The URL can be used to link to this page

Home My WebLink About15013 Goldenwest St - CofO (2)Jun 01 1511:05a Shawnie 16578596173 p.1 CERTIFICATE OF OCCUPANCY 0201 S - 3 22- CITY OF HUNTINGTON BEACH — DEPT. OF PLANNING & BUILDING APPLICATION Business Address 15013 Goldenmst Business Owners Name Lisa smith B usin= Narne AA Hez^"9 Aid Center Business Type Nearing Aid Devices (DME) (3'4 Floor — The Applicant Must Apply In -Person) Date 6f112015 Zip Code 92647 Telephone No. 6s7-SSTSI72 Bus. Pho11e 714-898-7027 Property Owner Information (required) Tenant/Emergency Contact (required) Name Business Propery Development Company Name Lisa Sm'th Address17631 Fitch Home Address 23 Via Ne isa City1rom State ,/ZipCA92614 CitySanClemente State/Zip CA92673 Telephone No. 949-4748900 Telephone No. 949� n & S'-% S S-17 617 ,?— THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or El Existing Building IS THIS BUILDING FIRE SPRINKLERED? 9 Yes []No CHECK ALL THAT APPLY: ❑ Change of Business Owner N Change of Occupant ❑ Change of Use ❑ Additional Occupant ■ Indicate former type of business ■ Are you requesting that the electricity be turned on? ®Yes ❑No ■ Will operations produce dust/wood shavings or similar material? ❑Yes ®No ■ Will operations involve the repair or replacement of automobile parts? ❑Yes ®No If yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? ❑ Yes A No ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? ❑ Yes ® No ■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? ❑Yes XNo ■ The following best describes my operation: ❑ Office Only ❑ Retail Sales ®Medical/Dental OWarehouse /Manufacturing/Distribution 0 Restaurant/Take-Out Food M Other ■ Will any meat products including beef, poultry, and/or fish bee cooked or fried onsite? ❑ Yes ® No 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 N No For 4ffacial Use Qtnr& Oce Group: __ Area: Occ Load: Oce Group: Area: Oce Load: Occ Group: Area: Oce Load: Total Sq Ft Occupied: No. of Stories: TIF Revie}}�� YIN Bldg. Permit# Entitlement#: Zoning: i!z Planning Initials J4 Hate: C J Building Reviewed By Initials— Ixate: Conditions of Approval or Other Notes: 1-403 SF 5p&tt d L -Apr V-r- 1 spate Grease Interceptor Verified Inspected By Initials: Date: Jun 01 1611:06.a Shawnie 16578696173 p.2 South Coast Air Quality Management District 21865-Copley -Drive; Diamond- Bar, -CA 9'1765-4182 rp- (909) 396-3529 * http:l/ 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: AA Hearing Aids Center Property Address: 15013 Goldenwest City: Huntington Beach Zip Code: 92647 Contact Person: Lisa Smith Title: President Type of Business: Hearing Aid Device Telephone: 714-898-7027 Fax Number 714-899-1050 ,e-mail address: lisdsmith aol.eom .Applicant{.print name): LL4 ASignature: Date: 6.1-/>/ Will the facility have any of the following equipment? es ❑ No 0 ' Charbroiler Dry cleaning machine Spray booth Printing press(scrLecAithographicfilexographie) 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 • 4tiill-any vfthe. following opciations be performed? Yes❑ No* 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 AQPN11D. 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 AQ D at their Small Business Assistance. Othee at.1"8W.CU*f,-S 4 OG-(1400=Z884664). -2-