HomeMy WebLinkAbout15121 Graham St - CofO (5)—----------------•---__—__—_-_---------------__-..---------
CERTIFICATE OF OCCUPANCY 12 / 13 / 9 5
CITY OF HUNTINGTON BEACH
Date
15121 GRAHAM 41029
Addresswu
Distri
Business Name Tel.
Business Type Occ. Group
CONFEDERATION �nLDING,,PWNER DAVID C itMPINESSOWNER/MANAGER
Name Name
260 INTERSTATE NORTH Home 915 EASTMAN
AdA�'s�A .� 3 ^358Adc eLix rat Wi f 3^
Home
i City Tot. CityH TeL
Construction No. of Stories Occupant Load Sprinklers
c,9QkMT9V§ 4FIfkRE99*bE ONLY ;1
9
l DEPARTMENT OF COMMUNITY DEVELOPMENT
i This Certificate of Occupancy
SHALL BE posted In a conspicuous place on the
pra-nises and shall not be removed except by the by
Buil_iing Official.
COMMUNITY DEVELOPMENT '
Me APPLICATION FOR CERTIFICATE OF OCCUPANCY
j, CITY OF HUNTINGTON BEACH /1rJ
- p RTMENT OF COMMUNITY DEVELOP ATE
lGi
I}UNiR�GfON `•";l �'"'uli.a (PRINT OR TYPE ONLY
Address ; District
1'
/ C, Tel
V Business Name r
�oti� s e�iS
/YPusiness Type 5 �5 ` ✓ Joe �'� amGv Occ. Group
/I%OT'7�/CuII�r
BUILDING OWNER COnTdv BUSINESS OWNERIMANAG R
Name Ci6,,-FedGVd 1 a 1, L�. i �C �h i Y/Name SCJ
AddressHome
'L6a �h-f` T & Y46 /Address
Q j f'✓ 5 G✓ f a
City r7/R� 1 �Gt. , {� 3 0.3�9 Tel. �ity ���G �t/�»ec., C 9�G,5 L Home Tel. i
/ �/-,V--35�0 7o7-7.
b's9 3-907.5' i`
TIS USE WOULD BE DESCRIBED AS:
/❑ NEWLY CONSTRUCTED BLDG. ANGE OF OWNER X CHANGE OF OCCUPANT
EXISTING BUILDING CHAN E OF USE ElADDITIONAL OCCUPANT
Indicate former use, if any % / CD Occupancy Gr.-Div.
$OUARE FT. OF BUILDING TO BE OCCUPIE Za%i
NOTICE: 1. Occupancy of any building is prohibited and a business license will not be issued until the building has been
inspected and a certificate of occupancy is issued. l`
2. No electrical service will be released for any existing building until the service has been inspected and !_
certified safe. All applicants for occupancy in an existing building are required to schedule an electrical r.
'fuse up' inspection in the Department of Community Development at the time this application is filed.
3. Change of occupancy or use inspection fee. Whenever it is necessary to make inspection of a building or ,i
premises in order to determine if a change maybe made in the characterof occupancy or use of the building
or premises which would place the building in a different division of the same group of occupancy or in a
different group of occupancy, a change of occupancy inspection fee of $ shall
be paid to the city.
4. Huntington Beach Fire (:ode Section 10.208 requires that building numbers must be a minimum of four (4)
11 11 � inches in height with one half (1/2) inch stroke, and of a contrasting color from the background. These
�b 111 numbers must be posted on your building in a location that is visible from the street.
Huntington Beach Fire Code Section 10,301 requires fire extinguisher selection and distribution per the
National Fire Protection Association pamphlet 10 (see reverse side).
------------------
TRAFFIC IMPACT FEE ./
DATE PAID
AMOUNT RECEIVED
NAME (FOR OFFICE USE ONLY)^
SUPPLEMENTAL INFORIgATION ZONING
OCCUPANCY GROUP- PLAN CHECK NO. NO PARKING SPACES
OCCUPANT LOAD PERMIT NO HEALTH DEPT APPROVAL
NO. OF STORIES ADMIN. ACTION UTILITIES RELEASED
CERTIFICATE OF OCCUPANCY FEE
WPROVED BY DATE CHANGE OF USE OR OCCUPANCY FEE
TOTAL
75-039 Rev. 11/90 COMMUNITY DEVELOPMENT
SUPPLEMENTAL INFORMATION
1 1 2/ ✓v-�j�,-,� � /a2 1� /yun-t')n9Tcn (l�c�
yY�yi
ii
1.
