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Home My WebLink About15039 Goldenwest St - CofOx aA-4 Tic./4�- • CERTIFICATE OF OCCUPANCY 0204 - �60 � Jj 0 CITY OF HUNTINGTON BEACH - DEPT. OF PLANNING & BUILDING APPLICATION HUNTINGTON BEACH I L' S 3 I� " Sol (3rd Floor — The Applicant Must Apply In -Person) �1 Business License # P� e�p �� Date Z 1 Business Address IsL� Gpt.1r "t- � � /-L3 c,o a Z (,q'j Zip Code 'M Business Owners Name W,4 y(A, j rj . /C" t b Telephone No. -"7 / Y Business Name C.oy,NKp g s f Bus. Phone Business Type Property Owner Information (required) Tenant/Emergency Contact (required) Name Name E L4c,n c �oMI_ 0",AtnL4 titd•�a�r,tl Nj x t a, _ ��,.t Kn,�1 Address 1-7 (v31 4-,Ft Home Address ((.A,_,i,j4 1,�� City 12v� n c;- State/Zip C-A City K I � i its State/Zip � �j ZS o G Telephone No. ct 7-(01 If Telephone No. THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or Existing Building IS THIS BUILDING SPRINKLERED? Yew No ❑ CHECK ALL THAT APPLY: 04-Change of Business Owner Change of Occupant []Change of Use ❑ Additional Occupant ■ Indicate former type of business Ce ,.. ^_ ■ Are you requesting that the electricity be Turned on? Yes ❑ Nog ■ Will operations produce dust/wood shavings or similar material? Yeses No ■ Will operations involve the repair or replacement of automobile parts Yes NQ( If yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? Yes NA ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? Yes ❑ NdK_ ■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? Yes❑ Nq;1 ■ The following best describes my operation: ❑ Office Only ❑ Retail Sales N°Medical/Dental ❑ Warehouse /Manufacturing/Distribution ❑ Restaurant/Take-Out Food ■ Will the Food Service Establishment Generate Fats, Oils Greases? Yes❑ No IIJA ■ Does the Facility Have a Grease Interceptor? Yes ❑ NQXjVIA ■ Other (describe) For Official Use Only Occ Group: Occ Group: Occ Group: Total Sq Ft Occupied: Bldg. Permit # Planning Initials: 114 Date: 2`I I I Area: �, Q Area: Area: No. of Stories: Entitlement #: Occ Load: C O Occ Load: Occ Load: TIF Review: Y/ N Zoning: C& Building Reviewed By Initials: _Date: I 3 t Conditions of Approval or Other Notes: 5awy ce�!) FriU • a Grease Interceptor Verified Inspected By Initials: Date: i South Coast 0a 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: s u c2, e 4 z— Property Address: l5 o l) C,Q Lt1 Giv r-yt-C,cf City: {�.,.� !,'.� re.„ g LA cal CA Zip Code: 1:� ZG'J D Contact Person: cj4,yLb-j Title: C.0 n Type of Business: Telephone: Fax Number: 9 S ( &%r0 Do � Z e-mail address: Applicant (print name): 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❑ NoR 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- B 5980 60 g 5980' 60 , ',� r �' Qf t. ._ y�r Grpup befinl8' Business Use Buittlingr r stri�cfiare or a portion thereof R ."---..Pf.'. used for afffce professionat or s�rvic type transaegon g .A