HomeMy WebLinkAbout15121 Graham St - CofO (9)ti
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HUNTINGTON BEACH
Business Addr
Business Own
Business Nam
Business Type
CERTIFICATE OF OCCUPANCY 020 �- 2�f
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION
(3rd Floor - The Applicant Must Apply In -Person)
Date
ess �l l��✓'I-(Ah'� J(��d� �I�J ����
ers Name Zip Code
eGl Telephone No.
IW� N�G.D)oraz � a►vl t`or4 Bus. Phone 9_1q-
Property Owner Information (required) Tenant/Emer enc Contact (r j uired)
Name hic5Q V j R WAIM-< W. Name
Address I I T) 1A f?) yL Vt? . it 2JS Home Address
city State/Zip 5 9 Z 2()j City 3"r jf) t�_State/Zip PO
1
Telephone No.9 3 Z 2 9 2. 7 Telephone No. li -O'ZZ - q13 1
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or Existing Building
IS THIS BUILDING FIRE SPRINKLERED? Yes ❑ No
CHECK ALL THAT APPLY:
❑ Change of Business Owner ❑ Change of Occupant ❑ Change of Use ❑ Additional Occupant
• Indicate former type of business
• Are you requesting that the electricity be turned on? ❑Yes XNo
• Will operations produce dust/wood shavings or similar material? ❑ Yes �(No
• Will operations involve the repair or replacement of automobile parts? ❑Yes [�Vo If yes: Describe the
components repaired or replaced.
• Does the operation involve the use of welding or open flame? ❑ Yes 'No
• Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? ❑ Yes k No
• Will there be storage racks, gondolas, or shelving exceeding 5 feet 9 inches in height? Dyes ❑ No
• The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑ Medical/Dental
%Warehouse/man ufacturing/Distribution ❑ Restaurant/Take-Out Food ❑ Other
• Will any meat products including beef, poultry, and/or fish be cooked or fried onsite? ❑ Yes XNo
If you answered yes, please proceed to the next question.
• Does your facility currently have a grease control device (i.e. grease trap or grease interceptor)?
Check one: ❑ Yes ❑No
Grease Interceptor Verified
For Official Use Only
Occ Group: t3
Occ Group: '5- \
Occ Group:
Total Sq Ft Occupied: `L1,20
Bldg. Permit #
Inspected By Initials:
Planning Initials-71G Date: is' er' le -
Conditions of Approval or Other Notes:
Date:
Area: )bo Occ Load:
Area: J�2W Occ Load: LA
Area: Occ Load:
No. of Stories: TIF Review: Y/ N
Entitlement #: Zoning: J L_
Use PermittedFuildinag
Parking Meets Code (for use)8N
Reviewed By Initials: � Date: C.7101/16
j . a (9 / ? — Z9Cj -7
Y - South Coast
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
Phone Number (909) 396-3529 http://www.agmd.gov
�_` P C
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:
Property Address: IS I L I (,re-Jn6m '6t. ff- 1U' I n.
City: an onf, M gwLI - Zip Code: `1U y
Contact Person: .�t�n1� Xhx 419tz Title: I'rQ5
Type of Business: 06S f? tnh�p,tz - W6,-"tf-e- '%ff45e. Telephone: `jq ? — r7y0l
Fax Number: 'f lq -- 3?3 - Z10�! E-mail Address: �7&fcC 100 �901_ C�7
Applicant (print name): 6, Signature: Date:
1. Will the facility release air pollutants, including but not limited to, dust fumes, gas, mist, odors, smoke, vapor, or a
combination of these to the atmosphere? ❑Yes XNo
2. Will the facility result of fuel -burning equipment including, but not limited to, boilers, generators, and internal combustion
engines? ❑Yes IgNo
3. Will the facility result of hazardous materials, including but not limited to, chemical, plastics, rubber, resins, solvents,
paints, and other parts cleaners? ❑Yes ` 10
4. Will the facility have use of above or underground storage tank? ❑Yes 'KNo
5. Will the facility consist of manufacturing, fabrications, finishing, or treatment of wood, metal or plastic products? ❑Yes�<No
6. Will the facility result in the use of the equipment listed below? ❑Yes KNO
(Select all that apply)
❑Abrasive Blasting Cabinet/Room ❑Internal Combustion Engine (rated > 50 bhp; e.g. back-up generator)
❑Air Conditioning System (containing > 50 Ibs of refrigerant)
❑Application of Paints/Adhesive/Resins
❑Baghouse/Dust Collector
❑Bakery Oven (gas fired)
❑BoilerMater Heater (max. heat input = or > 1 million BTU/hr)
❑Charbroiler/Smoker
❑Mixing/Blending of Liquids and/or Powders
❑Molding /Extruding/Curing of Plastic
❑ Pharm aceutical/Nutraceutical
❑Plasma/Laser Cutter
❑ Printing/Coating/Drying
❑ Production of Fumes/Dust/Smoke/Odors
❑Coffee Roaster/Afterbunner ❑Refrigeration Systems (containing > 50 Ibs of refrigeration
[]Deep Fryer (excluding equipment located at eating establishment) ❑Soldering Oven
[]Dry Cleaning Equipment
❑Electrostatic Precipitator
❑Fermentation
❑Gasoline Storage & Dispensing Equipment
❑Spray Booth
[-]Storage of Acids/Solvents/Organics Liquids/Fuels
❑Storage Silos (sugar, flour, etc.)
If you answered "No" to any of the above questions and your facility will not have the following
equipment listed, 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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Department of Planning & Building
2000 Main Street
Huntington Beach, CA 92648
Phone: (714) 536-5241 Fax: (714) 374-1647
CERTIFICATE OF OCCUPANCY
KEVIN AND TRACIE SMITH Cert. Number CO2012-001140
N IC TOOL Date Printed 05/09/2018
15121 GRAHAM #107
HUNTINGTON BEACH CA 92649
Address:
15121 Graham St107
Issue Date: 04/15/2013
Permit Number:
02012-001140
TCofO Issue Date:
Business Name:
N/C TOOL SERVICE INC
TCofO Expiration:
Business Type:
Retail
Approved Sq Ft.: 2,100.00
Current Use:
OFFICE/WAREHOUSE
# of Stories: 1
Occupant Groups: Description: Area: Occupant Load:
B OFFICE 500 5
S-1 WAREHOUSE 1600
Conditions of Approval:
4
Contacts:
Contact Type: Name: KEVIN AND TRACIE SMITH Phone: (714) 891-0284
Business Owner Address: 15121 GRAHAM #107 Cell! ( ) -
City / State: HUNTINGTON BEACH CA Fax: (714) 891-0296
Zip: 92649 Pager: ( ) -
Contact Type: Name:
CTRI
Phone:
(949) 330-5790
Property Owner Address:
65 ENTERPRISE
Cell:
( ) -
City / State:
ALISO VIEJO CA
Fax:
( ) -
Zip:
92656
Pager:
( ) -