HomeMy WebLinkAbout15121 Graham St - CofO (48)r
•
HUNTINGTON BEACH
CERTIFICATE OF OCCUPANCY 020/
CITY OF HUNTINGTON BEACH -
DEPT. OF PLANNING & BUILDING APPLICATION
1 ) (3'd Floor — Must Apply In -Person)
Business License #
Business Address
Business Owners Name bS
Business Name ASS -T-i L (�4 ��>`---t,'�►
Business Type pt:J-(-Tb,,'C,-ov1
714/536-5241
Date 91611,
Zip Code Q Z . y c '91e
Telephone No.(� 1,+) P;#4tr4-i
Bus. Phone T-� l �� ���rS 77
ProDertv Owner Information (required) Tenant/Emer enc Contact (required)
Name U/.gT17Q/J Lt-�- Name
Address �-"• , ; Home Address F`iaut_A Din
City \1 State/Zip CA q7-Lr4 City '' State/Zip rX JW 2
Telephone No. i320 -- S- 71 o Telephone No, bly) :mt- 7p kq
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or "xisting Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner khange of Occupant ❑Change of Use ❑Additional Occupant
■ Indicate former type of business N atk'.", ' w'4 m('q.teA eiune s A.-uTr" %-1T`®�1
■ Are you requesting that the electricity be turned 6n? Ye No ❑
■ Is the building sprinklered? YeW' , No❑
■ Will operations produce dust/wood shavings or similar material? Yes❑ , N4011,
■ Will operations involve the repair or replacement of automobile parts Yes 0 Nbe If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes[.] NVII
■ Will the bus in ss be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes ONO
■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? Yes DNA,,,'
■ The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑ Medical/Dental
Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food
(describe process and end product)
Other (describe)
For Official Use Onl
Occ Group: Area: 7,7—,0 Occ Load: Z
Occ Group: S Area: 0 p� Occ Load: 4t
Occ Group: Area: Occ Load:
Total Sq Ft Occupied: -Z'zoO No. of Stories: ( TIF Review: Y/OI
Bldg. Permit # Entitlement #: Zoning: IL,
Plnr Initials Dater 1 Plan Chkr Initials: Date: Insp Initials: '��-- Date: 2D
Conditions of Approval or Other Notes:
Inspection Date:
201
South Coast
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
(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: M Q� S Re l d, �b i- pU y Ca-- G "
Property Address: &Traka4u S-( . ) tO
City: �1 ' �� ZipCode:
r^q
Contact Person: `t$S '�� �"' tdcl,
Type of Business: / e[-1'tVT%ti7'O't
Fax Number: C t`-J)2-- ff6t?`?
Applicant (print name): Signature:
Date:
Title: A-ewq-'
Telephone: (-pQ)P?2--C-o77
,!� ail address:
• 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 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❑ N (�
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
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).
-2-