HomeMy WebLinkAbout15281 Graham St - CofO (3)J.
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HUNTINGTON BEACH
CERTIFICATE OF OCCUPANCY 020�-
CITY OF HUNTINGTON BEACH —
DEPT. OF PLANNING & BUILDING APPLICATION
714/536-5241
(3'd Floor — Must Apply In -Person)
Business License # - Date
Business Address -, Zip Code 92Z519
Business Owners Name ej:�- SAAAL-M&O Telephone No.
Business Name , Ts. Bus. Phone;/'/ -A9Y 003 i
Business Type
Property Owner Information (required) Tenant/Emergency Contact (required)
Name Name 773 _,yi L
Address , 9/ y `Sum M rr21 bC6 Home Address //-3 Vi&/�I�-v LbLlt
Cit}(�- State/Zip (7,ft 9 City,- tkg4 State/Zip Ct 92LZ;:7
Telephone No.7/L/ '998 '! 9S 9 Telephone No. 74Z F (�9Z
THIS USE WOULD BE DESCRIBED AS: Ll Newly Constructed Building or Lkisting Building
CHECK ALL THAT APPLY:
n Change of Property Owner P/Change of Occupant /Change of Use flAdditional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity b turned on? Ye No
■ Is the building sprinklered? YesW No❑
■ Will operations produce dust/wood shavings or similar material? Yes . Noz/
■ Will operations involve the repair or replacement of automobile parts Yesf; Nop" If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? YesQ. NOQ'
■ Will the busJ''ess be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes ❑No L
■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? Yes eNO ❑
■ TI}e following best describes my operation: ❑ Office Only C Retail Sales ❑ Medical/Dental
l!f Warehouse /Manufacturing/Distribution U Restaurant/Take Out Food
(describe process and end product)
Other (describe)
For Official Use Onl 2
Occ Group: - Area:
Occ Group: Area:
Occ Group: Area:
Total Sq Ft Occupied: 7 No. of Stories:
Bldg. Permit # Entitlement #:
Occ Load:
Occ Load:
Occ Load:
TIF Review: Y/ N
Zoning: n n 11--
Plnr Initials: P-P- Date: I'l ►f y 14Plan Chkr Initials: ate: *1qlLq Insp Initials: �� Date:/;�9 4-
Conditions of Approval or Other Notes:
Inspection Date:
E-A
s) G t-
South Coast
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
(909) 396-3529 • http:// www.agmd.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: 00 ri cec_�% a��
Property Address: G, W� A S7�,
City: /-I ► r3 , Zip Code: 9,,2,10 L j
Contact Person: J) j►o AA:%4 F-Eb
Type of Business: /L"71;`-- G
Title:
Telephone: 72V' 6??3.8339
Fax Number: ?� "/"' ' 6'78 SjZ9 a-mai d e : DSNeu r&Lo
Applicant (print name) - N S Eu4!r8ignaturc:�
Date:
• 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 No - - - -
Application of paints or adhesives
Etching, plating, casting, or melting of metals
Mol ing, siding, or curing of plastics
M' i and a of liquids and/or powders
Storage of acids, so ven ,organs • u ss r 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).
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