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Home My WebLink About15065 Goldenwest St - CofO(0 -CD \ sq ` • CERTIFICATE OF OCCUPANCY --026" - Jn a CITY OF HUNTINGTON BEACH - DEPT. OF COMMUNITY DEVELOPMENT APPLICATION HUNTINGTON BEACF (3`d Floor — The Applicant Must Apply In -Person) 15U (0 S Business Address Date 41 Z-- I v Business Owners Name LuKt Zip Code q (PL! Business Name OAS s s<(ctn, Telephone No. _71 LI 1Uu-Y o UI Business Type 4p,1L 5:� o11 Bus. Phone Vi Property Owner Information (required) Tenant/Emergency Contact (required) Name u s S t tJ C'�S V-i Name j�j c1Q.�j. Address (-1 �TcL'_ Home Address Q972 Gr,.)IkQ.. . City-�y1Vk State/Zip City tate/Zip Telephone No. qq cj " f` -)u-ct-�qo) Telephone No. THIS USE WOULD BE DESCRIBED AS: O Newly Constructed Building or ❑ Existing Building IS THIS BUILDING FIRE SPRINKLERED? ❑ Yes ❑No CHEC ALL THAT APPLY: P�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 "o ■ Will operations produce dust/wood shavings or similar material? ❑ Yes ,J�rNo ■ Will operations involve the repair or replacement of automobile parts? El Yes -I?fNo If yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? ❑ Yes J11 No ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? ❑ Yes Elyo ■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? ❑Yes C�Oqo ■ The following best describes my operation: ❑ Office Only JX Retail Sales ❑Medical/Dental ❑Warehouse /Manufacturing/Distribution ❑ Restaurant/Take-Out Food ❑ Other ■ Will any meat products including beef, poultry, and/or fish bee cooked or fried onsite? ❑ Yes NTNo If you answered yes, please proceed to the next question. • Does your facility cu ently have a grease control device (i.e. grease trap or grease interceptor)? Check one: ❑ Yes For Official Use Only Occ Group: 15 Occ Group: Occ Group: Total Sq Ft Occupied; Bldg. Permit # I (`; k 1j ifs Planning Initials: 71 Date: 7i (AI Conditions of Approval or Other Notes: Area: 6 cl o Occ Load: I Area: Occ Load: Area: Occ Load: No. of Stories: I TIF Review: Y`l _ Entitlement #: Zoning: ((�' Building Reviewed By Initials:��Date: /i3f1 (ter Grease Interceptor Verified Inspected By Initials: Date: B 1b"IN6 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: Oayc_, \�akY sn\o J1n Pronertv Address: t:iYP S C-Ab \A EM A1R-- City: Mlil/1 C.o Zip Code: �j 9Q 41 Contact Person: V c�IA'Vt., L i Title: Type of Business: RaV Telephone: IN Fax Number: VIA- e-mail address: AaN 1kA�e_ 1 Applicant (print name): Signature: Date: 10 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❑ Nolo 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-