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HomeMy WebLinkAbout17822 Beach Blvd - CofO (106)CERTIFICATE OF OCCUPANCY 020- CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION HUNTINGTON BEACH Business Address 17822 BEACH BLVD #215 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 Date 11-16-18 Zip Code 92647 Telephone No. 714-742-5734 Bus. Phone 714-847-2576 Property Owner Information (required) Tenant/Emergency Contact (required) Name ALAMITOS ASSOCIATES-HUNTINTON BEACH MEDICAL TOWERS Name AJAY & RAMA MEKA Address17822 BEACH BLVD -LEASING OFFICE Home Address 29 SARTEANO DR CityHUNTINGTON BEACH State/ZipCA CityNEWPORT COAST State/Zip CA 92657 Telephone No.562-754-4501 �(P,� _ - Dooms Telephone No. 714-742-5734 OR 714-742-4617 CCrA—`+- ) THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or ■❑ Existing Building IS THIS BUILDING FIRE SPRINKLERED? ❑ Yes ❑ No CHECK ALL THAT APPLY: ❑■ Change of Business Owner Change of Occupan ❑ Change of Use ■❑ Ad I cupa • Indicate former type of business SAM OLO PHYSICIAN • Are you requesting that the electricity be turned on? ❑■ Yes ❑ No • Will operations produce dust/wood shavings or similar material? ❑ Yes ❑p 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 ❑■ No • Will the business be a drinking, dining or assembly use with art 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 ❑p 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? p 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 Inspected By Initials: Date: For Official Use Only Occ Group: Occ Group: Occ Group: Total Sq Ft Occupied: ( ©6 Bldg. Permit # Planning Initials:Date: It-?, [. Ig Conditions of Approval or Other Notes: W tlJl� 'O&A f - 06Weowui i N 5T€ Area: (OC)S Area: Area: No. of Stories: `{ Entitlement #: Use Permitted: Y / N Occ Load: l Occ Load: Occ Load: TIF Revie . Y/ Zoning: I Parking Meets Code (for use): Y / N Building Reviewed By Initials:V-0 Date: Off t4jr 06' —5A"A,6 A-5 C)IB - T661 9 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 #215 City: HUNTINGTON BEACH Contact Person: RAMA MEKA Zip Code: 92647 Type of Business: MEDICAL CLINIC -PRIMARY CARE Title: ADMINISTRATOR Telephone: 714-7425734 Fax Number:714-842-2593 E-mail Address: rama@amistadclinics.com �l Applicant (print name): ) M G - ` 1 AKA N . D Signature: 1 - !' C k — X1-0 Date: //- /6 -/T 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 [1111INo 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 0No 5. Will the facility consist of manufacturing, fabrications, finishing, or treatment of wood, metal or plastic products? ❑Yes ONo 6. Will the facility result in the use of the equipment listed below? ❑Yes ❑■ No (Select all that apply) ❑Abrasive Blasting Cabinet/Room ❑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 ❑Internal Combustion Engine (rated > 50 bhp; e.g. back-up generator) ❑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). 1 r- olz-�C0619 Department of Planning & Building 2000 Main Street Huntington Beach, CA 92648 Phone: (714) 536-5241 Fax: (71.4) 374-1647 17822 1 Beach Blvd 215 HUNTINGTONASSOCIATES 1. 17822 APN 167-601-20 Occupancy Application Certificate of Occupancy Application �kvialicatioit Binder Num Street Unit Bld Job Address 17822 Beach Blvd 215 APN 167-601-20 RD 3416 Zoning CO Lot = Tract Block File Number Cofo? E2003-042853 No M1999-023854 No M2000-024281 No P2000-025647 No P2000-025741 No P2000-025742 No 01996-001068 Yes 01998-001069 Yes 01990-001070 Yes 01998-001071 Yes 01996-001072 Yes 01998-001073 Yes ! Entered By Default Inspector Permit Type Origin Building Use - City Building Use - County Description Internal Notes Date Entered 07/15/1998 Status Issued Certificate of Occupancy Issue Permit? Date 08/10/1998 Issued By Planner New Building? Plan Checker Frisby, Chad CofO Number IC01998-0010731 Choose Print All CofO Type Fees and Payments Sheets to Issue Issued By Single C/O CofO Status Issued Inspections CofO Date Issued 08/10/1998 Temp. CofO Issued Date Printed Utility Release Date Temp. COFO Expiration —•-••••-•••••-•••-••••-••— License Click the « button to copy the Business License Number information into the Certificate of Occupancy. Business Name JARTHUR CALICK M.D.,INC. Business Licenses Business Name Business Type ICARDICLOGY OFFICE A238134 NEWPORT CHILDREN'S MEDICAL t A161456 LINDAC SANICOLA PHD Business Phone (714) 842-8889 A046770 ANGELOVIC THOMAS E MD A211732 JOSEPH F CHOW MD INC Proposed Use Former Use SAME -MEDICAL OFFICE Conditions Approved Occupied Area (Scl Ft) 11,005.00 # of Stories 14 11 Change of Owner? Elec. Available? Drinking / Dining > 50 Occupants? 13 Change of Use? Want Electricity,On? Welding I Open Flame? � . Change of Occupant? Sprinklered? Automobile Repairs? Additional Occupant? Dust / Wood? Auto Parts Desc. ..Group/Load Grout) Descriotion Area Construction Type Occupancy Load B 0 B 0 Group Definitio A building or structure, or a portion thereof, for office, professional or service -type transactions, including storage of --A, ­4 --nfo• c finn.­4 ririnlrinn o fnhliehmenfe with nn nrrunnnf Innri nf. 1pcc than 5f1