HomeMy WebLinkAbout15121 Graham St - CofO (17)• � �� l y5-OWN - (aZ
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HUNTINGTON BEACH
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Business License
:Business Address
Business Owners�T
Business Name C�
Business Type 7
CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH"-
DEPT. OF BUILDING & SAFETY APPLICATION
714/536-5241 1'/An(111V 61(off
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15-12—I k4V /0
ame &Wla r��t7MIL,
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(3rd_ Floor - Must apply In-Person)W / 7/
Date 10 9 Or
Zip Code 49
Telephone No. 4 dam% 102/
Bus. Phone if
Property Owner Information (required) Tenant/Emergency Contact (required)
Name GT-l-rwMjiNEToAj LL.c -t L.SEsex A&*w*)' MNG Name W -M-W O
Address / g012 st-Y P/Wt G4Qcc4- , 20o Home Address /2V 1voo4wAQ Lif Mi=-
City IAA I .I E State/Zip (s-4' 124/-�- City -H -4 6�F� p 2 CA-
Telephone No. 9 � s3 9-743 Telephone No. // �
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or <Existing Building ;
CHECK ALL THAT APPLY: $`
❑ Change of Property Owner )dthange of Occupant . AChange of Use ❑Additional Occupant,
■ Indicate former type of business jFt�XC4 i wy lCo�iy7 C T1S)
■ Are you requesting that the electricity be turned on? Yes 0 No ❑
■ -Is the building sprinklered? Yes)( No ❑
■ Will operations produce dust/wood shavings or similar material? Yes ❑ Nok
• Will operations involve the repair or replacement of automobile parts Yes 0 NoK If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes q NoX
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes 0'NoK
■ The following best describes my operation: Office Only ❑ Retail Sales ❑ Medical/Dental
❑ Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food
(describe process and end product)
Other (describe)
For Official Use Only
Occ Group: Area: 400 Occ Load:
Occ Group: Area: Occ Load:
Occ Group: Area: Occ Load:
Total Sq Ft Occupied: %n%C) No. of Stories: TIF Rev' w: Y
Bldg. Permit # Entitlement #: Zoning:
Plnr Initials: Date: 6.3.08 Plan Chkr Initiais:_e�--'�ate: 11�6 Insp Initials: ZC_ Date:
Conditions of Approval or Other Notes:
4"t&1r_>
wt
Inspection
!(:•R� �iliiin n A Amin /Wnhilnn� � mnntcl!`ar+ii+nn*an4Ylrr•� �»onr.rl
1 South Cast
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
' p (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: &^w7 aN
Property Address: IVZ-4 G zt/frh—
City:Zip Code: _
Contact Person: z iJrb G,owb N
Title: /�Ax'�7
Type of Business: �X'7Aft -r-j1.4r"W-j Teleph ne: �I fF A-
0y/
Fax Number: a -mail dress: G(OPtv%d
Applicant (print name): • �P,N Signature: �9t��
Date: /0 9 O V
Will the facility have any of the following equipment? Yes ❑ No N
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[] NoX
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
H 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-
Revised Jane 2005