BUSINESS ADDRESS
vEl /
i
2.
Person to contact in case of emergency o
Telephone number: 9y/115—
is
j
3.
Does the building in question have electricity?
Yes
`
® No
(a) If No, are you requesting that the electricity be
Yes
„
turned on?
❑ No
r;
s
4.
The building is sprinklered?
❑ Yes
No
5.
Operations will produce dust/wood shavings or similar
material?
❑ Yes
C. No
6.
Operations will involve the repair or replacement of
❑ Yes;
automobile parts?
.23 No
If Yes:
(a) Describe the components repaired or replaced.
j
(b) Does the operation involve the use of an open flame?
❑Yes
No
7.
The business is drinking, dining or assembly use that will
result in an occupant load of more than 50 persons.
❑Yes
h No
8.
The following best describes my operation;
L, e fice Only
Retail Sales
►warehouse
Manufacturing / Distribution (describe process and end product)
Restaurant/Take Out Food
Medical / Dental
Other (describe)
SUPPLEMENTAL INFORMATIOP!
SUPPLEMENTAL INFORMATION (Continued)
i
Does the operation involve any of the following materials? Yes
❑ No
If Yes, indicate quantities:
Material Quantity
1. Flammable liquids
Class I -A
Class I-B
Class I-C
2. Combustible liquids
Class 11
Class III -A
3. Combination flammable liquids
4. Flammable gases n
5. Liquefied flammable gases 33,4 C14 � �,'�✓ �,�✓oT »ems yrct �a,'fT
Flammable fibers - loose
t
7. Flammable fibers - baled
8. Flammable solids
9. Unstable materials s
10. Corrosive liquids
11. Oxidizing material - gases
12. Oxidizing material -liquids
13. Oxidizing material - solids
14. Organic peroxides
15. Nitromethane (unstable materials)
16. Am
monium nitrite
17. Ammonium nitrate compound mixtures
containing more than 60% nitrate
by weight
18. Highly toxic material and
poisonous gas
19. Smokeless powder
20. Black sporting powder
hereby rtif that the above formation is true and correct to
the best f y kno l e.
�-' �dJ
Signature Date
SOUTH COAST AIR QUALITY MANAGEMENT (DISTRICT
(Nonresidential Buildings Only)
Location of Subject Property:J5/ zI �Ywl1arrm S71�?�,un4;h�,ty
Property Owner Nanie:_CG �ero�f ivn L;TCs, ---_ ___ Phone #:
,
s
Name of the person arin f rm in print and signature: n
Name: -- - �� Signature:__
The person preparing this form must be the same person applying for building permits. Please answer the E
following questions regarding your proposed occupancy of the subject building. IF YOU DO NOT KNOW n
THE ANSWER TO A QUESTION, MARK IN THE "YES" COLUMN:
AGMD PERMITTING CHECKLIST
YES NO EE
1. Does your facility use any internal combustion engines greater than 50HP? —
2. Does your facility involve mixing, blending, or processing any solvents,
i;
adhesives, paints or coatings? -------- — X f
3. Does your facility create an} dusts or smoke? i
t
4. Does your facility refine any liquids or solids or reclaim any metals?
—
5. Does your facility plate or coat anything? _
6. Does your facility have any combustion equipment (i.e. boiler, furnaces, I'
broiler, baking ovens, etc.) rating greater than 2,000,000 BTU/HR? X f
7. Does your facflity handle or store solvents or motor fuel? __ X
8. Do you use or store any acids? X
t:
,
9. Do you use any chemical process? x E>
10. Do you use any solvents for clean-up? — X —
11. Are you a dry cleaner, restaurant with a charbroiler, body shop, gasoline X
station, printer, br part coater? --
12. is the subject building located within one thousand (1,000) feet of any X
school? PROPERTY LINE TO PROPERTY LINE. GRADES K-12.
If you have marked "NO" in all columns, you do not need an Air Quality permit at this time. If you have marked
any questions in the "YES" column you must contact the South Coast Air Quality Management District located at:
21865 E. Copley Drive
Diamond Bar, CA 91765-4182
Please call: Plan Check (909) 396-2000