HomeMy WebLinkAbout15131 Triton Ln - CofO (71)a
CERTIFICATE OF OCCUPANCY 020
J� CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION
HUNTINGTON BEACH (3rd Floor — The Applicant Must Apply In -Person)
Business Address ZAJ -74�F 2 Date /4 �_ _
Business Owners Name i'C,A,2do ZQd e,'6Ut, Zip Code %Z 6( 1
Business Name 3Cfi Telephone No. `7/�e6SLq: M
Business Type W AC ek ovS4 3,) A P lv Bus. Phone
Pr ert Owner Information (Wquired) Tenant/EmergencyContact (required)
Name i16t21-LLLc Name _ � QdLzr i"jcz
Address S/ q t (54A✓2 t 0 ' Home Address e0 52 KA[e9- Ave -
City State/Zip 1 2-6y' ( City State/Zip 5?2-6 (6
Telephone No. j/ (4, U�� �� Telephone No. 'Z/ U 6' aO —�-3-�
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or 4P Existing Building
IS THIS BUILDING FIRE SPRINKLERED? ❑ Yes E]No
CHECK ALL THAT APPLY:
❑ Change of Business Owner `q Change of Occupant ❑ Change of Use Additional Occupant
■ Indicate former type of business � c S u f � A U to �SsC
■ Are you requesting that the electricity be turned on? ❑Yes P No T(USA( cu�,Ns
■ Will operations produce dust/wood shavings or similar material? ❑Yes p�No
■ Will operations involve the repair or replacement of automobile parts? ❑Yes Colo 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 NNo
■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? []Yes allo
■ The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑Medical/Dental
,I Warehouse /Manufacturing/Distribution ❑ Restaurant/Take-Out Food a Other SA16�
■ ill any meat products including beef, poultry, and/or fish bee cooked or fried onsite? ❑ Yes $2 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 C�No
For Official Use Only..
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied:
Bldg. Permit #
Planning Initial Date:
h�in
Conditions of Approval or Other Notes:
Area: 2..
Area:
Area:
No. of Stories:
Entitlement #:
Use Permitted: 0N
Occ Load:
Occ Load: r
Occ Load:
TIF Review:�Y/ N
Zoning:
Parking Meets Code (for use):10 N
Building Reviewed By Initials:_MW Date: r_+
Grease Interceptor Verified Inspected By Initials: Date:
South Coast 0
Air Quality Management ement District
21865 Copley Drive, Diamond Bar, CA 91765-4182
e (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).
Company Name:
361 _:i e s
Property Address: IS 1 4
City: iA � Zip Code: Z �4
Contact Person: ZcN-WLTitle: G(J Ve �—
Type of Business: WAW�oCQ_l S,,r Telephonej /
k)ASCA-s1-7/Lil R1zegA41L
Fax Number: e-mail address:
Applicant (print name): kCP290 Signature: ate: / O Z-7 3-
Will the facility have any of the following equipment? Yes ❑ 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[:] NoKb
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).
-2-
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CERTIFIC-ATM OF OCCUPANCY
0X OF NUNTIWrwi SDLN Flay 26, 1580.
OEPhRTMW OF CommL �pTY DEVELOPMENTre,s15131 Triton Ln, . 124
�k LETI�ERP�R5S
easiness Type T=tt PRINTING "`—
'
&II NG OWNER eUCINE6S OWNEWAUWAGER
C Neme Name!z(lh R. Gunther
r�--- Address
Gly Tel Hunting Eon Beach A
GIIY .Flume To9j;
e Conslfuct o 1 No. to ,&orws OwTanl LOW $
P _ ' SCrmklcued '
d Thlt Corti �. of DscaS•u+c� DEPARTMENT OF COWAuWTY DEVELOPMENT
SI IALL Bc posted In'. conspicK . PIa , an
the premises and shad nvt be ren ve +X.
4 cPlby the SuHdrtp Ofiiciaj.
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SUPPLEZIENTAL INFORNATION
1.
BUSINESS ADDRESS 1,15'131 TRITN) LIV 1211 bVtr'7
2.
Persnn to contact in case of emergency; JV11,Y1 6CIU712;;q�
Telephone number: 7/q 0 ;?53
3.
Does the building in question have electricity?
ayes
ONO,
ai if No, a-r I e-you requesting that the electricity be
Myes
turned on?
ONO
4
The building is sprinklered?
55Yes.
.0 No
S.
ojerations will produce I dust/wood sbavin I gs. I o r similar
material?
Oyes.
ONO
6.
operations will.itiVolve the repair or replacement of
OYes
Automobile parts?
If yes.
(a) Describe the components repaired or replaced.
(b) Does the operation involve the use of ali opft - flame?
Oyes
EMO
7.
The bus-ness is drinking, dining or assembly.use.that Will,
result in an occupant load of more than SO persons.
Oyes
-QNo
8.
The following best describes my operation:
Office Only
Retail Sales
warehouse
ManufactUring/Distribution (describe pro6ess and end
product)
RestazraBt7Ma out Food
Medical/Dental'
Other (describe) OtF-
(0562D)
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