HomeMy WebLinkAbout19030 Brookhurst St - CofO (2)0`
HUNTINGTON BEACH
Business Add
Business Owr
Business Nan
Business Typi
CERTIFICATE OF OCCUPANCY V620 -
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION
(3rd Floor — The Applicant Must Apply In -Person)
Date 8
Zip Code,?
Telephone No.`i 14 2(0"7 2( trU
Bus. Phoneg4!j 42:;?, (og-f dL
Property Owner Information (required) f / / Tenant/Emergency Contact (required)
Name � Ir66t`v 1U 1/S� ++ LJ - _ Name �,Gl4A ( t'-email !! Y� d 1'� p �q
Address N5A -325 0 Ct CatM 10 0 V�Q� Home Address
Sl'1 Q ✓�QMd�a�T l�
City
�v State/Zip
aD® p k C- 2-�1�Q City t"f State/Zip .Ul cj.2 % q (o
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Telephone No. R ;� S-75 D Telephone No. -71 q 2-Co % Z(. n 0
M fA 1-5 Sa
THIS USE WOULD BE DESCRIBED AS: -- //
El�� Newly Constructed Building or 'Existing Building
IS THIS BUILDING FIRE SPRINKLERED? ❑ Yes &�,No
CHECK ALL THAT APPLY:
❑ Change of Business Owner 215hange of Occupant u4ange of Use ❑ Additional Occupant
• Indicate former type of business c,, le-,
• Are you requesting that the electricity be turned on? lames 111 No
• Will operations produce dust/wood shavings or similar material? ❑ Yes 531�o���
• Will operations involve the repair or replacement of automobile parts? ❑Yes ®J o 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 w1fVo
• The following best describes my operation: ❑ Office Only ❑ Retail Sales. ❑ Medical/ ental
❑ Warehouse/Manufacturing/Distribution ❑ Restaurant/Take-Out Food Other tp'gM-e4,lYIC,irncl�%4
• Will any meat products including beef, poultry, and/or fish be cooked or fried onsite? ❑ Yes U?Kb S+Uc co
If you answered yes, please proceed to the next question.
• Does your facility currentjy have a grease control device (i.e. grease trap or grease interceptor)?
Check one: ❑ Yes iNo
Grease Interceptor Verified
For Official Use Only
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied: 6 T2_
Bldg. Permit # bi� OCR
Planning Initials: 1 f J Date: 1�
Conditions of Approval or Other Notes:
IA & -IA i) Gye �Z1 &1
Inspected By Initials:
Area: 1 2—
Area:
Area:
No. of Stories:
Entitlement #:
Use Permitted: Y / N
Date:
Occ Load: `F-7
Occ Load:
Occ Load:
TIF Review:,,-Y/
Zoning: (>(�
Parking Meets Code (for use): Y / N
Building Reviewed By Initials ate: . �. i r
15 Sid&hf5 /1uhnA) cno gc,5�i�n • Maxi X
South Coast
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
Phone Number (909) 396-3529 http://www.agmd.gov
A
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).
Coml
Props
City:
Conti
Type
Fax P
Appli
1. Will the facility release air pollutants, including but npt limited to, dust fumes, gas, mist, odors, smoke, vapor, or a
combination of these to the atmosphere? ❑Yes 040
2. Will the facility res of fuel -burning equipment including, but not limited to, boilers, generators, and internal combustion
engines? ❑Yes ZNo
3. Will the facility result of hazardous materia , including but not limited to, chemical, plastics, rubber, resins, solvents,
paints, and other parts cleaners? ❑Yes fNo
M
4. Will the facility have use of above or underground storage tank? ❑Yes M/No
5. Will the facility consist of manufacturing, fabrications, finishing, or treatment of wood, metal or plastic products? ❑Yes to
6. Will the facility result in the use of the equipment listed below? ❑Yes N�No
(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/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).
N-g306
Department of Planning & Building ow
2000 Main Street
Huntington Beach, CA 92648
Phone:(714)536-5241 Fax:(714)374 _ Occupancy Application
1647
19050 BA
rst St
19030 st St-23
Certificate of Occupancy Application
ADolication Binder
Num Street Unit Bldg
Job Address 19030 Brookhurst St APN 155-281-23 RD 3720
Zoning CG Lot = Tract = Block
File Number Cofo?
B2010-006826 No
B2011-000272 Yes
E2011-000398 No
02011-001200 Yes
E2011-001462 No
P2011-001464 No
M2011-001634 No
02011-002191 Yes
02011-000272 Yes
02011-002229 Yes
02011-003286 Yes
02011-003905 Yes
Entered By Daley, Jasmine Date Entered 07/06/2011
Default Inspector Dean, Mike Status Pending
Permit Type Certificate of Occupancy Issue Permit? Date
Origin Counter —� Issued By !�
Building Use - City Planner Villasenor, Jennifer f
Building Use - County o New Building? Plan Checker Daley, Jasmine
Description SCRAPBOOKING "`ONCE UPON A MEMORY --
Internal Notes
i
—tificate of Occupancy
CofO Number CO2011-003905 Choose Print All CofO Type Permanent Fees and Payments
y Sheets to Issue ��
Issued B Single C/O CofO Status Pendin Inspections
i
Cofo Date Issued Temp. CofO Issued —� Date Printed
Utility Release Date Temp. COFO Expiration_ .
License Number A224750
Business Name ONCE UPON A MEMORY
Business Type Retail
Business Phone (714) 965- 0088
Proposed Use LLETAIL
Former Use RETAIL
Conditions
Click the « button to copy the Business License
information into the Certificate of Occupancy.
Business Licenses Business Name
A154286 DANIELLE
A004684 SHOREPOINT INSURANCE SERVIC
A222832 SOUTH SHORES INSURANCE AGE
A009720 RICHARD'S BEAUTY COLLEGE
Approved Occupied Area (Sq Ft) 3,000.00
# of Stories I
Change of Owner?
Elec. Available?
Drinking / Dining > 50 Occupants?
U
Change of Use?
❑: Want Electricity On?
Welding / Open Flame?
Change of Occupant?
❑ Sprinklered?
Automobile Repairs?
Additional Occupant?
Dust / Wood? Auto Pads Desc.
Occupancy Group/Load
Grouo Description
Area
Construction Type Occupancy Load
M
SALES
3000
100
M
SALES
3000
100
Group Definitio
Mercantile Use - Building or structure, or a portion thereof, used for the display and sale of merchandise, and involves
atnrkc of nnnrls warps nr mPrrhandi4P incidental to such nurnoses and accessible to the oubiic.