HomeMy WebLinkAbout15121 Graham St - CofO (40)Business License # f\
Business Address /S / 21
Business Owners Name
Business Name ,tj'?yi
Business Type DO -IV
J� 7S5.5C'
CERTIFICATE OF OCCUPANCY 020t ( - 02,51
CITY OF HUNTINGTON BEACH
DEPT. OF PLANNING & BUILDING APPLICATION
r-94MMIMAl
(3rd Floor — Must Apply In -Person)
Date
Zip Code ct V--el'
Telephone No. '7 tq, ggq.37oO
Bus. Phone —I#q• G31,5(6najl
Property Owner Information (required) Tenant/Emerp-ency Co tact (required
Name G 1 ivas rs Name r e.i t ui i . er
Address S art4eMrise esvi*,p Home Add e s (o3'd Z /'t v o
City o V i ' o State/Zip Cel. q 2(.6 6 City pig , rt State/Zip e� . -9Z683
Telephone No(! 467) 3,51- S, 59 414 N Cow 4It .tTelephone No. 'I tt{ - (081 .511. o G e j t'
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or KI Existing Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner K Change of Occupant ❑ Change of Use ❑ Additional Occupant
■ Indicate former type of business
■ Are you requesting that the electricit be turned on? Yes ONo X
■ Is the building sprinklered? Yes No ❑
■ Will operations produce dust/wood shavings or similar material? Yes[�Nox
■ Will operations involve the repair or replacement of automobile parts Yes KNo ❑ If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes E]No f
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes ONo K
■ The following best describes my operation: &Office Only ❑ Retail Sales ❑ Medical/Dental
❑ Restaurant/Take Out Food ❑ Warehouse /Manufacturing/Distribution
(describe process and end product)
05-. Other (describe) �11a-10 QV ; o
For OZicial Use Only
Oce Group:_ 16—I Area: Occ Load:
Oee Group: 12�> Area: C�-''�O Occ Load:
Occ Group: Area: Occ Load:
Total Sq Ft Occupied:-. No. of Stories: TIF Review —
Bldg. Permit # _ Entitlement #: Zoning:
Plnr Initial . Y
Date5 Plan Chkr Initials: Date: �'q 11 Insp Initials: Date: S 2S
Conditions of Approval or they otes:
'lk)
Inspection Date:
*1
G:Building/Forms/document id goes here)
Y/ N
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: Uy V i ks i I VIC
Property Address: 145 / Z. ( _ (�jora A n," "Pt. 44 log
City: a-i 964diT 41. 'Zip Code: qZ61" ¢ r
Contact Person: �! S G t Title: Per. o ra e; f
Type of Business: "jjb Telephone: (-b 6
Applicant: (print name) Co,pr S G ` Signature:
EJ Will the facility have any of the following equipment? Yes U 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
El Will any of the following operations be performed? Yes []No
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
QIf you answered "No" to both questions, this checklist is your clearance from AQMD.
QIf 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.