HomeMy WebLinkAbout15121 Graham St - CofO (39)' Certificate of Occu cy No. 0200< (� 3
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®JAPPLICATION FOR CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH — DEPT. OF BUILDING & SAFETY
' 714/536-5271 (3'd Floor — Must Apply Its -Person)
Business License # k o2 a ��'`t �`t" Date d je --0 6
Business Address A -" UPIT !3, Zip Code 92,G y y'
Business Owners Name E Q ,t-aT rci A Telephone NoS6 X
Business Name Xvee_ Bus. Phone
Business Type _ P.C41saN e.i 72R-IA/i„1c.
Pro ert Owner Information (required) TenantMmer enc Contact (required)
Name LT oN 4-vG• Name.
Address c;)6 t SC SGcll,�►tia�+�' 1�'rc1 S Home Address /4 6 W r92G-,
,City f)exg&!1 Ga!�c k State/Zip Cf* o/a V o City �749e tits State/Zip go 7
Telephone No. TC"J �J %S� O I Q (, Telephone No. 7SS
THIS USE WOULD BE DESCRIBED AS: G�lr
0 Newly Constructed Building or Existing Building
CHECK ALL THAT APPLY:
0 Change of Property Owner ❑ Change of Occupant ❑ Change of Use ❑ Additional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity be turned on? Yes 0No
■ Is the building sprinklered? Yes B O11
■ Will operations produce dust/wood shavings or similar material? YesONoV�
■ Will operations involve the repair or replacement of automobile parts Yes QNo 01"' If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes QNo E,
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes ONo
■ The following best describes my operation: 0 Office Only ❑ Retail Sales ❑ Medical/Dental
❑ Restaurant/Take Out Food ❑ Warehouse /Manufacturing/Distribution
(describe process and end roduct)
Other (describe) /Yo,✓G ri;✓J,� g.
For Official Use Onl6t4'VA
Occ Group: Area: G� 3 ,Occ Load: �O
Occ Group: Area: 'Q - rat tUy ` Occ Load: (7
Occ Group: Area: Occ Load:
Total Sq Ft Occupied: as O o, _ No. of Stories: TIF Review: Y
Bldg. Permit# ( Entitlement #: Zoning:L
Plnr Initial s�.� DatP!� ��� flan Chkr Initials:Date:insp Initials:
- Date:
Condit'ons of Approval or Other Notes:
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South Coast
Air Quality Management District
21865 E. Copley Drive
Diamond Bar, CA 91765-4182
(909) 396-3529 htpp://www.agmd.gov
Air Quality Permit Checklist
California Government Code 65850.2 prohibits cities from issuing a Certificate of Occupancy 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:
Property Address: l �i 2 f v[!:��„cpMP7 �u �� /U 2 /.3
City: , Zip Code: C/ 2 G
Contact Person:Title:
Type of Business: tf'Pels6ru e,, 7—&44 W „ c„ Telephone:
Applicant: (print name) �.C" XeEs—k--I Signature: 1`
Q Will the facility have any of the following equipment? Yes 0 No R'
Charbroiler
Dry cleaning machine
Spray Booth
Printing Press (screen/lithographic/flexographic)
Internal combustion engine (greater than 50HP) (excluding motor vehicles)
Boiler/combustion equipment (greater than 2 million BTU/hr. maximum input)
Abrasive blasting cabinet/room
Baghouse/cartridge type dust filter/scrubber
Motor fuel storage and dispensing equipment
Q Will any of the following operations be performed? Yes D NO l'1
Application of paints or adhesives
Etching, plating, casting, or melting of metals
Molding and blending of liquids and/or powders
Storage of acids, solvents, organic liquids or fuels
Production of acids, solvents, organic liquids, or fuels
Production.of fumes, dust, smoke or strong odors
QIf you answered "No" to both questions, this checklist is your clearance from AQMD.
Q 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 (800) 388-2121.