HomeMy WebLinkAbout15081 Goldenwest St - CofO0
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HUNTINGTON BEACH
CERTIFICATE OF OCCUPANCY 020 -
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION
(3rd Floor — The Applicant Must Apply In -Person)
Business Address l50el G D &-kjest j. %`ivri ,"00v+ gee1C h Date -7 17 Zoi
g26�17
Business Owners NameOleo Vt) CA q2"7 Zip Code
Business NameS;M01V beauto-P1 Telephone No. 562-20�-3o�P
Business Type P,-r n+0.nen+ rA#,K¢vp , Sk;ncare , i nq; IS Bus. Phone sb 2- 209- 30 O
Property Owner Information (required) Tenant/Emergency Contact (required)
Name B%js;ne-55 Prooev fies RetneName Kiev Uu
Address e12 S Cg li'h, n,A St ioill F/. Home Address 24V SeillIt AV# -
City 54, Fvrjne;sco State/Zip c- 4 T- 0'1 city A m6i^ State/Zip GA quo6
Telephone No. eNq -305— 9177 Telephone No. 5 kz-2ol -S080
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or ® Existing Building
IS THIS BUILDING FIRE SPRINKLERED? 0 Yes ❑ No
CHECK ALL THAT APPLY:
50 Change of Business Owner N Change of Occupant ❑ Change of Use ❑ Additional Occupant
• Indicate former type of business Sk:r• Core avid Sop"
• Are you requesting that the electricity be turned on? ZYes ❑ No
• Will operations produce dust/wood shavings or similar material? ❑ Yes ® No
• Will operations involve the repair or replacement of automobile parts? ❑Yes ONO 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 ® No
• Will there be storage racks, gondolas, or shelving exceeding 5 feet 9 inches in height? ❑Yes ® No
• The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑ Medical/Dental
❑ Warehouse/Manufacturing/Distribution ❑ Restaurant/Take-Out Food 00 Other Sa jo n
• Will any meat products including beef, poultry, and/or fish be 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 ❑No
Grease Interceptor Verified
For Official Use Only Y�
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied:
Bldg. Permit #
Inspected By Initials: Date:
Planning Initials:SA�Date: / 0b
Conditions of Approval or Other Notes:
Area: 1100
Area:
Area:
No. of Stories: t
Entitlement #:
Use Permitted: Y / N
Occ Load: �I
Occ Load:
Occ Load:
TIF Revie Y N
Zoning:
Parking Meets C de (for use): YIII
/ Q'
Building Reviewed By Initials: Date: Z v
South Coast 0 I / J .766
Air Quality Management District "I
21865 Copley Drive, Diamond Bar, CA 91765-4182
Phone Number (909) 396-3529 http://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:
f ; p. I Pe e rr►4oe►,t
e
Property Address: 25081 &vldenwed- St
City: Rjntnlon 19ftd, Zip Code: q2 6y?
Contact Person: N i Cv Vu Title: ow A er
Type of Business: ner-m-cent MAkevp. 6JIVe-care,k Nails Telephone: 562- - 269 -3080
Fax Number: P1 A E-mail Address: ; J quq1MVIJ • Cowl
Applicant (print name): ;eu Va Signature: ��'JI 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 ®No
2. Will the facility result of fuel -burning equipment including, but not limited to, boilers, generators, and internal combustion
engines? ❑Yes XNo
3. Will the facility result of hazardous materials, including but not limited to, chemical, plastics, rubber, resins, solvents,
paints, and other parts cleaners? ❑Yes KNo
4. Will the facility have use of above or underground storage tank? ❑Yes ®No
5. Will the facility consist of manufacturing, fabrications, finishing, or treatment of wood, metal or plastic products? ❑Yes KNo
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)
❑Boiler/Water Heater (max. heat input = or > 1 million BTU/hr)
❑Charbroiler/Smoker
❑Mixing/Blending of Liquids and/or Powders
❑Molding /Extruding/Curing of Plastic
❑ Pharmaceutical/N utraceutical
❑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).
il
Department of Planning & Building
2000 Main Street
} Huntington Beach, CA 92648
110-01FVI�
Phone: (714) 536-5241 Fax: (714) 374-1647
CERTIFICATE OF OCCUPANCY
Address:
15081 Goldenwest St
Permit Number:
02004-012355
Business Name:
LINDA SKIN CARE AND SPA
Business Type:
SKIN CARE AND SPA
Current Use:
Occupant Groups:
i description: j Lr
B
Conditions of Approval:
Contacts:
Contact Type: Name:
Property Owner Address:
City / State:
Zip:
Cert. Number
Date Printed
Issue Date:
TCofO Issue Date:
TCofO Expiration:
Approved Sq Ft.:
# of Stories:
Occupant Load:_
11
CO2004-012355
07/24/2018
02/10/2005
1,100.00
1
LESTER SMULL Phone: (949) 474-8900
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