The URL can be used to link to this page

Home My WebLink About5500 Bolsa Ave - CofO (63)2 HUNTINGTON BEACH Business Add Business Owr Business Narr Business Typ( CERTIFICATE OF OCCUPANCY 020 J? - ' VF q q CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION (3rd Floor — The Applicant Must Apply In -Person) `-1 Date —nU�/ f� p-NeG Zip Code Telephone No '�__LkV 6 Bus. Phone 417 ' 3%�3 "9By Propertv Owner Information (required) Tenant/Emergency Contact (required) Name ge/y e / !�T Address Home Address G✓ City S®tatte/Zip -A City State/Zip � &.4 Telephone No.��' lJ 75i Telephone NoC_ THIS USE WOULD BE DESCRIBED AS: �[ El Newly Constructed Building or I61 Existing Building IS THIS BUILDING FIRE SPRINKLERED? ❑ Yes ❑ No CHECK ALL THAT APPLY: • KChange of Business Owner ❑ Change of Occupant ❑ Change of Use ❑ Additional Occupant icate former type of business • Are you requesting that the electricity be turned on? ❑Yes No • Will operations produce dust/wood shavings or similar material? ❑ Yes No • Will operations involve the repair or replacement of automobile parts? ❑Yes '�Vo If yes: Describe the components repaired or replaced. • Does the operation involve the use of welding or open flame? ❑ Yes A No • Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? ❑ Yes )(No • Will there be storage racks, gondolas, or shelving e c eding 5 feet 9 inches in height? ❑Yes XNo • The following best describes my operation: [Office Only ❑ Retail Sales ❑ 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? El 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 Vo Grease Interceptor V rifled Inspected By Initials: Date: For Official Use Onl Occ Group: Occ Group: Occ Group: Total Sq Ft Occupied: Bldg. Permit # Area: Area: Area: No. of Stories: Entitlement #: Occ Load: Occ Load: Occ Load: TIF Review Zoning: Y/N IL Use Permitted: Y / N Parking Meets Code (for use): Y / N Planning Initials: � ! Date: 1 1r5'( 8 Building Reviewed By Initials: Date: Conditions of Approval or Other Notes: C) F F i Cr--- TO O Fr- I C;p- South Coast Air Quality Management District 21865 Copley Drive, Diamond Bar, CA 91765-4182 " Phone Number (909) 396-3529 http://www.agmd.gov 0D 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: City: Contact Person: Type of Business: Zip Code: Title: Telephone: Fax Number: E-mail Address: Applicant (print name): 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 o 2. Will the facility re of fuel -burning equipment including, but not limited to, boilers, generators, and internal combustion engines? []Yes o 3. Will the facility result of hazardous mat ri s, including but not limited to, chemical, plastics, rubber, resins, solvents, paints, and other parts cleaners? ❑Yes V,,No 4. Will the facility have use of above or underground storage tank? ❑090 Yes 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 Xo (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 ❑Coffee Roaster/Afterbunner ❑Internal Combustion Engine (rated > 50 bhp; e.g. back-up generator) ❑Mixing/Blending of Liquids and/or Powders ❑Molding /Extrudi ng/Cu ring of Plastic ❑ Pharm ace utical/N utraceutical ❑Plasma/Laser Cutter ❑ Printing/Coating/Drying ❑ Production of Fumes/Dust/Smoke/Odors ❑Refrigeration Systems (containing > 50 Ibs of refrigeration ❑Deep Fryer (excluding equipment located at eating establishment) ❑Soldering Oven ❑Dry Cleaning Equipment ❑Spray Booth ❑Electrostatic Precipitator ❑Storage of Acids/Solvents/Organics Liquids/Fuels ❑Fermentation ❑Storage Silos (sugar, flour, etc.) ❑Gasoline Storage & Dispensing Equipment 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). 0--1- 0&--r?4Q t �e 714/536-5271 Certificate of Occupancy No. 0200 -( Oq E' Z APPLICATION FOR CERTIFICATE OF OCCUPANCY I ml- CITY OF HUNTINGTON BEACH - DEPT. OF BUILDING & SAFETY Business License # t ogos c2 (3r° Floor — Must Apply In -Person) Business Address "p D (6 v L + r" 11 5 1 . CN Business Owners Name L f)U Jq t3 _ t- L p 5 o fy Business Name = L L 156 4 t a j e 4- 5 Business Type j0 k4 ('90 f 0 R 13 T I D fi 1✓ I a0i r�dflfi( 016TW Date 2— 0 7 Zip Code 941 Telephone No.7/ V -W'!b - 080 9 Bus. Phone :) ► -j - 7 fa -y 707 Property Owner Information (required) Tenant/Emergency Contact (required) Name t 1 t yV t (rY6 t`onl M?a-t l + ('A R TrV v`/L 5-N / (j Name LO 1 ,C) (: I-Z 1 I'll Address )5�.L( i�AtVSt d�' _�19N( Home Address 0a . City J 1 a n)r . (; rot ci"tate/Zip C yg- City C 5 rA f 4-FaL State/Zip 614 q�ZG 8 -9 Telephone No. 7 I Y' �� " 7� �7 Telephone No. 7 N ' 3 1-6 9 / 1-1 rLe�3 Ear Si � �L/�,�Gt-f7' THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or istmg Building CHECK ALL THAT APPLY: ❑ Change of Property Owner 01�hange of Occupant 0 Change of Use ❑ Additional Occupant ■ Indicate former type of business ■ Are you requesting that the electricity be turned on? YesQNol( ■ Is the building sprinklered? Yes,>No❑ ■ Will operations produce dust/wood shavings or similar material? YesQNo'0 ■ Will operations involve the repair or replacement of automobile parts Yes ONo If yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? Yes ONo'K ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? Yes QNox ■ The following best describes my operation: ;K Office Only ❑ Retail Sales ❑ Medical/Dental ❑ Restaurant/Take Out Food ❑ Warehouse /Manufacturing/Distribution (describe process and end product) ❑ Other (describe) For Q ficial Use Only Oec Group: Occ Group: Occ Group: Total Sq Ft Occupied: 760 Bldg. Permit # Area: Area: Area: No. of Stories: Entitlement #: Occ Load: Occ Load: Occ Load: TIF Review: Y� Zoning: :J Plnr Initials. Date: 13 D'*Plan Chkr Initials: Date: Insp Initials: Date: Conditions of Approval or Other Notes: VFF1 61e7 orrice f�o C Z'F O Inspection Date: (G:Building/Forms/document id goes here)