}c., .
• South Coast 13--` 914
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
(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 rom the South Coast Air Quality Management District (AQMD).
Company Name:
Address:
City:
Contact Person:
` Zip Code: `—t
Title: V 1 \ 2
Type of BusinessJ1 Vrx(--- V Telephone - kJ 1 V`1--,1 gyp'
Fax Numert Ili IG W-i I e-mail address: G( , 1 ��ri C�T�t—
Applicant (print name) ' , A W.
i t ture:0ADate:
• Will the facility have any of the following equipment? Yes ❑ Npr
Charbroiler
Dry cleaning machine
fj
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❑ NoV
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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