HomeMy WebLinkAbout19670 Beach Blvd - CofO (5)•
HUNTINGTON BEACH
CERTIFICATE OF OCCUPANCY 020 ]$- a
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION
`d M A 1 In P
(3 Floor - The Apphcant ust pp y - erson)
Business Address
Date ,- 6 �.c, j
Business Owners
Name L-cm- <S"t- /Y �;,..
_Nn,_
Zip Code 7� Gy7
Business Name
ti
Telephone No. --4?1- -
Business Type
Bus. Phone
� S_'�7
06
Property
Owner Information (required) Tenant/Emer e
c Contact (required)
Name
Cv✓kry Name
Address 1'l
a -a Home Address .7,F
ceyl-14'v-0 be- 1� y- 4hAt-.o
jz'h/
City Sa C
Q t State/Zip C t- cl� 7,oS- City .S� G,�a-,�, w
State/Zip G!�
Telephone No.
�l b y — 59 a --7 o u� Telephone No.
`%l� —d-175'
THIS USE WOULD BE DESCRIBED AS: ��
O Newly Constructed Building or [i�Existing Building
IS THIS BUILDING FIRE SPRINKLERED? ❑ Yes E]No
CHECK ALL THAT APPLY:
[9/C-hange 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 o
■ Will operations produce dust/wood shavings or similar material? ❑ Yes EJNo'
■ Will operations involve the repair or replacement of automobile parts? ❑Yes ERI-6 If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? ❑ Yes o
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
❑ Yes ELN6
■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? ❑Yes EZI>K
■ The following best describes my operation: ❑ Office Only detail. 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 EL_Wi5'_
If you answered yes, please proceed to the next question.
• Does your facility curreenttllY have a grease control device (i.e. grease trap or grease interceptor)?
Check one: El Yes �Z
For Official Use Onl
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied: 1006
Bldg. Permit #
Planning Initials o
JJALDate:
Conditions of Approval or Other Notes:
Area: < b u b
Area:
Area:
No. of Stories: 1
Entitlement #:
Use Permitted: Y / N
Occ Load:
Occ Load:
I a_
OccLoad:
TIF Review: Y_ /-�N
Zoning: _
`(
Parking Meets Code (for use): Y / N
Building Reviewed By Initials:Date: 14 i&
%I-
V1p rsk
Grease Interceptor Verified Inspected By Initials: Date:
r South Coast
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
p (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:
Property Address:
City:
Contact Person:
Title:
Type of Business: Telephone:
Zip Code:
Fax Number: -e-mail address:
Applicant (print name):
Signature:
Date:
• Will the facility have any of the following equipment? Yes ❑ No ❑
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 I 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❑ No❑
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-
r
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:
Property Address:
a
City: 4(W_h,�r-bCAzL 11:�^ Zip Code: 471 C''1 %
op
Contact Person: e� Title: 1101-e-sie,"
Type of Business: ikli Sfl'�oN Telephone: 7/ 6--- A �,c- 8 s—
Fax Number: /V/A E-mail Address: ejAOV�,ryyi 41,1+-
Applicant (print name): #f>4,✓&,J Signature: _ Date: P dW -4�p
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 ❑Xo
2. Will the facility result o duel -burning equipment including, but not limited to, boilers, generators, and internal combustion
engines? ❑Yes o
3. Will the facility result of hazardous materials, including but not limited to, chemical, plastics, rubber, resins, solvents,
paints, and other parts cleaners? ❑Yes [UN6
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 ®fo
6. Will the facility result in the use of the equipment listed below? ❑Yes Leo
(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 fired)
❑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/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).
•
�J
HUNTINGTON BEACH
CERTIFICATE OF OCCUPANCY 020 -
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION
Business Address
Business Owners Name
Business Name
Business Type
Property Owner Information (required)-'
Name Name
(3rd Floor — The Applicant Must Apply In -Person)
Date
Zip Code
Telephone No.
Bus. Phone
Tenant/Emergency Contact (required)
Address Home Address
City State/Zip City.
Telephone No. Telephone No.
THIS USE WOULD BE DESCRIBED AS:
State/Zip
❑ Newly Constructed Building or ❑ Existing Building
IS THIS BUILDING FIRE SPRINKLERED? ❑ Yes ❑ 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 ❑ No
• Will operations produce dust/wood shavings or similar material? ❑ Yes ❑ 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 an 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 ❑ No
• 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? ❑ 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 On/y
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied:
Bldg. Permit #
Planning Initials: Date:
Conditions of Approval or Other Notes:
Area:
Area:
Area:
No. of Stories:
Entitlement #:
Occ Load:
Occ Load:
Occ Load:
TIF Review
Zoning:
Y/ N
Use Permitted: Y / N Parking Meets Code (for use): Y / N
Building Reviewed By Initials: Date:
Department of Planning & Building
? 2000 Main Street
Huntington Beach, CA 92648
Phone: (714) 536-5241 Fax: (714) 374-1647
Sip
19676 1 Beach Blvd W T NEWLAND ESTATE
19694 APN 153-091-22
Occupancy Application
Application Binder
Num Street Unit Bldg
Job Address 19670 Beach Blvd APN 153-091-22 RD 3816
Zoning CG Lot Tract P0158 Block 43
File Number CofO?
02011-001749 Yes
B2011-003549 No
M2011-003550 No
E2011-003553 No
P2011-003554 No
B2011-003556 No
E2011-003557 No
M2011-003558 No
P2011-003559 No
B2011-004560 No
02011-005953 Yes
Entered By Watson, Daniel Date Entered 10/14/2011
Default Inspector Dean, Mike Status Issued
Permit Type Certificate of Occupancy Issue Permit? 0 Date 02/25/2013
Origin Counter Issued By Cochran, Brian
Building Use - City Planner Nguyen, Tess
Building Use - Countyt� New Building? Plan Checker Lee, Eddie
Description 1"`SUPERCUTS--
Internal Notes
of Occupancy
CofO Number CO2011-005953 Choose PrfntAll CofO Type Permanent I Fees and Payments
Sheets to Issue
Issued By Cochran, Brian Single C/O CofO Status Issued Inspections
CofO Date Issued 02/25/2013 Temp. CofO Issued Date Printed
Utility Release Date Temp. COFO Expiration I11 02/25/2013
License Number A281622
Business Name SUPERCUTS #90846
i
j Business Type Professional / Other
Business Phone (714) 694-5706
Proposed Use SALON
Former Use SALON
Conditions
Click the « button to copy the Business License
information into the Certificate of Occupancy.
Business Licenses Business Name
A225640 YOGA SHAKTI
A244722 PIPALOFF DIANA
A107220 FANTASTIC SAM'S
A202276 FANTASTIC SAMS
Approved Occupied Area (Sci Ft) 1,000.00
# of Stories{,
Change of Owner?
Elec. Available?
Drinking / Dining > 50 Occupants?
Change of Use?
Want Electricity On?
Welding / Open Flame?
��ta11r
Change of Occupant?
Sprinklered?
Automobile Repairs?
Additional Occupant?
Dust / Wood? Auto Parts Desc.
W
Occupancy Grou• ..•
Group Description Area
Construction Type Occupancy Load•
B
SALON
1000
12
B
SALON
1000
12
Group Definitio
Business Use - Building or structure, or a portion thereof, used for office, professional or service -type transactions,
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