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Home My WebLink About16162 Beach Blvd - CofO (45)• 1� JJ HUNTINGTON BEACH CERTIFICATE OF OCCUPANCY 020 - 00<S'T CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION Business Address16162 Beach Blvd, #100 Business Owners Name Kim Phan Business Name Careconnect Business Type Administrative office for medical Property Owner Information (required) NameHuntington Beach Executive Park Name (3'd Floor — The Applicant Must Apply In -Person) Date 11/20/2018 Zip Code 92647 Telephone No. 714-619-8777 Bus. Phone 714-619-8777 Tenant/Ennergency Contact (required) Kim Phan Address16168 Beach Blvd, #200 Home Address 308 Evening Canyon Road City Huntington Beach State/Zip CA / 92647 City Corona Del Mar State/Zip CA / 92625 Telephone No. 714-847-2531 Telephone No. 714-904-4588 THIS USE WOULD BE DESCRIBED AS: O Newly Constructed Building or El Existing Building IS THIS BUILDING FIRE SPRINKLERED? ❑ Yes ONo CHECK ALL THAT APPLY: ❑ Change of Business Owner El 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 M No ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? ❑ Yes El No ■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? ❑Yes ®No ■ The following best describes my operation: ® Office Only ❑ Retail Sales ❑Medical/Dental ❑Warehouse/Manufacturing/Distribution ❑Restaurant/Take-OutFood ❑Other ■ Will any meat products including beef, poultry, and/or fish bee 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 For Official Use Only Occ Group: Occ Group: Occ Group: Total Sq Ft Occupied: Bldg. Permit # Planning Initials: Date( Conditions of Approval or Other Notes Area: Occ Load: Area: Occ Load: Area: Occ Load: No. of Stories: TIF Review: Y/ N Entitlement #: Zoning: Use Permitted: Y / N Parking Meets Code tfor use): Y / N Building Reviewed By Initials: Date: Grease Interceptor Verified Inspected By Initials: Date: v M - (,oS_q Q 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: careconnect Property Address: 16162 Beach Blvd, #100 City: Huntington Beach Contact Person: Kim Phan Title: CEO Zip Code: 92647 Type of Business: Medical Group Telephone: 714-619-8777 Fax Number: 714-619-8770 e-mail address: kPlankcareconnectma.com Applicant (print name): Kim Phan Signature: Date: _L&-Lo-1 Will the facility have any of the following equipment? Yes ❑ No x❑ 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 1 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 x❑ 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- Department of Planning & Bullding 2000 Main Street ^� j Huntington Beach, CA 92648 Phone: (714) 536-5241 Fax: (714) 374-1647 ` \-- Occupancy Application i Property • 4�® 16162 Beach Blvd 100 — HUNTINGTON EXECUTIVE PARK 16162 APN 107-781-04 Certificate of Occupancy A• • • Application Binder Num Street Unit Bldg Job Address 16162 Beach Bivd 100 APN 107-781-04 RD 3116 Zoning SP14-FP2 Lot Tract P0051 Block 48 File Number CofO? 02010-002853 Yes j 02010-003002 No 02010-003003 Yes E2011-003942 No B2012-000975 Yes 02012-002822 No 02013-005754 Yes B2014-007981 No 02014-008162 Yes 02016-003387 Yes 02016-004289 Yes 02016-006304 Yes Entered By Niemczyk, Sandy Date Entered 08/23/2016 Default Inspector Stewart, Vic Status Issued Permit Type Certificate of Occupancy! Issue Permit? Date 08/23/2016 Origin Counter Issued By jPermit3 Building Use - City F Planner Burden, Kimo Building Use - County New Building? Plan Checker Woo, Melanie — Description Internal Notes of Occupancy CofO Number I CO2016-006304 I Choose Print All CofO Type Permanent Fees and Payments Sheets to Issue Issued By Permit3 Single C/O ---- - — - CofO Status Issued Inspections CofO Date Issued 08/23/2016 Temp. CofO Issued Date Printed Utility Release Date Temp. COFO Expiration 08/23/2016 License Number Click the « button to copy the Business License information into the Certificate of Occupancy. Business Name Business Licenses Business Name Business Type A236632 HUGHES JAMES H - MA,MS,LMFT A178108 SOUTH COAST DEALERS SVCS IN, Business Phone ( ) A136584 NEW LIFE REHABILITATION A159878 MONEY STORE THE / CALIF INC. Proposed Use Former Use Conditions 131 Change of Owner? Change of Use? Change of Occupant? 0 Additional Occupant? Approved Occupied Area (Scl Ft) 12,000.00 # of Stories'r3 �! Elec. Available? Want Electricity On? Sprinklered? ❑ Dust / Wood? Auto Parts Desc. !,Occupancy • • •.• Group Description Area Construction Type Occupancy Load nDrinking / Dining > 50 Occupants? Welding / Open Flame? Automobile Repairs? B OFFICE 2000 20 B OFFICE 2000 20 Group Definitio Business Us!- Building or structure, or a portion thereof, used for office, professional or service -type transactions,