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Home My WebLink About2124 Main St - CofO (50)• R J� HUNTINGTON BEACH CERTIFICATE OF OCCUPANCY 0201-_ !7C�-ES CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION (3rd Floor - The Applicant Must Apply In -Person) Business Address Z 171 Lf M c&t n 5tre-eJ Date f l AV /f3 Business Owners Name Me r v i ge- Zip Code cl Z_& Y 8 Business Name f i w) ear i c & n '�) t\A c Telephone No. 114) 9 o7 -51(69 Business Type Ut'ubter Me,d'i c.� g�jvierv�eA Rrev i oie� Bus. Phone(`i) Z3-3p0l'� Property Owner Information (required)kf, (, O(JY'Qf, t�� Tenant/Emergency Contact (required) Name G��l` C ` VN"ame j cAy_ Address `� �� Home Address i9�75 vJoaa�to�r�c�S D (1- City A,n � JAL,\A, State/Zip (, City taw n%i �q lord �3 c c4,State/Zip CP �12G4 5 Telephone No. ) ig 5 1 — Oboa Telephone No. (i tLi) 36 f 351 Z THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or M Existing Building IS THIS BUILDING FIRE SPRINKLERED? VYes ❑ No CHECK ALL THAT APPLY: ❑ 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 2 No • Will operations produce dust/wood shavings or similar material? ❑ Yes 2<( • Will operations involve the repair or replacement of automobile parts? ❑Yes to 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? El Yes p No • Will there be storage racks, gondolas, or shelving exceeding 5 feet 9 inches in height? ❑Yes o • The following best describes my operation: Office Only I -]Retail Sales al ElWarehouse/Manufacturing/Distribution Restaurant/Take-Out Food ElOther C • Will any meat products including beef, poultry, and/or fish be cooked or fried onsite? ❑ Yes 6;,WO 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 pro Grease Interceptor Verified Inspected By Initials: Date: For Official Use Onl Occ Group: Occ Group: Occ Group: Total Sq Ft Occupied: Bldg. Permit # Planning Initial Date Conditions of Approval or Other Notes: Area: Area: Area: No. of Stories: Entitlement #: Use Permitted: Occ Load: Occ Load: Occ Load: TIF Review,: Y/ N Zoning: Parking Meets Code (for use): 9N Building Reviewed By Initials: Date: c e b 4ilU_ - IA..f,> C'�_ o South Coast ti Air Quality Management District 21865 Copley Drive, Diamond Bar, CA 91765-4182 Phone Number - be (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: P\ ry e k _\�) N'v E Property Address: 2 Mc>,V1 S+Y'e e--V- City: nfl `I-0 ,(\ U ee.,c V\ Zip Code: `i 8 Contact Person: 1'(y )2, T4tlq: Gib Type of Business: `�vrr�b�� Nledci cc�\ qui(df`�Q+'�� Telephone: l�ILO (iT�-3oc-,,-� Fax Number: ' E-mail Address: rj.►\,-,eX c_Gt (1 - o\me i G) Applicant (print name): e- MA&f c\1 CL�_ Signature: Date: YVI g 1. Will the facility release air pollutants, including but riptlimited to, dust fumes, gas, eist, odors, smoke, vapor, or a combination of these to the atmosphere? ❑Yes 9no 2. Will the facility resu of fuel -burning equipment including, but not limited to, boilers, generators, and internal combustion engines? ❑Yes o 3. Will the facility result of hazardous material , 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 Will the facility consist of manufacturing, fabrications, finishing, or treatment of wood, metal or plastic products? ❑Yes to Will the facility result in the use of the equipment listed below? ❑Yes ffNo (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/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). a1q- r?6 _j 0 J� HUNTINGTON BEACH CERTIFICATE OF OCCUPANCY 020 - 0 CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION (3`d Floor— The Applicant Must Apply In -Person) Business Address 11 a !I/'i� �� . SL_[t ,�P �� D Date &oA# / j5�_ Business Owners Name �p�nni nr f-lne%�'%/ j✓r.��/�D�vdnsL/(RUFm�� Zip Code 9_2&!ZP Business Name rr �'nRe, /3u /fin 1 �Telephone No. 7 /!!- 39'/ 7 &S (, Business Type (fin j� n /vthlnc f /,cJ� (�ci /c 4`F•fi�Gty . Bus. Phone -)Iq - /&q ,Q paciC_rt_S •, J t s t+,T � vra Property Owner In12nnation (required) Tenant/EmergencyContact (required) Name '5._ r ct pi '-P* Pfi r 4 r."- rs � L-Lo_ Name Jen n n; I 1 i ✓rA L� Address t 1 5 N. C a hri 1) v NrR 2 .�`3a5Home Address (oa `I Oanuge, City 6r,nfA ft el State/Zip%' A City State/Zip ( J �7.1o2j1s TelephoneNo.-7 1 q 5y"7- OFfOD Telephone No. 38ti—%(4�� THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or 9 ExistingBuilding IS THIS BUILDING FIRE SPRINKLERED? C"Yes ONO CHECK ALL THAT APPLY: ❑ Change of Business Owner [ Change of Occupant ❑ Change of Use . ❑ Additional Occupant ■ Indicate former type of business P�a i 1- 6 ON I'�) S ■ Are you requesting that the electricity be turned on? ❑Yes RNo ■ Will operations produce dust/wood shavings or similar material? ❑Yes [31�0 ■ Will operations involve the repair or replacement of automobile parts? []Yes fff o If yes: Describe the components repaired or replaced. Does the operation involve the use of welding or open flame? ❑ Yes ONO ■ Will the buss ess be a drinking, dining or assembly use with an occupant load of more than 50 persons? ❑ Yes [J No ■ Will there be storage racks, gondolas, or shelviinv�exceeding 5feet 9 inches in height? ❑Yes CBS i�o ■ The following best describes my operation: C'Office Only ❑ Retail Sales ❑Medical/Dental ❑Warehouse /Manufacturing/Distribution ❑ Restaurant/Take-Out Food []Other ■ Will any meat products including beef, poultry, and/or fish bee cooked -or fried onsite? ❑ Yes o If you ansivered 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 For Official Use Onl Occ Group: Occ Group: Occ Group: Total Sq Ft Occupied: _ Bldg. Permit # Area: Occ Load: Area: Occ Load: Area: Occ Load: No. of Stories: TIF Reviewer� INYI``/ N Entitlement #: Zoning: C.' 0 Use Permitted: Y / N Parking Meets Code (for use): Y / N Planning Initials: Date: �0 i� '1 Building Reviewed By Initials: Date: Conditions of Approval or Other Notes: t % Cf Grease Interceptor Verified Inspected By Initials: Date: