HomeMy WebLinkAbout714 Adams Ave - CofO (77)c.
vCERTIFICATEJ OF OCCUPANCY 020 _
CITY OF HUNTINGTON BEACH P 2A8 3-'�k3 ,
DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION
HUNTINGTON BEACH
(3rd Floor - The Applicant Must Apply In -Person)
Business Address 714 Adc*,,S Ps ie- 5,jtte 2 o2, Date to % 2 6� %) T
Business Owners Name W � Coke tNav\5%kc Zip Code q2 (o 4 9 .
Business Name _ _5+�,�, 0 20 2 Telephone No. (� kg)9 53-Z6-P3
Business Type Pec .r�...cna M a jc a j_.,jQ Bus. Phone
Property Owner Information (required) Tenant/Emergency Contact (required)
Name Name basn'C.1
Addresses C3 o x 3c' g S Home Address 15tQo ► W hick
City Neap , r-+r Ge-A c,a, State/Zip CA City rState/Zip C& / �12(py -}-
l�iA�-rtvr,���
Telephone No. ( 7 t y) -7 7 -SS y Telephone No.
THIS USE WOULD BE DESCRIBED AS:
O Newly Constructed Building or )2f Existing Building
IS THIS BUILDING FIRE SPRINKLERED? gYes ONO
CHECK ALL THAT APPLY:
❑ Change of Business Owner XChange of Occupant ❑ Change of Use AFAdditional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity be turned on? ❑Yes 1gNo
■ Will operations produce dust/wood shavings or similar material? ❑ Yes TzNo
■ Will operations involve the repair or replacement of automobile parts? ❑Yes ;ZNo If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? ❑ Yes WNo
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
❑ Yes P No
■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? ❑Yes ENO
■ The following best describes my operation: ❑ Office Only ,Retail Sales ❑Medical/Dental
❑Warehouse [Manufacturing/Distribution ❑ Restaurant/Take-Out Food ❑ Other
■ Will any meat products including beef, poultry, and/or fish bee cooked or fried onsite? ❑ Yes /Ef 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 PNo
For Official Use Onl -
Occ Group: _
Occ Group:
Occ Group:
Total Sq Ft Occupied:
Bldg. Permit # IF) 1 t P 1i7 P3
Planning Initials: Date?
Conditions of Approval or Other Notes:
Area: _..
Area:
Area:
No. of Stories:
Entitlement #:
Use Permitted:
Y/N
Occ Load:
Occ Load:
Occ Load:
TIF Review: Y/ N
Zoning:
Parking Meets C de (for use): Y / N
Building Reviewed By Initials:_ate:
Grease Interceptor Verified Inspected By Initials: Date:
..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: cQ_� o 2-02.
Property Address: -7 N AAcwn .% Am 5 u ; +2 2 02
City: �kL,,,� Zip Code:
Contact Person: tut co(,e mk,, SKc Title: l?L,,,. c. r-
Type of Business: l7t c ,c..t MrA&pTelephone: M -14,) 4 32 SS
Fax Number: e-mail address: 95�
Applicant (print name): 11_� c' &^s,ti Signature: Date:
• 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❑ Nom
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
0MC
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 hirSh needed, AQMD will assist you "mitting 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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