HomeMy WebLinkAbout15131 Triton Ln - CofO (107)HUNTINGTON BEACH
CERTIFICATE OF OCCUPANCY 020 - QOuRS-(,p
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION
(3rd Floor - The Applicant Must Apply In -Person)
Business Address15131 Triton Ln. suite 111 Date 2/1 /2018
Business Owners Name Erik Peterson Zip Code 92649
Business Name Intec Network Solutions Inc. DBA Intec Telephone No.714-580-6980
Business Type contractor Bus. Phone 714-475-6675
Property Owner Information (required) Tenant/Ememency Contact (required)
NameBolsa Business Park Name Erik Peterson
Address5142 Bolsa Ave. suite 101 Home Address 16172 Ballantine Lane
cityHuntington Beach State/ZipCA/92649 cityHuntington Beach State/Zip CA/92647
Telephone No.714-8992791 Telephone No. 714-580-6980
THIS USE WOULD BE DESCRIBED AS:
❑Newly Constructed Building or m Existing Building
IS THIS BUILDING FIRE SPRINKLERED? ®Yes [:]No
CHECK ALL THAT APPLY:
❑ Change of Business Owner 0 Change of Occupant ❑ Change of Use ❑ Additional Occupant
• Indicate former type of business
• Are you requesting that the electricity be turned on? []Yes ®No
• Will operations produce dust/wood shavings or similar material? ❑ Yes 0No
• 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? ❑ Yes ® No
• Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? ❑Yes m No
• Will there be storage racks, gondolas, or shelving exc feet 9 inches in height? m Yes ❑ No
• The fo t describes my operation: Offs my ❑Retail Sales ❑ Medical/Dental
rehouse IN
ja6ufacturing/Distribution estaurant/Take-Out Food ❑ Other
• at products including beef, poultry, and/or fish be 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 ON
Grease Interceptor Verified
For Official Use Only
Occ Group: S� 1
Occ Group: �}
Occ Group:
Total Sq Ft Occupied: %(4'1�7
Bldg. Permit #
Planning Initials:,./1L-Date: 2
Conditions of Approval or Other Notes:
Inspected By Initials: Date:
Area: SOS -
Area: 9 0
Area:
No. of Stories:
Entitlement #:
Use Permitted- N
Occ Load:
Occ Load: 1
Occ Load:
TIF Review: Y/ N
Zoning:
Parking Me is Code (for us 0N
Building Reviewed By Initials Date:
nw.Lz
On -a�5-6
South Coast
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA.91765-4182
Phone Number (909) 396-3529 http://www.agmd.gov
p a
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:Intefc Network Solutions, Inc. dba Intec
t Property Address: � 13 ( 1 &17DK( Lj,f, 5(-)�7r
city: Huntington Beach Zip Code: 92649
Contact Person:Erik Peterson Title: President
Type of Business -contractor Telephone:714-580-6980
Fax Number:none E-mail Address: erik@intecsocal.com
Applicant (print name):Erik Peterson Signature: Date. 2/1 /18
1. Will the facility release air pollutants, including but not limited to, dust fumes, gas, mist, odors, smoke, vapor, or a
combination of these to the atmosphere? DYes ®No
2. Will the facility result of fuel -burning equipment including, but not limited to, boilers, generators, and internal combustion
engines? QYes ZNo
3. Will the facility result of hazardous materials, including but not limited to, chemical, plastics, rubber, resins, solvents,
paints, and other parts cleaners? QYes ®No
4. Will the facility have use of above or underground storage tank? QYes oNo
5. Will the facility consist of manufacturing, fabrications, finishing, or treatment of wood, metal or plastic products? QYes ®No
6. Will the facility result in the use of the equipment listed below? QYes Olo
(Select all that apply)
[]Abrasive Blasting Cabinet/Room
❑Internal Combustion Engine (rated > 50 bhp; e.g. back-up generator)
[]Air Conditioning System (containing > 50 Ibs of refrigerant)
[]Mixing/Blending of Liquids and/or Powders
[]Application of Paints/Adhesive/Resins
[]Molding /Extruding/Curing of Plastic
[]Baghouse/Dust Collector
Pharmaceutical/Nutraceutical
[]Bakery Oven (gas fired)
❑Plasma/Laser Cutter
❑Boiler/Water Heater (max. heat input = or > 1 million BTU/hr)
[]Printing/Coating/Drying
❑Charbroiler/Smoker
❑ Production of Fumes/Dust/Smoke/Odors
[]Coffee Roaster/Afterbunner
[]Refrigeration Systems (containing > 50 Ibs of refrigeration
[]Deep Fryer (excluding equipment located at eating establishment)ElSoldering
Oven
❑Dry Cleaning Equipment
[]Spray Booth
[]Electrostatic Precipitator
Storage of Acids/Solvents/Organics Liquids/Fuels
[]Fermentation
atorage Silos (sugar, flour, etc.)
[]Gasoline Storage & Dispensing Equipment
If you answered "No" to any of the above questions and your facility will not have the following
equipment listed, 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).
013-U756
HUNTINGTON BEACH FIRE DEPARTMENT
FIRE PREVENTION DIVISION Fire Only
2000 MAIN STREET - HUNTINGTON BEACH, CA 92648 File #:
(714) 536-5676 - FAX (714) 374-1551 FP:
FIRE PREVENTION — BUSINESS DATA SHEET
For new Certificates of Occupancy
Business Name: Intec Network Solutions, Inc. Start Date:2/1/2018
Business Address:15131 Triton Ln. suite 111 92649
Number Street unit Zip Code
Billing Address: ❑same as business
Business Contact: Erik Peterson 714-475-6675 erik@intecsocal.com
Emergency Contact: Erik Peterson 714-580-6980 erik@intecsocal.com
(24-hour) Name Phone Email
Description of Business: contractor
Will there be any of the following uses on the premise?
