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Home My WebLink About17122 Beach Blvd - CofO (21)• HUNTINGTON BEACH CERTIFICATE OF OCCUPANCY 020 l8 - CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION (3rd Floor - The Applicant Must Apply In -Person) Business Address ZZ �EA CO kV2 0 3 Date [ 2 4 D 6Z_D1 Business Owners Name kl ri- 1 �}� 1�) fi l� S Zip Code q 2 Ca 4-7 Business Name PEA RL`f S MILE EIS �1 L Telephone No - 2 - b Business Type , LJT IS T12`'i Bus. Phone Z _ �� Property Owner Information (required) Tenant/Emergency Contact (required) Name E,\Ak' nyMik") - P(A,�.(l"t, C&"Ati U C, Name IPIJ0N� NG V ELI Address } 2' 7 �_ S Cie n� l`t.� ,� wa�t^n Home Address (� (� Z-i (�GoKt �U S I S!/ I'�D City 2)0,n�. State/Zip MCA- a, City E2j�QAIIJ LO LLl State/Zip CAqnj Telephone No. .�h 4_ i?, 0 z Telephone No. ( 2� 3 S�j— �j 3 ?j THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or `f 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 T)twTts T (ZY • Are you requesting that the electricity be turned on? ❑Yes 15a No • Will operations produce dust/wood shavings or similar material? ❑ Yes IgNo • 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 IA 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 'KNo • The following best describes my operation: ❑ Office Only El Retail Sales 14 No ❑ Warehouse/Manufacturing/Distribution ❑ Restaurant/Take-Out Food ❑ Other • Will any meat products including beef, poultry, and/or fish be cooked or fried onsite? ❑ Yes 9 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 allo Grease Interceptor Verified Inspected By Initials: Date: For Official Use Only Occ Group: Occ Group: Occ Group: Total Sq Ft Occupied: Bldg. Permit # �6/"i� (2-10-�8 Planning Initials: Date: Area: �� k0j::; Area: A 01 Area: No. of Stories: Entitlement #: Use Permitte ( Y"/ N Building Reviewed B Occ Load: 141 y Occ Load: 1 Occ Load: TI F Review: Y/ N Zoning: Cam- 1-4 Parking Meets Code (for use Y / N Initials:f4Lj_Date: ?' 0/18 Conditions of Approval or Other Notes: A-VV I Tf 0JAL- 0&,Q (2A k11' — (; x (iT( I � Jam, A L D �� 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: y �`�tzl W\-( SIMILE (iZNi` L Property Address: ( t I 2-2. t3t/AC H (3LVD City: BEE C H zip Code: 92 04 I-7 Contact Person: UN (: NCai Title: stcp\r 4 IZ j Type of Business: NTNT&j Telephone: 1 2-- Fax Number: E-mail Address: Applicant (print name): LIfT I�AN Signature: Date: (2 1. Will the facility release air pollutants, including but of limited to, dust fumes, gas, mist, odors, smoke, vapor, or a combination of these to the atmosphere? ❑Yes [No 2. Will the facility result of fuel -burning equipment including, but not limited to, boilers, generators, and internal combustion engines? ❑Yes N Vo 3. Will the facility result of hazardous materials, including but not limited to, chemical, plastics, rubber, resins; solvents, paints, and other parts cleaners? ❑Yes Lsl�o 4. Will the facility have use of above or underground storage tank? ❑Yes VNo 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 151No (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). Department of Planning & Building Ow 2000 Main Street ) Huntington Beach, CA 92648 Phone: (71.4) 536-5241. Fax: (714) 374-1647 Occupancy Application 17122 1 Beach Blvd 1103 BANK CALIFORNIA FIRST 17122 APN 1167-325-15 lCertificate of Occupancy Application Application Binder Num Street Unit Bld Job Address 17122 Beach Blvd 1103 1 APN 167-325-15 RD 3316 Zoning CG Lot 25 Tract S0005 Block 11 File Number CofO? NOTE: Permit Type 'COMBO' not available for Commercial projects. P2003-031224 No P2003-031226 No P2003-031563 No P2003-032050 No S2001-002967 No 02003-011523 Yes 02006-007486 Yes 02006-008434 Yes 02006-008971 No 02008-000704 Yes 02009-001639 Yes 82009-002450 Yes Entered By Tavakoli, Jasmine �� Date Entered 05/11/2009 Default Inspector Knight, SteveStatus Finaled ^� Permit Type Building Issue Permit? Date 06/02/2009 Origin Counter Issued By Permit3 T� Building Use - City C-MISC Commercial Misc 1 Planner Building Use - County 34.1 New Building? Plan Checker Description i INT. T.I. TO CREATE NEW DENTAL OFFICE -DR. HAN HA DUONG" (C OF O IN FILE) "'PLANS SENT TO SCANNING-TL 10/09" Internal Notes CofO Number I CO2009-02450 Choose Print All CofO Type Permanent Sheets to Issue--- --- - Issued By Diaz, Michele Single C/O CofO Status Issued Fees and Payments Inspections CofO Date Issued 11/13/2009 Temp. CofO Issued Date Printed —71 Utility Release Date _ Temp. COFO Expiration - 11/13/2009 --- Click the « button to copy the Business License License Number A273588 information into the Certificate of Occupancy. Business Name HAN HADUONG DDS INC/BRACES & T Business Licenses Business Name A256654 THIBAULT DAVID Business Type I Professional /Other A228382 NEW LIFE REHABILITATION INC Business Phone (562) 904-2157 A238916 CHARLES W JACKSON M D INC A236862 AVALON MASSAGE Proposed Use JDENTAL OFFICE Former Use JTRAiNiNE CENTER Conditions Approved Occupied Area (Scl Ft) 11,647.00 # of Stories Change of Owner? Elec. Available? 0 Drinking / Dining > 50 Occupants? Change of Use? Q� Want Electricity On? Welding / Open Flame? Change of Occupant? ❑ Sprinklered? Automobile Repairs? 0 Additional Occupant? Dust / Wood? Auto Parts Desc. Occupancy GrouplLoad Grout) Description Area Construction Type Occupancy Load B MED OFFICE 1358 Type V - B 14 B B MED OFFICE LOBBYNVAITING 1358 289 Type V - B Type V - B 14 19 Business Use - Building or structure, or a portion thereof, used for office, professional or service -type transactions, Group Definitio 9 P p Ype