HomeMy WebLinkAbout15121 Graham St - CofO (46)I=
CERTIFICATE OF OCCUPANCY 020_a- i33�i
CITY OF HUNTINGTON BEACH -
Business AddressI
Business Owners Nq'
Business Name
Business Type LvaLr
DEPT. OF PLANNING & BUILDING APPLICATION
(3`d Floor — The Applicant Must Apply In -Person)
�l It &fil'* -r Date 11
[ Zip Code
,-)4 Telephone No.:1Y C-Yb
h11 Bus. Phone
Property Owner Information (required) T n nt/Emer enc Contact required)
NameS �7r�'
LL`l' Name
11
Address 1 -1eC1 tM7-^- Home `dress
City N11 9�70 State/Zip (o City fate/Zip 2��7
,
Telephone No._
phone No
v/ Q,�J� �✓�� Telephone
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or Exis�ta�tg Building
IS THIS BUILDING FIRE SPRINKLERED? a Yes []No
CHECK ALL THAT APPLY:
❑ Change of Business Owner Change of Occupant ❑ Chang(
■ Indicate former type of business x
■ Are you requesting that the electricity be turned on? ❑Yes no
■ Will operations produce dust/wood shavings or similar material? ❑ Ye
■ Will operations involve the repair or replacement of automobile parts?
zu
of Use 14ditional Occupant
s ivNo
[]Yes 0 If yes: Describe the
components repaired or replaced.
■ Does theVe�aopera'n involve the use of welding or open flame? ❑ Yes o
■ Will thebe a drinking, dining or assembly use with an occupant load of more than 50 persons?
❑ Yes %
■ Will there bestorage racks, gondolas, or shely' ceeding 5feet 9 inches in height? ❑Yes
■ e Mowing best describes my operation: ice Only El Retail Sales ❑Medical/Dental
A
rehouse /Manufacturing/Distribution Restaurant/Take-Out Food ❑ Otherny meat products including beef, poultry, and/or fish bee cooked or fried onsite? ❑ Yes - 2<o
If you answered yes, please pro -eed to the next question.
Does your facility current ave a grease control device (i.e. grease trap or grease interceptor)?
Check one: ElYes o
For Official Use QUl
Occ Group:?
Occ Group:
Occ Group:
Total Sq Ft Occupied:
Bldg. Permit #
Planning Initials: Date: 7
Conditions of Approval or Other Notes:
Area:
Area:
Area:
No. of Stories:
Entitlement #:
Occ Load: IQ
Occ Load: i
Occ Load:
TIF Review: Y/ N
Zoning:
Building Reviewed By Initials2L�`Date:AJ,
1 I
Grease Interceptor Verified Inspected By Initials: Date:
Oi'IOF
-1334
South Coast
Air Quality Management ement District
21865 Copley Drive, Diamond Bar, CA 91765-4182
p (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:
V-I�q vl;t� 646X,7� -
Property Address: J q 09--Y 1- �`� klOq
City: Zip Code: LJ7f
Contact Person: tRj- �i Title:
Type of Business: PWqTJN1A16 Telephone: �O'q;Wtl
I
Fax Number. e-mail address: e U
Applicant (print name): W� C Signature: 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
v_�
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
1�
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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