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Home My WebLink About19092 Beach Blvd - CofO (62)J J. HUNTINGTON BEACH Business Addre. Business Ownei Business Name Business Type _ CERTIFICATE OF OCCUPANCY 020 L- 7 G 3 -7 CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION 111nga: (3`d Floor - The Applicant Must Apply In -Person) Date 1 �_v Zip Code Telephone Bus. Phone 701 cf(P�3 - 2-1 Property Owner Information (required) Tenant/Emergency Contact (re uired)J ) Name 9 p Vlq "l Name 'W Y � _ ��l O -- (CT � 1g;t Address -t'" Home Address AN &I 0i- City_(24 P1 'f� . State/Zip Qn City C Q EN r W7 State/Zip Telephone NoN t !�- ) -% S -3 - <2� Telephone No.d N ) 4 b � R THIS USE WOULD BE DESCRIBED AS: O Newly Constructed Building or J Existing Building IS THIS BUILDING FIRE SPRINKLERED? El Yes ONO CHECK ALL THAT APPLY: a 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 V�-No ■ Will operations produce dust/wood shavings or similar material? ❑ Yes ®No ■ Will operations involve the repair or replacement of automobile parts? ❑Yes �ENo If yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? ❑ Yes 93 No ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? ❑ Yes g No ■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? ❑Yes El No ■ The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑Medical/Dental. ❑Warehouse /Manufacturing/Distribution KRestaurant/Take-Out Food ❑ Other ■ Will any meat products including beef, poultry, and/or fish bee cooked or fried onsite? XYes 14 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: Y1 Yes ❑ No For Official Use Only c Occ Group: _ Area: 8 Z S— Occ Load: Occ Group: Area: Occ Load: Occ Group: Area: Occ Load: Total Sq Ft Occupied: 9 2 No. of Stories: TIF Review: Y/ N Bldg. Permit # Entitlement #: Zoning: Use Permitted: Y / N Parking Meets dobe (for use): Y / N Planning Initials'--j Date: Building Reviewed By Initials: I Date: Conditions of Approval or Other Notes: G;F- CC`� Grease Interceptor Verified Inspected By Initials: Date: j 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: Property Address: VA? VA?rl Q City: VW1 � \ �Zip Code: - 6 Contact Person: 1-1nW Cc Q "Y� Title: Type of Business: Telephone:(-71D Fax Number: e-mail address: `�I\ Applicant (print name): TAN Signature: 1'� l Date: tL� Jim g • Will the facility have any of the following equipment? Yes No z 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❑ Nof� 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- Business Name: Business Addre: HUNTINGTON BEACH FIRE DEPARTMENT FIRE PREVENTION DIVISION Fire Only 2000 MAIN STREET • HUNTINGTON BEACH, CA 92648 File #: (714) 536-5676 • FAX (714) 374-1551 FP: FIRE PREVENTION — BUSINESS DATA SHEET For new Certificates of Occupancy Number Street Unit Lip Gode Billing Address: ❑same as 1 Business Contact: UU NIA LAM -- LPLEV I ISJ Y Emergency Contact: jn w (�: p(m N (24-hour) Name nn l Description of Business: K9 LiM AA1 Will there be any of the following uses on the premise? ❑ Storage >6 feet If yes, describe: _ 4.-i. . . PhoneEmail { ❑ Welding ❑ Special amusements (escape room or similar) ❑ Motor vehicle repair Will there be any of the following equipment (E =existing equipment, A = adding or new equipment) Dry cleaning — list solvent Industrial oven — list fuel Propane patio heaters —# of heaters, # of spares Cooking equipment (fryers, ovens, pizza conveyor, etc.) Backup generators — list fuel IE Walk in refrigerators or coolers — list size, refrigerant _ Spray booth or dipping tank _ Tents or air supported structure Grinding/milling equipment that creates _ Fuel dispensing (including storage tanks) combustible dust _ Carbonated beverage system — list total pounds of CO2 If yes, provide details (e.g., number, fuel, size, etc.) Does the building have any of the following features (E =existing feature, A = adding feature) G Sprinkler system _ Other fire suppression system Fire alarm system IG� Smoke detectors _ Other detectors (e.g, methane) _ Other alarm system Private fire hydrants _ Battery systems Fire pump _ Methane barrier or other methane control installed If yes, provide details Does the business handle any of the following: YES NO 55 gallons or more of a liquid hazardous material or hazardous waste. ❑ �@ Compressed gas (or liquid/cryogenic equivalent) of 200 cubic feet or more ❑ 14 Inert compressed gas (e.g., argon, nitrogen, helium) of 1,000 cubic feet or ❑ more. 500 pounds or more of a solid hazardous material or hazardous waste. ❑ 21 Extremely hazardous material or radioactive