HomeMy WebLinkAbout15121 Graham St - CofO (35)— f�oc)> -
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APPLICATiON FOR CERTIFICATE OF OCC NCY
110a ji CiTY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT
HUNTWGT(*
{PRINT OR TYPE ONLY) r MATE
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Address District —
Business Name— r� ' �'� C. ...._ sr4'1'tt�.. .,5!' . ..._ Tel
Business Type d ' i (7cc Group t
BUILDING, OWNER BUSINESS OWNEP/MANAGER
Address-'7 23g >3 r t,-,/ *' Borne
�1c� !' f�+�+ Address
TO 7y'" 4el', ty . �.C'� � ���-� Home Teter her!
3
THIS USE WOULD BE DESCRIBED AS:
El NEWLY CONSTRUCTED BLDG ❑ CHANGE OF OWNER � CHANC= OF OCCUPANT
9 EXISTING BUILDING CHANGE OF USE ADDITiONAL OCCUPANT
Indicate former use. if any, d sir4 �_O{ �;;oancy Gv Div
SQUARE FT. OF BUILDING TO BE OCCUPIED.Cr�m,/ /1'r.> w X`"'
NOTICE: 1. Occupancy of any building is prohibi}ed 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 inspectedand
certified safe. All applicants for occupancy in an existing building are reg!iired 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, maybe made in the character of occupancy or use ofthe 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.�� i
4. Huntington Beach Eire Code Section 10.208 requires that building numbers must be a minimum of four (4)
inches in height with one half (;:) 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).
(FOR OFFICE USE ONLY)
1 _CNiN i
, OCCUPANCY G��,,L P-L3 � _ _ . PLAN CHECK NO NO 0ARKIN'.3 SPACES —
~OCCUPANT LOAD .. ...._ _ _ ,. FERMI T NO _ _. HEX-TH DEPT APPROVAL____
�� _. _ A:?Ra.f ACT4; r�.- . _ to.,TIPS TIES RELEASED .
. ILIryy
8' 13' � c F�;1;F .ATE F O UPAN'';4 F FF.
'ROVED BY 047E c, HANCE C)F n. SC i"rq { =� .i �ANt, FEE S �
TGTAt. a
Rev. Test
SUPPLEMgNTAL INFORMATION
1.
BUSINESS ADDRESS / `� �k z&1' &22A/( r ✓ ,
2.
Person to contact in case of emergency• 41�-
Telephone number.
3.
Does the building in question have electricity?�
Yes
(a) If No, are you requesting that the electricity be
C> No
❑ Yes
turned on?
0 No
4.
The building is sprinklered?
Yes
El No
5.
Operations will produce dust/wood shavings or similar
material?
El Yes
ON o
6,
Operations will involve the repair or replacement of
Yes
automobile parts?
�,No
If Yes.
(a) Describe the components repaired of, replaced.
3
(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.
II Yes
8,
jhe following best
No
describes my operation,
Office Only
Retail Sales
Warehouse
Manufacturing / Distribution (describe process and end
product)
�2tsyC er.
x
t
Restaurant / Take Out Food'
I
Medical / Dental'
r
Other (describe)
i
3
1
i
i
SUPPLEMENTAL. MIFORM TIOM
4C011ti!itied)
_.. x. aY 4. r.@
Yos
4V �,Xo
indicate
Material y .4
x.., ,... n.w
`e
bi
Class
Combustible a#ti:ia lids:
Class€
Gass I44-
dj
HaM> lat)10 hCy' uid
tAa
,
Ram
f.
Fl+a{"tii ah1, (gba
,
Y in
•
Oxidizing
Y S..,e
....n+ray.vu-,.+.,..wa,+.,,n.+.,.w«-......x.w„v+,�wmr.-...w,...n.we:.w+.,,,
g,{�yy
'LnrJ1Ev,Jlb MQ%39✓'D 91.r7G �"{ Sa1a'i ,T
' �j yy{
$Ma
..,...,-. .. r. :v. .. .... •
L/�p Y� ¢ y��+^� g �+! . ».... .... .., .w.. ...�.... . . ........
}�syg 4�ryp�,�i �Jp material
\F J6li�.$Elal�u( 19Yir"AS4w9 �G4S @� Li4✓ili'�ta
.. . ......... r .,,.... ... ,.. ._.. r- .xww..a ...-.>,w. ,......
14.
eSanic peroxides
,
1,44~irom thane . (i<inS41 4(3„
t6.
�njr.ci,.- , rim r�itraAg�
n_
r
its,
A.mrnoni(i,.�t".�i t
$$"alFFning "nore
y than
by ,rrveight
Highly tOXiC arid
.,__, .... .ro_„� �. _.•_».. 1
Poisonous cas
19.
Smokeless powder
20,
sporting Powder
l r> IYY c e," lye 1"hat Vice mro.,,,n AJon is true
and correct to
the best of my Io v,edgg e,
i
Jp
°,r Date
Soul.h Coast
AIR QUALITY MANAGEMENT DISTRICT
21865 E. Copley Drive, Diamond Bar, CA 91765.4182 (909) 396-2000
AER .� A:JRYjLiQUALTITY101117 I T CHECKLIST
for nonresidential buildings only
Company Name: . 6
Location of Property:
City 41V n -A, i\ Zip Code: V 9
Contact Person: Title:-.
Telephone Number: Fax Number:
Type of Industry/B usiness: 6
To apply for a nonresidential building permit, you must complete this checklist. If you have any
questions about completing this checklist, please call (800) 388-2121.
YES Na
1. Will the facility have a charbroiler?
2. Will any internal combustion engine with greater than 50 horsepower
operate at the tacu.'V (excluding motor vehicles)?
3. Will operations at the faz;J-tv involve mixing, blending, or processing of
solvents, adhesives, paints or coatings?
r�-
4. Will dust or smoke be generated at the faQihty?
5. Will refining 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?
Applicant: A(�AL 7t Signature:
(Print name clearly)
If you have marked "NO" in all the boxes, an air quality permit is ng-t needed at this time,
and this checklist is your written release.
If you marked "YES" in any ofthe boxes, you must contact the South Coast Air Quality
Management District (AQKD). Pleas-- read the reqCmements on the back of the checklist.
(800) 388-211-1
ACi'A 01,