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Home My WebLink About6041 Bolsa Ave - CofO (36)HUNTINGTON BEACH Business Business Owners Business Name Business Type CERTIFICATE OF OCCUPANCY 020 16- L,(o`a CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION 0 (3rd Floor - The Applicant Must Apply In -Person) Date WON �p3�% Zip Code / Z ( y7 Telephone No. Bus. Phone _AAProoerty Owner Information (required) ( r�S Tenant/EmergencyContact (required) Name) 01'`h oar � . Cat- NG� eh 1 �� Name Address M 93 9e, Weevily kle • Hom Address 0 S4 S City [_0S4v1q, State/Zip 9y 5 CityLX'F (- State/Zip (A 90Z7-7 Telephone No.',I 0 Z-15 7 Telephone No. )I d Q %s �{ THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or Existing Building IS THIS BU DING FIRE SPRINKLERED? Yes ❑ No CHECK L 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 "0 � • Will operations produce dust/wood shavings or similar material? ❑ Yes DO/No • Will operations involve the repair or replacement of automobile parts? ❑Y o If yes: Describe the components repaired or replaced. • Does the operation involve the use of welding or open flame? ❑ Yes f5 No • Will the business be a drinking, dining or assembly use with an occupant load of more than persons? M Yes ❑ No • Will there be storage racks, gondolas, or shelving exceeding 5 feet 9 inches in height? [ es ❑ No • The following best describes my operation: ❑ce Only ❑ Retail Sales ❑ Medical/Dental ❑ Warehouse/Manufacturing/Distribution [ Restaurant/Take-Out Food ❑�res r • Will any meat products including beef, poultry, and/or fish be cooked or fried onsite? ❑ No If you answered yes, please proceed to the next question. • Does your facil' currently have a grease control device (i.e. grease trap or grease interceptor)? Check one: V Yes ❑No Grease Interceptor Verified For Official Use On/y Occ Group: -A-2- Occ Group: Occ Group: Total Sq Ft Occupied: 35�� Bldg. Permit # Planning Initials:, k Date: / A3 1 Conditions of Approval or Other Notes: Inspected By Initials: Date: Area: IYy0 Area: Area: No. of Stories: Entitlement #: Use Permitted: Y / N Occ Load: Occ Load: Occ Load: TIF Review M Y/ N Zoning: Parking Meets Code (for use): Y / N Building Reviewed By Initials: Z>Q Date: I L i3 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: L Prope Address: City: Contact Person: cxco �l✓ Type of Business: IKkS d-rk�- IrtiVA Zip Code: Title: L%l►�1nLhhnn�` Telephone: ? V 7,W 75q ,, A Fax Number: E-mail Address: 2 Applicant (print name): kco� Sadk e- Signature Date: 1. Will the facility release air pollutants, including but r I/Iimited to, dust fumes, gas, mist, odors, smoke, vapor, or a combination of these to the atmosphere? ❑Yes U240 2. Will.the facility rVNo t of fuel -burning equipment including, but not limited to, boilers, generators, and internal combustion engines? ❑Yes 3. Will the facility result of hazardous materia , including but not limited to, chemical, plastics, rubber, resins, solvents, paints, and other parts cleaners? ❑Yes PlNo 4. Will the facility have use of above or underground storage tank? ❑Yes U<10 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 No (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 /Extruding/Curing of Plastic ❑ Pharmaceutical/N utraceutical ❑Plasma/Laser Cutter ❑Printing/Coating/Drying , r. ❑ 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/Solvent's/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). ■20M Department of Planning & Building 2000 Main Street Huntington Beach, CA 92648 Phone: (714) 536-5241 Fax: (714) 374-1647 Occupancy Application !660041 Bolsa Ave 1 IHENDIFAR PAUL E & SHAHNAZI 6041 1 i APN 195-053-17 of Occupancy A• • • Application Binder Num Street _ _ _ rr Unit rr Bldg Job Addressr6041 16olsa Ave___h._ APN 1195 053-17 _ - RD (2812 -- _ Zoning tCG Lot 10 I Tract S0005_i Block �11 File Number CofO? f02013-006305 Yes Entered By Bolls, Derek IP2014-002616 No -02014-003828 Yes Default Inspector Martin, Brian �P2014-004168 No Permit Type Certificate of Occupancy �C2014-004564 No — 102015-005646 Yes Origin (Counter f 1 E2015-005942 IC2015-006522 No No Building Use - City �i ' B2018-000251 IE2018-000354 No Building Use - County D New Building? No iM2018-000356 No Description MIRAGE CAFE & LOUNGE 02018-001481 Yes Internal Notes CofO Number CO2018-001481 ' Choose Print All CofO Type Permanent —� Sheets to Issue Issued By Pei itl — Single C/O CofO Status Issued CofO Date Issued ;03/0812018 Utility Release Date Temp. CofO Issued Temp. COFO Expiration License Number ` Business Name Business Type Business Phone Proposed Use RESTAURANT Former Use RESTAURANT Conditions (CHANGE a Date Entered �03/08/2018 —� Status rrlssued i l_ Issue Permit? j�j Date 03/08/2018 _ —..._ — Issued By iPermiti I Planner I Bourgeois, Nicolle Plan Checker (Bolls, Derek Fees and Payments Inspections Date Printed 03/08/2018 Click the « button to copy the Business License information into the Certificate of Occupancy. Business Licenses Business Name A156254 SUPREME DONUT A148778 DRAGONS PALACE A181256 DRAGON PALACE CHINESE A155734 GEOCOPY 2 Approved Occupied Area (Scl Ft) 3,540.00 # of StoriesFl—__1 Change of Owner? Elec. Available? 0 Drinking I Dining > 50 Occupants? Change of Use? Want Electricity On? 0 Welding / Open Flame? U Change of occupant? ❑ Sprinklered? ❑ Automobile Repairs? 11 Additional Occupant? El Dust / Wood? Auto Parts Desc. Occupancy • • •.• Group Description Area Construction Type Occupancy Load A-2 RESTAURANT 3540 131 A-2 I RESTAURANT 3540 131 i Group DefinitioAssembly Use - Building or structure, or a portion thereof, used for the gathering of persons, intended for food and/or ,drink consumption. Type Business Owner Property Owner Business Owner ;Tenant i Name field must be blank to add/change Contractor, Designer or Engineer Same As i Contractor Designer / Engineer Mobile Phone l( ) - Name ANDRAOS, JOHN Pager ( ) - Company MIRAGE CAFE & LOUNGE State License Type I Address 6041 BOLSA AVENUE #7 ❑ Self Insured / Non -Employer? City (State /Zip HUNTINGTON BEACH CA 92647 a Override Contractor Expiration Dates? Email Phone (714) 892-3200 x Fax Date Overridden Overridden By