❑ Storage >6 feet []Welding []Special amusements (escape room or similar) ❑ Motor vehicle repair
If yes, describe:
Will there be any of the following equipment.(E =existing equipment, A = adding or new equipment)
_ Dry cleaning — list solvent — Industrial oven — list fuel
Propane patio heaters —# of heaters, # of spares _ Cooking equipment (fryers, ovens, pizza conveyor, etc.)
_ Backup generators — list fuel — Walk in refrigerators or coolers — list size, refrigerant
_ Spray booth or dipping tank _ Tents or air supported structure
Grinding/milling equipment that creates — Fuel dispensing (including storage tanks)
combustible dust _ Carbonated beverage system — list total pounds of CO2
If yes, provide details (e.g., number, fuel, size, etc.)
Does the building have any of the following features (E =existing feature, A = adding feature)
E Sprinkler system Other fire suppression system
�_ Fire alarm system Smoke detectors
_ Other detectors (e.g, methane) _ Other alarm system
_ Private fire hydrants _ Battery systems
Fire pump Methane barrier or other methane control installed
If yes, provide details
Does the business handle any of the following:
YES
NO
55 gallons or more of a liquid hazardous material or hazardous waste.
❑
0
Compressed gas (or liquid/cryogenic equivalent) of 200 cubic feet or more
❑
m
Inert compressed gas (e.g., argon, nitrogen, helium) of 1,000 cubic feet or
❑
more.
500 pounds or more of a solid hazardous material or hazardous waste.
❑
m
Extremely hazardous material or radioactive material
❑
m
I certify, under the penalty of perjury, that the above information is true and correct to the best of my knowledge.
Signatur_, ��� Title: President Date:2/1/2018
HUNTINGTON BEACH FIRE DEPARTMENT
FIRE PREVENTION DIVISION FirFile #e Only
2000 MAIN STREET - HUNTINGTON BEACH, CA 92648
(714) 536-5676 - FAX (714) 374-1551 FP:
IMPORTANT INFORMATION
ABOUT HAZARDOUS MATERIAL DISCLOSURE
If you are subject to hazardous material disclosure there are important steps you need to take.
We encourage you to reduce your hazardous material inventory below disclosure amounts to avoid
fees and inspections. However, if your business requires hazardous materials equal to or in excess of
disclosure amounts, you must comply.
A Fire Department representative will contact you to verify the information you submitted for your
Business License. If you are subject to this program, you will need to:
❑ Disclose online,
Businesses must disclose on-line either through either (but not both):
o Orange County ESubmit portal (https://www.esubmit.ocgov.com/home/)
o California Environmental Reporting System (CERS) (http://cers.calepa.ca.gov/)
Business must disclose information on the following forms:
o Business Activities
o Business Owner/Operator
o Chemical Description
o An Annotated Site Map
Identification o Emergency Plan.
You are encouraged to proceed directly to either online disclosure system and begin the
disclosure process. Failure to disclose is a violation and subject to significant fines and
penalties.
❑ Annually review and certify your online disclosure.
❑ Update your Business Emergency Plan every three years.
❑ Pay an annual HMDP fee. The fee is determined based on number and quantity of
hazardous materials handled at your facility.
❑ Inform your landlord if you operate in a leased or rental property that you are subject to
hazardous material disclosure. These are done in writing and sample forms are available on
our web site.
❑ Receive an inspection by the Fire Department's Hazardous Materials Program Specialist, at
a minimum of once every three years.
If you have question or are unsure whether you need to disclose please call (714) 536-5469 or (714)
536-5676. You can also obtain additional information on the City's website at www.surfcity-hb.org on
the Fire Department page under the section Fire Prevention.
02010-006915
Yes
02011-050130
Yes
02611-000168
Yes
02011-000196
Yes
02011-002084
Yes
02011-002251
Yes
B2011-003323
No
M2011-003324
No
02011-003414
Yes
02011-003937
Yes
02011-004071
Yes
E2011-004265
No
Entered By Watson, Daniel Date Entered 07/25/2011
Default Inspector Kirby, Kevin Status I Finaled
Permit Type Electrical Issue Permit? 0 Date 07/25/2011
Origin counter issued By I Permit2
Building Use - City Fc --m 1 _s 6711Commercial Misc Planner 1
Building Use - County 99.6 New Building? Plan Checker
Description CEILING LIGHTS AND INSTA HOT WATER HEATER
Internal Notes
CofO Number - Choose Print All CofO Type Fees and Payments
Sheets to Issue
Issued By �� Single CX CofO Status j Inspections
CofO Date Issued Temp. CofO Issued Date Printed
Utility Release Date Temp. COFO Expiration
License Number
Business Name
Business Type
Business Phone
Proposed Use
Former Use
Conditions
Group Definitio
Type
Property Owner
Property Owner
Primary Contact
Click the «button to copy the Business License
information into the Certificate of Occupancy.
Business Licenses Business Name
A197956 A-MED HEALTH CARE CENTER
Al 18666 C B S DECK COATING
Al58872 ACTION APPRAISERS
A048828 LYNCH CONSTRUCTION INC
Approved Occupied Area (Sq Ft)
# of Stories
' Name field must be blank to addichange Contractor, Designer or Engineer
Contractor 1. Designer I Engineer l�
Name DELAURAEVERETfJ
Company
Address 5142 BOLSA#101
City IState IZip HUNTINGTONBEACH CA 92649
Email
Phone (714) 315-2832 x Fax ( ) -
SameAsl 1
Mobile Phone ( ) -11
Pager (') -
State License Type I
Self Insured I Non -Employer?
a Override Contractor
Expiration Dates?
Date Overridden
Overridden By