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Home My WebLink About17822 Beach Blvd - CofO (107)JJ HUNTINGTON BEACH CERTIFICATE OF OCCUPANCY 020 CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION Business Address 17822 BEACH BLVD #, ; I Business Owners Name AJAY G. MEKA MD (3rd Floor — The Applicant Must Apply In -Person) Business Name AJAY G. MEKA MD INC.-AMISTAD MEDICAL CLINICS -SENIORS FORST MEDICAL CLINIC Business Type PRIMARY CARE -INTERNAL MEDICINE -CARDIOLOGY MEDICAL GROUP Property Owner Information (required) Name ALAMITOS ASSOCIATES-HUNTINTON BEACH MEDICAL TOWERS Date 11-16-18 Zip Code 92647 Telephone No.714-742-5734 Bus. Phone 714-847-2576 Tenant/Emergency Contact (required) Name AJAY & RAMA MEKA Address 17822 BEACH BLVD -LEASING OFFICE Home Address 29 SARTEANO DR CityHUNTINGTON BEACH State/Zip CA CityNEWPORT COAST State/Zip CA 92657 Telephone No.562-754-4501 �(p�_ c_ 00oj_ Telephone No. 714-742-5734 OR 714-742-4617 THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or IN Existing Building IS THIS BUILDING FIRE SPRINKLERED? ❑ Yes ❑ No CHECK ALL THAT APPLY: ❑p Change of Business Owner l�Chan�geof Occupan ❑ Change of Use❑ Ad I upa • Indicate former type of business SAM OLO PHYSICIAN • Are you requesting that the electricity be turned on? XYes ❑ No • Will operations produce dust/wood shavings or similar material? ❑ Yes p No • Will operations involve the repair or replacement of automobile parts? ❑Yes XNo If yes: Describe the components repaired or replaced. • Does the operation involve the use of welding or open flame? ❑ Yes IN No • Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? ❑ Yes p No • Will there be storage racks, gondolas, or shelving exceeding 5 feet 9 inches in height? ❑Yes EN No • The following best describes my operation: ❑ Office Only ❑ Retail Sales N 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 []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 QQ Occ -Group: Occ Group: Occ Group: Total Sq Ft Occupied: O� 7 Bldg. Permit # Inspected By Initials: Date: Planning Initials:Date: �-2 �• Conditions of Approval or Other Notes: W VLA, 1� 6 4 A P - 0/,'U) ref r N <-1€ Area: Area: Area: No. of Stories: Entitlement #: Use Permitted: Y / N Occ Load: Occ Load: Occ Load: TIF Review: YI Zoning: Parking Meets Code (for use): Y / N Building Reviewed By Initials: R% Date:_ k\%2!1N im v AIL, Dff t-4,E Ole -SA"A,15 1�5 0 196 - 7oo Fko 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: AJAY G. MEKA MD INC-AMISTAD MEDICAL CLINICS -SENIOR'S FIRST MEDICAL CLINIC Property Address: 17822 BEACH BLVD nW A City: HUNTINGTON BEACH Zip Code: 92647 Contact Person: RAMA MEKA Type of Business: MEDICAL CLINIC -PRIMARY CARE Title: ADMINISTRATOR Telephone: 714-7425734 Fax Number:714-842-2593 E-mail Address: rama@amistadclinics.com Applicant (print name): ) M G • 0 EKA N • D Signature: 121.- In-0 Date: 11 16 -ly 1. Will the facility release air pollutants, including but not limited to, dust fume , gas, mist, odors, smoke, vapor, or a combination of these to the atmosphere? ❑Yes ONo 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 ❑■ No 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 ■❑No 6. Will the facility result in the use of the equipment listed below? ❑Yes ❑■ No (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 Fred) ❑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/Nutraceutical ❑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). r Department of Planning & Building f 2000 Main Street Huntington Beach, CA 92648 Phone: (714) 536-5241 Fax: (714) 374-1647 OccupancyApplicafion Property Info 17822 Beach$Ivd. 218 HUNTINGTONASSOCIATES 17822 APN 167-601-20 of Occupancy A• • • Application Binder Num Street Unit Job Address 17822 jBeachBlvd 218 APN 167-601-20 RD 3416 Zoning F60 Lot 25 Tract FS00057 Block 11 File Number CofO? 02004-012763 jYes 02001701.0084 Yes 01991-001085 Yes 02005-004990 Yes 02005-008934 Yes 02005-009077 Yes 02005-009365 Yes 02005-009439 Yes 02005-009735 Yes 02005-009875 Yes 02006-003115 Yes 02006-003280 Yes Entered By Chuor, Phillip Date Entered 05/03/2006 Default Inspector Dean, Mike Status I Expired Permit Type Certificate of Occupancy _ Issue Permit? ® Date 05/23/2006 Origin Counter Issued By Diaz, Michele --- --- Building Use - City Planner DaVeiga, Paul BuildingUse- County ��fJl New Building? Plan Checker Chuor, Phillip Description IMED.OFFICE USE Internal Notes Certificate of Occupancy CofO Number CO2006-003280 Choose Print All CofO Type rPermanent Fees and Payments Sheets to Issue Inspections Issued 'By Single CIO CofO Status Issued CofO Date Issued 05/23/2006 Temp. CofO Issued Date Printed Utility Release Date Temp. COFO Expiration 05/23/2006 License Number; A094034 Business Name SHAH HARSHAD R MD Business Type I Professional / Other Business Phone (714) 847-2576 Proposed Use ISAME Former Use SAME Click the « button to copy the Business License information into the Certificate of Occupancy. Business Licenses Business Name A238134 NEWPORT CHILDREN'S MEDICAL t A161456 LINDAC SANICOLA PHD A046770 ANGELOVIC THOMAS E MD A211732 JOSEPH F CHOW MD INC Approved Occupied Area (Scl Ft) 800.00 # of Stories�4 Conditions Change of Owner? Elec. Available? Q Drinldng / Dining> 50 Occupants? Change of Use? � Want Electricity On? Welding / Open Flame? Change of Occupant? 11 Sprinklered? Automobile Repairs? Additional Occupant? Q Dust / Wood? Auto Parts Desc. Occupancy Group/Load r:rni in ; , np@rrintinhi Area Construction Tvoe Occupancv Load B MEDMOFFICE 800 8 B MED OFFICE 800 8 Group Definitio A building or structure, or a portion thereof, for office, professional or service -type transactions, including storage of records and accounts; eating and drinking establishments with an occupant load of less than 50. Type ' * Name $eld'must be, blank to add/change Contractor, Designer. or Engineer Same As j Property Owner Contractor �Designer / Engineer l� Mobile Phone ( ) Property Owner i Name I HUNTINGTON ASSOCIATES Pager ( ) Tenant Business Owner Company Address I PO BOX 740026 City/State/Zip 1LOUISVILLE Email Phone (000) 000-0000 x == State License Type ❑ Self Insured / Non -Employer? KY 40201 ` G Override Contractor _. Expiration Dales? Fax ( ) -� Date Overridden Overridden By i