HomeMy WebLinkAbout15121 Graham St - CofO (34)I APPLICATION FOR CERTIFICATE OF OCCUPAN Y
C1+Y OF HUNTINGTON. BEACH
Hun'r:Tgy Mawr DEPARTMENT OF DEVELOPMENT SERVICES
Address
Business Name L . fit. w- �-`` C District
Business Type K1f.,tti Sip Tel %
j� BU11DING OWNER ~—`— --------- Occ. Group
Name— BUSINESS OWr_ FRIMANA'-- _
-------- Name4c., ��rL-i� Address_ Home ,--'" L r
City Address-�
Tel._ _ C i I y ��—
THIS USE WOULD BE DESCRIBED AS: Home Tel.���
❑ NFWLY CONSTRUCTED BLDG ❑ CHANGE Gf- OV✓NER
El EXISTING BUILDING CHANGE OF OCCUPANT
❑ CHANGE OF USE
Indicate former use, if any ❑ ADDITIONAL OCCUPANT
SOUArRE FT. OF BUILDING TO BE OCCUPIED_ CvrC�!
NOTICE: 1. Occupancy Of any building is prohibited and a business lice,,se will not be issued until the building has
been inspected and a certificate Of Occupancy is issued.
2. No electrical service 6'1 be released for
certified safe. All appany exlcting building un,i1
licants fur occupancy ithe service hn inspected and
n an exisfng building are required I scbean electrical
`fuse up' inspection in the Department of Development Services a` the time t
his S Change Of occupancy or use inspection fee. Whenever it is necessaryto maKe inspection
o; premises in order to determine � a change may pp'ic'ation is filed.
9 - y be made in the charcler of Occ pancy or useUofdthe
• bt:ildinc, or premises which �vutd place the building in a different division of ire or in a different group Of Occupancy. a change Of occupancy insoecti;acne gr�,up Of occupancv
on fee of
shall be paid to the city.
I,Ivlrl�
4 Hi ntington Beach Fire Code Section 10.208 reoui;es that building numb
( 1 inches in height with one half (?:'a) inch stroke and of a contrasting color from the background. ers must be a mini These
numbers must be posted on your building in a location that is visible from the street.
5• he National
Beach Fire Code Section 1G.301 requi,es fire extinguisher seleolion and distribution per
the National Fire Protection Association pamphlet 10 (see reverse side).
SUPPLEMENTAL INFORMATION (FOR OFFICE USE ONLY)
OCCUPANCY GROUP ,B--F-- ZONINGL
OCCUPANT LOAD — PLAN CHECK NO
PERMIT NO. i NO PARKING SPACES
NO OF STOR �S ---- — _ HEALTH DEPT APPROVAL r
/j ADMIN. ACTION_.._,_____ UTILITIFS RELEASED
r C� t 4DCHANGE
CERTIFICATE OF
APPROVE Y OCCUPANC;Y FEE OF USE OR OCCUPANCY FEE S �—
TOTAL
i 75-039 REV
1
tl-FV'I,OP il.N
SUPPLEMENTAL INFORMATION
1. BUSINESS ADDRESSij
2. Person to contact in case of emergency: % c=_')
Telephone number.: iZ(c3
3. Does the building in questz.on have electricity? O Yes
Jago
a. if NO, are you requesting that the electricity be 01-es
turned on? ONO'
4. The building is sprinklered? ,2 es
ONO
5. Operations will produce dust/wood shavings or similar
material? ❑ Yes
e'
6. Operations will involve the repair or replacement of Oyes
automobile parts?
If yes:
(a) Describe the components repaired or replaced.
(b) Does the operation involve the use of an oper, flame? OY
No
7. The business is drinking, dining or assembly use that will
result in an occupant load of more than 50 persons. OYe s
0
8. The following best describes my operation:
Office Only
Retail Sales
fare ouse_
Manufacturing/Distribution (describe process and end
product)
Restaurant Ta a Out Foo 1
Medical/Dental
Other (describe)
(0562D) (12/8/8E)
SUPPLEMENTAL INFORMATION (Continued)
Does the operation involve any of the following materials?Yes
0
if Yes, �n icate quantities: -
Material Quantity
1. Flammable liquids
Class I -A
Class I-B
r Class I-C _
2. Combustible liquids
Class II
Class III -A
3. Combination flammable liquids
4. Flammable gases
5. Liquefied flammable ,gases
6. Flammable fibers -.loose
7. Flammable fibers - baled _
8. Flammable solids
9. Unstablematerials
10. Corrosive liquids
11. Oxidizing material - gases
12. Oxidizing material - liquids
13. Oxidizing material - solids _-
14. Organic peroxides
15. Ni.tromethane (unstable materials)
16. Ammonium nitrate �-•
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
I hereby certify that the above information is true and correct to the
best of my knowledge.
k r Signature Date
(0562D) (12/8/86)
April 20, 1988
1512;1 Graham St., #108
L. A. BATHTUB LINERS, INC. 898-5913
WAREHOUSE B-2
GBW 'drop,-lrties Jay Shachter
17782 Altamirano Ln.
H.B. 847-8126
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