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HomeMy WebLinkAbout15121 Graham St - CofO (30)CERTIFICATE OF OCCUPANCY 020 11 - CITY OF HUNTINGTON BEACH DEPT. OF PLANNING & BUILDING APPLICATION (3"d Floor - Must Apply In -Person) Business License # tL 9 5 Business Address 2 ( (mac ra k&r-i Business Owners Name -7ry77mo-r&r( G14 AA Business Name Business Type Date 2- -16 ^ l 1 Zip Code 4 DD 61-(q Telephone No. --rig Sg3 -3361 Bus. Phone Property Owner Information (required) Tenant/Emergency Contact (required) Name C 1 r� v-eAp r-`� Name ke"-, S e-L-'&6 F- Address 6 nl,�Pr - w Home Address 72 St 5a,t pu r rl'► o I - City - !,o U �,d) © State/Zip q1656 City F r-e 4w,- State/Zip Telephone No. C(L(4, 330 '5-77-0 Telephone No. 360 7S)- IDLIqA9 THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or CHECK ALL THAT APPLY: ❑ Change of Property Owner >K C ■ Indicate former type of business ri � Existing Building of Occupant ��❑ Change off Use { ❑ Additional Occupant Spirt (� l i� ✓aQ"C oerSo-" \ -P SS 0.d i v►ar ■ Are you requesting that the electricity be turned on? YesONoX, ■ Is the building sprinklered? Yes 0No0 ■ Will operations produce dust/wood shavings or similar material? YesONX ■ Will operations involve the repair or replacement of automobile parts Yes ONo)< If yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? Yes E]No '�R4 ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? Yes El No ■ The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑ Restaurant/Take Out Food ❑ Warehouse /Manufacturing/Distribution (describe process and end product) �K Other (describe) ❑ Medical/Dental For Official Use Ong Occ Group: (O ct) ea: �� �" Occ Load: r� Occ Group: j /,p X cr j xe4ea: `� �� Occ Load: ;2,0 Occ Group: 04 Area: Occ Load: Total Sq Ft Occupied:No. of Stories: TIF RevieY/ N Bldg. Permit # Entitlement #: Zoning: Plnr Initials: Date: l0 < < Plan Chkr Initials: Date: [ c 1 Insp Initials: 'Z(- Date: Conditions of Approval or Other Notes�A Inspection Date: W Ilk EM :Building/Forms/document id goes here) South Coast Air Quality Management District 21865 E. Copley Drive Diamond Bar, CA 91765-4182 (909) 396-3529 htpp://www.agmd.gov Air Quality Permit Checklist California Government Code 65850.2 prohibits cities from issuing a Certificate of Occupancy 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: I<iw Property Address: C sli� 1 � a � 5 4— City: &Wt A Zip Code: (�-( Contact Person: Title: �w— Type of Business: 6,r &N Cc kve_55�aw_�Telephone: Applicant: (print name) —F/ vj 0-T AV S L1-I F Signature.� Q 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 50HP) (excluding motor vehicles) Boiler/combustion equipment (greater than 2 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 [INo-;( Application of paints or adhesives Etching, plating, casting, or melting of metals Molding and blending of liquids and/or powders Storage of acids, solvents, organic liquids or fuels Production of acids, solvents, organic liquids, or fuels Production of fumes, dust, smoke or strong odors DIf you answered "No" to both questions, this checklist is your clearance from AQMD. DIf 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 (800) 388-2121.