material ❑ a I certify, under the penalty of perjury, that the above information is true and correct to the best of my knowledge. Signature: ,11 iMl AV7-`f� +' Title: Date: r HUNTINGTON BEACH FIRE DEPARTMENT FIRE PREVENTION DIVISION FirFile #e Only, 2000 MAIN STREET - HUNTINGTON BEACH, CA 92648 (714) 536-5676 - FAX (714) 374-1551 FP: IMPORTANT INFORMATION ABOUT HAZARDOUS MATERIAL DISCLOSURE If you are subject to hazardous material disclosure there are important steps you need to take. We encourage you to reduce your hazardous material inventory below disclosure amounts to avoid fees and inspections. However, if your business requires hazardous materials equal to or in excess of disclosure amounts, you must comply. A Fire Department representative will contact you to verify the information you submitted for your Business License. If you are subject to this program, you will need to: ❑ Disclose online, Businesses must disclose on-line either through either (but not both): o Orange County ESubmit portal (https://www.esubmit.ocgov.com/home/) o California Environmental Reporting System (CERS) (http://cers.calepa.ca.gov/) Business must disclose information on the following forms: o Business Activities o Business Owner/Operator o Chemical Description o An Annotated Site Map Identification o Emergency Plan. You are encouraged to proceed directly to either online disclosure system and begin the disclosure process. Failure to disclose is a violation and subject to significant fines and penalties. ❑ Annually review and certify your online disclosure. ❑ Update your Business Emergency Plan every three years. ❑ Pay an annual HMDP fee. The fee is determined based on number and quantity of hazardous materials handled at your facility. ❑ Inform your landlord if you operate in a leased or rental property that you are subject to hazardous material disclosure. These are done in writing and sample forms are available on our web site. ❑ Receive an inspection by the Fire Department's Hazardous Materials Program Specialist, at a minimum of once every three years. If you have question or are unsure whether you need to disclose please call (714) 536-5469 or (714) 536-5676. You can also obtain additional information on the City's website at www.surfcity-hb.org on the Fire Department page under the section Fire Prevention. Department of Planning & Building 2000 Main Street " I Huntington Beach, CA 92648 Phone: (714) 536-5241 Fax: (714) 374-1647 ` Occupancy Application 19092 1 Beach Blvd 120 DEMOND 19092 __...........__..._...._...... APN 153-041-28 Certificate of Occupancy Application . •f : ff Num Street Unit Bld Job Address 19092 Beach Blvd V APN 153-041-28 RD 3716 Zoning SP14 Lot = Tract l= Block File Number Cofo? B2015-008933 No P2015-008934 No M2015-008935 No E2015-009021 No E2015-009022 No 02016-000429 Yes 02016-001989 Yes 02016-001990 Yes E2016-004890 No 02016-004891 Yes P2017-000056 No 02017-000170 Yes Entered By Bolls, Derek Default Inspector Andino, Richard Permit Type Certificate of Occupancy Origin Counter Building Use - City Building Use - County i I U New Building? Description —BIG CHOPSTICKS -'- Internal Notes Date Entered 01/09/2017 Status Issued Issue Permit?®' Date 01/09/2017 Issued By Permitl I Planner I Bourgeois, Nicolle Plan Checker ILee, Eddie CofO Number CO2017-000170 Choose Print All CofO Type Permanent Fees and Payments Sheets to Issue Issued By Permitl Single C-10 Cofo Status IssuedInspections L Cofo Date Issued 01/09/2017 Temp. CofO Issued Date Printed Utility Release Date ! Temp. COFO Expiration_ 01/09/2017 License Number Business Name Business Type Business Phone Proposed Use I RESTAURANT Former Use IRESTAURANT Click the « button to copy the Business License information into the Certificate of Occupancy. Business Licenses Business Name A176356 H O W HALL INC A124982 ULTRA CLEANERS A167540 R & R CLEANERS A190384 ULTRACLEANERS Conditions (CHANGE OF BUSINESS OWNER ONLY - USE OK Approved Occupied Area (Sci Ft) # of Stories 11 �. Change of Owner? n Elec. Available? ❑ Drinking /Dining > 50 Occupants? aChange of Use? Want Electricity On? D Welding / Open Flame? Change of occupant? Sprinklered? Automobile Repairs? DAdditional Occupant? ❑ Dust / Wood? Auto Parts Desc. ,qccuf • f ! f Group Description Area Construction Type Occupancy Load B RESTAURANT 825 8 B RESTAURANT 825 8 Group Definitio Business Use - Building or structure, or a portion thereof, used for office, professional or service -type transactions, in'I, vii' n efn'_ of --rA. _—A nren f._. .