HomeMy WebLinkAbout15091 Goldenwest St - CofOpro
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HUNTINGTON BEACH
Business
Business
Business
Business
Business
CERTIFICATE OF OCCUPANCY 0200.1- 0 DSS W
CITY OF HUNTINGTO EACH
DEPT. OF BUILDING &f.,SAFETY„AP LOCATION
714/536-5241 V 1ann
Apply In -Person)
Date
Zip Code 910If I
Telephone No. q 49 - U 33-3 6 9
Bus. Phone 31'1- ww' u"
Provertv Owner Information (required) Tenant/Emergency Contact (required)
Name ht_&S W, A0 Tw Name WIrO
Address J3ti i13ch alp'. Home Address V401 GdLM
City Irllirt State/Zip f/t g141j City LQk.t State/Zip C& qW 3V
Telephone No. qq L114- 64Ob Telephone No. Tiq- (0- 33 - 34j3w
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or K Existing Building
CHECK ALL THAT APPLY:
Change of Property Owner hange of Occupant ❑ Change of Use ❑ Additional Occupant
■ Indicate former type of business �A _
■ Are you requesting that the electricity be turned on? YesjC No❑
■ Is the building sprinklered? Yes)( . No ❑
■ Will operations produce dust/wood shavings or similar material? Yes ❑ . NoW
■ Will operations involve the repair or replacement of automobile parts Yes 4 No)3 If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes Q No%
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes 1� No Y
■ The following best describes my operation: ❑ Office Only A Retail Sales ❑ Medical/Dental
❑ Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food
(describe process and end product)
❑ Other (describe)
For Official Use Only
Occ Group: ,T AA Area: Occ Load: W 1-5 /
Occ Group: -sue.-.s, Area: / L (-/ Occ Load:
Occ Group: orrA& Area: q-�j ,s Occ Load:
Total Sq Ft Occupied: USOOt No. of Stories: TIF Review: N
Bldg. Permit # Entitlement #: Zoning:
P1nr Initials: Dater Plan Chkr Initials: Date:AO O -z oNnsp Initials: QL Date: \
Inspection Date:
pr
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: cos}lt FW bridu
Property Address: 15D9 ( EkMetq W ,4 St
City: Y1 &01 Zip Code: q 2,U4 +
Contact Person: WkftTitle: MOW
Type of Business: bh,g,.( r _ Telephone: ik::.�)''�
Fax Number: e-mail address: e At Co,, 6Nts
Applicant (print name) Signature: �;/�✓ ��'• cam►
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❑ Nog
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).
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