HomeMy WebLinkAbout15301 Graham St - CofOJ�
HUNTINGTON BEACH
CERTIFICATE OF OCCUPANCY
714/536-5241
CITY OF HUNTINGTON BEACH —
DEPT. OF BUILDING & SAFETtY APPLICATION
P,
— Must Apply In -Person)
Business License # I -A INV 14 V�t r011— y Date 6 " z (I —ID i
Business Address H' M �- Zip Code 'L-Co 5
Business Owners Name rD F/Z, Telephone No. 3t D 0 3 0 3Zd
Business Name Bus. Phone
Business Type �ti4
Property Owner Inf rmatio (required) Tenant/Emer encyContact (required)
Name tF� -G Name
Address Home Address
City tate/Zip City L /State/Zip
Telephone No. u r-:23 00Telephone No. �5 Z S
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or el Existing Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner f Change Occupant ❑CIfange of Use ❑Additional Occupant
■ Indicate former type of business ( o C-O-
■ Are you requesting that the electricity be turned on? Yes N
■ Is the building sprinklered? Yes No❑
■ Will operations produce dust/wood shavings or similar material? Yes ❑ Ne�
■ Will operations involve the repair or replacement of automobile parts Yes 0 Noio If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Ye NOQ LG
■ 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: Yi Office Only ❑ Retail Sales ❑ Medical/Dental
Warehouse /14pn*iasPx4mgA)istribution ❑ Restaurant/Take Out Food
(describe process and end product)
❑ Other (describe)
For Official Use Onl
Occ Group: V Area: 3500 0? Occ Load: 3t5_
Occ Group: Area: b�°t'-'l t}� Occ Load : l3
Occ Group:_ Area: Occ Load:
Total Sq Ft Occupied: No. of Stories: Z TIF Review: Y/ N
Bldg. Permit # Entitlement #: Zoning: 2 1, .
Plnr Initials: Dater Plan Chkr Initial :CII
Date: 2� v lttsp Initials: • Ze-- Date: 0 9 l
Conditions of App oval or Other Notes:
Inspection Date: g1`7"i 110 �1
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:
Property Address:
City: �/'�/5C%� �� Zi Code: L�
Contact Person: 3 I Title:
Type of Business: Telephone: 1��/3��
Fax Number: —f / n� e-mail address: /7�(
Applicant (print name): Signature:
Date: /f Z' �" 9
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 BP (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❑ N
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
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 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).
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