HomeMy WebLinkAbout15121 Graham St - CofO (42)f3 v7
AMe APPLICATION FOR CERTIFICATE OF OCCUPANCY
i CITY OF HUNTINGTON BEACH /
DEPARTMENT OF COMMUNITY DEVELOPMENT
HuNnNMON, er a+ DATE
(PRINT OR TYPE ONLY) '•
Address J 1 d Di ict i
Business Name - el.
Business Type y f Occ. Gr ,
BUILDING OWNER _ SUSIt ESS OWPIER ANAL
Name Name
Home
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Address j ✓ / u
.40
Address _ 71�j7C
City. L-�51•i��/ City OO' l� 962 Home Tel.
THIS USE WOULD BE DESCRIBED AS:
❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER I,�i CHANGE OF OCCUPANT
XEXISTING BUILDING ('C_HANGE OF USSE /❑ ADDITIONAL OCCUPANT
Indicate former use, if any O MT' / 0.7 Occupancy Gr. Div.
SQUARE FT OF BUILDING TO BE OCCUPIED
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.
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
'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
premises in order to determine if a change may be made in the character of occupancy or use of the building
or premises which would place the building in a different r1(vision of the same group of occupancy or in a
different group of occupancy, a change of occupancy insp—Mon fee of $ shall
be paid to the city.
4. Huntington Beach Fire Code Section 10.208 requires that building numbers must be a minimum of four(4)
i
inches in height with one half (1/2) inch stroke, and of a contrasting color from the background. These
numbers must be posted on your building in a location that is visible from the street.
5. Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection and distribution per the
National Fire Protection Association pamphlet 10 (see reverse side).
T -FIC R'dPACT FEE
12ATE If3
AMOLIN ECEIVECr
NAME (FOR OFFICE USE ONLY) s
ZONING 1
OCCUPANCY GROUP "�1,1�-- PLAN CHECK NO. NO. PARKING SPACES ._
OCCUPANT LOAD PERMIT NO_ HEALTH DEPT. APPROVAL
NO. OF STORIES h� ADMIN. ACTION UTILITIES RELEASED
CERTIFICATE OF OCCUPANCY FEE I �
r�
AP ROVED13Y �- DATE CHANGE OF USE OR OCCUPANCY FEE $
TOTAL $ "
75-039 Rev.1/97 )
COMMUNITY DEVELOPMENT ��3%S3 7Z
it
I
SUPPLEMENTAL INFORMATION
`
1.
BUSINESS ADDRESS
2.
Person to contact in case of emergency,C�r N
Telephone number:
3.
Does the building in question have electo icity?
,(a�Sles
(a) If No, are you requesting that the electricity be
No
❑ 'Yes
turned on?
❑
No
4.
The building is sprinklered?
2-Yes
5.
Operations will produce dust/wood shavings. or similar:
O No
material?
Yes
_
kTiVo .-
6.
Operations will involve the repair or replacement- of
❑ Yes
_
automobile parts?
_
,0'No
If _ Yes:
(a) Describe the components repaired or replaced:
❑, Yes .
(b) ,Dees the operation involve the use of an open flame? ..
7.
The business is drinking, dining or assembly use that will
.12'No , ,
result in an occupant load of more than , 50 persons.
❑ Yes
8.
The foll 'wing best describes my operation;
`
ff Only
ta's
faZ�factu'ring
/ Distribution (describe process and end product)
Restaurant / Take Out Food
Medical / Dental
Other (describe)
SUPPLEMENTAL INFORMATION
F
r
x
South Coast
k
AIR QUALITY MANAGEMENT DISTRICT
21865 E. Copley Drive, Diamond Bar, CA 91765.4182 (909) 396-2000
AIR QUALITY PERIVIIT CHECKLIST
for nonresidential buildings only
Company Name:
Location of e Pro
p?
City: Zip Code: ��
►� 7 -q
�� —, --.
Contact Person;d... ./ 7 `1e:_,[���lL
Telephone Number: �-7' 7�h� `r Fax Number:_
Type of Industry/Business: lrlJ/'yl/�'lGli✓! �'i�'%6 % �(,
c,
To apply for a nonresidential building permit, you must complete tl:'s checklist. If you have any
questions about completing this checklist, please call (800) 388-2121.
.:.�
I. Will the facility have a charbroiier2 .YES NO
2. Will any internal combustion engine with greater than 50 horsepower
operate at the facility (excluding motor YelInficles)? [ .] I].
3. Will operations at the facility involve mixing, blerding, or processing of
solvents; adhesives, paints or coatings? [
4 Will dust or smoke be generated at the facility?
5 Will re--inmg of any liquids or solids be done at the facility? [ ] [
6. Will any plating or coating of materials be done at the facility? [) {
7. Will any combustion equipment rated greater than 2,000,000 BTU/hr be
operated at the facility?
` 8. Will any acids, solvents, or motor fuel be used or stored at the facility?
9. Will any organic liquids or gases be reacted or produced? [ ]
10. Will any ovens be used to dry or cure products at the facility? ) �]
11. Will any CFC (Freon) recycling machines operate at the facility? [ ]
i /ice _ • "
Applicant: d,Gf / ,h� /
/ !Ci d Signature:
(Print name clearly)
If you have marked "NO" in all the boxes, an air quality permit is nQt needed at this time,
and this checklist
kLst is
I
Your written release.
t
If you marked "YES" in any of the boxes, you must contact the South Cosist Air Quality
Management Distrct (AQ111)). Please read the requirements on the back of the checklist.
(800) 388-2121
ACOITI9N43UPPLEMENTAL INFORMATION.. ,..
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