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HomeMy WebLinkAbout18881 Beach Blvd - CofO (4)J. HUNTINGTON BEACH CERTIFICATE OF OCCUPANCYj"0�0 jam - CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION (3rd Floor - The Applicant Must Apply In -Person) Business Address 1T76`bCXL_-V \ VDate 110k \`1 k 15- " Business Owners Name Zip Code OraW Business Name S�Ww -yn Sft_- &M"T��� w71A��� t s-Nielephone N6. 1��,' Business TypeBus. Phone Property Owner Information (required) Tenant/Emergency Contact (required) Name Q . 10s Name It1 `l02X'Q'U-z- Address 'tom 1)c Home Address Qnsbl -` Citks\� State/Zip Cck. OQg3,y City 01 --LfaE> State/Zip , U�' Telephone No. WR 4� Telephone No. OAR THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or ❑ Existing Building IS THIS BUILDING FIRE SPRINKLERED? Yes ❑ No CHECK ALL THAT APPLY: ❑ Change of Business Owner ❑ Change of Occupant ❑ Change of Use ❑ Additional Occupant • Indicate former type of business • Are you requesting that the electricity be turned on? ❑Yes )KI No • Will operations produce dust/wood shavings or similar material? .19 Yes ❑ No • 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 ❑ No • Will there be storage racks, gondolas, or shelving exceeding 5 feet 9 inches in height? ❑Yes ❑ No • The following best describes my operation: ❑ Office Only ' $6 Retail Sales ❑ Medical/Dental ❑ Warehouse/Manufacturing/Distribution ❑ RestaurantfTake-Out Food ❑ Other • Will any meat 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 ❑No Grease Interceptor Verified Inspected By Initials: Date: For Official Use Onl Occ Group: 15 Occ Group: —47-1 S Occ Group: _47u� Total Sq Ft Occupied: be, Lo Bldg. Permit # Planning Initials: h Date: I b f 2`t Conditions of Approval or Other Notes: Area: I f6q 6 U Area: Area: No. of Stories: Entitlement #:_ Use Permitted: Y / N Occ Load: k % 0 Occ Load:.Z Occ Load: TIF Review: Y/ NN Zoning: C. (71 q Parking Meets Code (for use): Y / N Building Reviewed By Initials: PO Date: CalZ��r� lwb - q C45s South Coast Air Quality Management District 21865 Copley Drive, Diamond Bar, CA 91765-4182 Phone Number (909) 396-3529 http://www.agmd.gov ¢ o 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: E--Ar Property Address: City: Zip Code: �_X fq ' Contact Person: - Title: U� \ fticms "Ck4tiCNa Type of Business:" 1m, Telephone: �� �1`1 •� _� .� Fax Numbe0�"(-`tZS E-mail Address: Applicant (print name).' Signature: Date:l©� �� t 1. Will the facility release air pollutants, including but not limited to, dust fumes, gas, mist, odors,\t4noke, vapor, or a combination of these to the atmosphere? ❑Yes ❑No 2. Will the facility result of fuel -burning equipment including, but not limited to, boilers, generators, and internal combustion engines? ❑Yes ❑No 3. Will the facility result of hazardous materials, including but not limited to, chemical, plastics, rubber, resins, solvents, paints, and other parts cleaners? ❑Yes ❑No 4. Will the facility have use of above or underground storage tank? ❑Yes ❑No 5. Will the facility consist of manufacturing, fabrications, finishing, or treatment of wood, metal or plastic products? ❑Yes ❑No 6. Will the facility result in the use of the equipment listed below? ❑Yes ❑No (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) ❑Application of Paints/Adhesive/Resins ❑Baghouse/Dust Collector ❑Bakery Oven (gas fired) ❑Boiler/Water Heater (max. heat input = or > 1 million BTU/hr) ❑Charbroiler/Smoker ❑Mixing/Blending of Liquids and/or Powders ❑Molding /Extruding/Curing of Plastic ❑ Pharmaceutical/Nutraceutical ❑Plasma/Laser Cutter ❑ Printing/Coating/Drying ❑ Production of Fumes/Dust/Smoke/Odors ❑Coffee Roaster/Afterbunner ❑Refrigeration Systems (containing > 50 Ibs of refrigeration ❑Deep Fryer (excluding equipment located at eating establishment) ❑Soldering Oven ❑Dry Cleaning Equipment ❑Electrostatic Precipitator ❑Fermentation ❑Gasoline Storage & Dispensing Equipment ❑Spray Booth ❑Storage of Acids/Solvents/Organics Liquids/Fuels ❑Storage Silos (sugar, flour, etc.) 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).