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Home My WebLink About20932 Brookhurst St - CofO (58)r 7 • 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 BYo_ok hrtiirS_C Srt -,a 1,.03 R. J , Date Business Owners Name Zip Code Business Name (c�,; H. g (� a <AA'II\\5,, G. Telephone No. qq I Business Type Bus. Phone Z 3 I Property Owner Information (required) W Tenant/Emergency Contact (required) Name ii W l l'lacH ��* S Name G 411ew If -<a� Address I mortiihti SLIA Home Address ! LZ C-0— City 7yowe State/Zip Q A 03 City -3iryIk a State/Zip"Z- Telephone No. ��Z� �ti1" 6% �3 Telephone No. Q THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or NfExisting Building IS THIS BUILDING FIRE SPRINKLERED? ❑ Yes lam{ No CHECK ALL THAT APPLY: ❑ Change of Business Owner gChange of Occupant ❑ Change of Use ❑ Additional Occupant • Indicate former type of business b}—_Mtal> ata,e • Are you requesting that the electricity be turned on? ❑Yes L� No • Will operations produce dust/wood shavings or similar material? ❑ Yes RNo • Will operations involve the repair or replacement of automobile parts? ❑Yes EgNo 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:ErNo • Will there be storage racks, gondolas, or shelving exceeding 5 feet 9 inches in height? ❑Yes c®' No • The following best describes my operation: ❑ Office Only ❑ Retail Sales ,RT Medical/Dental ❑ Warehouse/Manufacturing/Distribution ❑ Restaurant/Take-Out Food ❑ Other • Will any meat products including beef, poultry, and/or fish be cooked or fried onsite? ❑ Yes j�'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 ,EgNo Grease Interceptor Verified For Official Use Only Occ Group: Occ Group: Occ Group: Total Sq Ft Occupied: L3 00 Bldg. Permit # Inspected By Initials: Date: Planning Initials: W Date: q' ,16 Area:', Area: Area: No. of Stories: Entitlement #: Use Permitted: Y / N Conditions of Approval or Other Notes: I,JP��I' /`fU 44 Building Reviewed B Occ Load: Occ Load: Occ Load: TIF Review: Y/ N Zoning: C ( Parking Meets Code (for use): Y / N y Initials:_f �, Date: South Coast Air Quality Management District 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: 7S H's b'D5 _�n c� Property Address: �ro `� 3 �- �(7un�s T 5-t :W j 3 City: Zip Code: I --> Contact Person: Title: 6cutne.v� Type of Business: 1�e,A-tA Telephone: (!�e �7fi ?3 l c( Fax Number: 4�K 1114 qGl • 3zoo E-mail Address: Applicant (print name): M 6Aew �Sal Signature: _ 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 3E�rNo , 2. Will the facility result of fuel -burning equipment including, but not limited to, boilers, generators, and internal combustion engines? ❑Yes �No 3. Will the facility result of hazardous materials, including but not limited to, chemical, plastics, rubber, resins, solvents, paints, and other parts cleaners? ❑Yes glo 4. Will the facility have use of above or underground storage tank? ❑Yes ONO 5. Will the facility consist of manufacturing, fabrications, finishing, or treatment of wood, metal or plastic products? ❑Yes;�TNo 6. Will the facility result in the use of the equipment listed below? []Yes �?fNo (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) ❑Mixing/Blending of Liquids and/or Powders ❑Application of Paints/Adhesive/Resins ❑Molding /Extruding/Curing of Plastic ❑Baghouse/Dust Collector ❑Pharmaceutical/Nutrace utical ❑Bakery Oven (gas fired) ❑Plasma/Laser Cutter ❑Boiler/Water Heater (max. heat input = or > 1 million BTU/hr) ❑Printing/Coating/Drying ❑Charbroiler/Smoker ❑ 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). A z7 u ti � a o � a -cr m > C► ^ C N - 1 Yr ri J Ail LU > !Y .. > } AJ A .. zo U n a O a p o U. C7 V p = 1 �r � V � I1Q1.-U � •� �+ A L1 L.. t D uj ui ^, 'z li — � H •riLU -_ U _- v ram, a Q 4J m N I A )II CCLLJ a C c a Im rn O 0_ w c ��y ar' a V 1'J t r-I X � � u < G s • RFCE�VE� APPLICATION FO6R CERT FICATE OF OCCUPANCY of_An n' t5h—beach Department of Build FILL IN (Print or type only DATE Appi•icai fippon is 1,1,�reV,Im for a Certificate of Occupancy for a: Describe Business Use: ri--g bsCo1, el onmen Ocqy.Laricy: Gr.. Di �- To be known s. N �, Name of Business Located at Business Address MamP: BUS NE S OWNER Resideiic—e-Pdress City p Phone No. - Business: Residence: Name: BUILDING WNER Address 1tC' y zip W.0 ne o. TNIS USE WOULD BE DESCRIBED AS: Newly Constructed Building Change, of (hiner Change of Occupant 2]Egi"sting Building Change of Use <rf -itional Occupant Indicate former use if any _ _ Occupancy: Gr. Div. Occupancy of any building is prohibited and a business license will not be issued until the building has been inspected and a Certificate of ^ccupancy is issued. 2. No electrical service will be released for any exi'tiny..building until tl:: service has been.inspected and certified safe. All applicants for occupancy in an exist.ng building are required to schedule an, "fuse up, inspection 'in the Department of Building .electrical and Coninunity Development at the time this application is filed. 3. CNARGE V OCCUPANCY OR USE INSPECTION FEE..: Whenever it -is Necessary to make �4 inspection of a building or premises in order to determine�ifya change may_,,,. be made in the character of occupancy or use of the btiilding'or•prem•tses which would place the building in a different division of £die same groClp of occuancy or in a. different group of occupancy, a change of occupancy inspection fee of ''boo/ $30.00 shall be paid to the City. (FOR OFFICE USE ONLY) SUPPLEMENTAL INFORMATION Sq. ft. of building '[JC1 'T' Plan Check No. OcclWaiicy Group - 1- Permit No. Occupant Load Admin. Action No. of Stories No. Parking Spaces i Health Dept. Ap'prbva' Uti 1 i ti es Rel eased .B ff=� APPROVED BY 7" j" E CERTI F I CATE ' Of' OCCUPANCY FEE .00 CHANGE OF OCCUPANCY OR USE INSPECTION FEE T'1TAL (#75-039) �� `