HomeMy WebLinkAbout15121 Graham St - CofO (41)CERTIFICATE OF OCCUPANCY -020 1
CITY OF HUNTINGTON BEACH -
DEPT. OF PLANNING & BUILDING APPLICATION
HUNTINGTON BEACH
Business License #2�o��iZ
Business Address 1. w
Business Owners tZe b.
Business Name C.,
Business Type
(3"d Floor — Must Apply In -Person)
Date
Zip Code _
Telephone I
Bus. Phone
Prgperty Owner Information (required) enant/Eme enc Contact (required) .
Name U Name
Address Home Addr" 'ss
City State ip ' ' City St e/Zip C. � 4
Telephone No. i , TelephoneNo.t "_a1_Tj�ii-lye
THIS USE WOBE DESCRIBED AS:
ON ewI 'onstructed Building or ,Existing Building
CHECK ALL THAT APPLY: ...
D Change of Property Owner , hange of Occupant DChange of Use DAdditional Occupant
■ Indicate former type of business -
■ Are you requesting that.the electricit' be turned on? Ye `� NOD
■ Is the building sprinklered? Yes NoO
■ Will operations produce dust/wood shavings or similar material? YesD No
■ Will operations involve the repair or replacement of automobile parts YeS6 No If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? YesD No
■ Will the business be a drinking, dining or assembly use with an occupant tI
of more than 50 persons?
Yes E1No V
■ Eescribe
following best describes my operation: ItQResauufant/Take
Only D Retail Sales D Medical/Dental
arehouse /Manufacturing/Distrib=ti O t ood
( process and end product) Gon �JJ� f
Other (describe)
For Official Use Only
Occ Group: --
Area: i{ I,-?( C,
Occ Load:
3
Occ Group: �_
Area: ) , 0-,qn
Occ Load
Occ Group:
Area:
Occ Load:
Total Sq Ft Occupied:�_Plj 2--1
No. of Stories:
TIF Review: Y/ N
Bldg. Permit #
Entitlement #:
Zoning: I L
Plnr Initials. V. Date Plan Chkr Initialsx:: - Date - 1 Insp Initials: 'rZc-_ Date:
25 l
Conditions -of Approval or Other Notes:
� � nek► off --ice S��✓�
South Coast
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 917654182
(909) 396-3529 • http:// www.aqmd.gov
Air Quality Permit Checklist
_ .
California State Law Code 65850.2 prohibits cities from issuing an'occupancy permit 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: -n, NL
PropertyAddress: �1z`C9�ti�- • I _t
City: Zip Code: L ��
Contact Person: A,bV4 \\''
Type of Business: 6jumxA
Fax Number:
Applicant (print name)- Signature:
Date:
Title: 0` -4
Telephone: 13-0\VM
Will the facility have any of the following equipment? Yes No
Charbroiler , k�
Dry cleaning machine
Spray booth
Printing press (screen/lithographic/flexographic)
Internal combustion engine greater than 50 HP (excluding motor vehicles)
Boiler/combustion equipment (greater than 1 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❑ Non
Application of paints or adhesives
Etching, plating, casting, or melting of metals
Molding; extruding, or curing of plastics
Mixing and blending of liquids and/or powders
Storage of acids, solvents, organic liquids, or fuels
Production of fumes, dust, smoke, or strong odors
M
If you answered "No" to both questions, this checklist is your clearance from AQMD. If
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 1-800-CUT-SMOG (1-800-288-7664).
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