HomeMy WebLinkAbout15471 Edwards St - CofO (24)A
CERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
020
DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION
HUNTINGTON BEACH
(3r Floor -The Applicant Must Apply In -Person)
Business Address
Business Owners Name zip 1, L
Business NamE
Business Type
Date �)� kn-
Zip Code !3 1 111 `7
Telephone N�l
Bus. Phone
/Property Owner Information (required) Tenant/EmergencyContact (required) j
Name ( � uun' S (1 �d �� rr\a Y\ � Name
Address \ 0 Home Address L 67 0 �._ �60�
City �� State/Zip �d City C _SS l State/Zip-
Telephone No%�Telephone No. -S�.Z►WO2
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or �-Existing Building
IS THIS BUILDING FIRE SPRINKLERED? %5�Xes ❑ No
CHECK ALL-THAT-APpPLI�E
hange of Business Owner ❑ Change of Occupant ❑ Change of Use ❑ Additional Occupant
• Are you requesting that the electricity be turned on? ❑Yes ) J No
• Will operations produce dust/wood shavings or similar material? ❑.,Yes 4No
• Will operations involve the repair or replacement of automobile parts? [-]Yes VWo 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�j No
• • Will there be storage racks, gondolas, or shelving exceeding 5 feet 9 inches in height? ❑Yes V]_No
• The following best describes my operation: ❑ Office Only Retail Sales ❑ Medical/Dental
❑ Warehouse/Manufacturing/Distribution dZ-Fiestaurant/Take-Out Food ❑ Other
• Will any meat products including beef, poultry, and/or fish be cooked or fried onsite?o-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: q6jes ❑No
Grease Interceptor Verified Inspected By Initials: Date:
For Official Use On/y
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied: r5.
Bldg. Permit #
Planning Initials Date.121-hs
Area: I
Area:
Area:
No. of Stories: N
Entitlement #:
Use Permitted: Y / N
Occ Load: 0-5
Occ Load:
Occ Load:
TIF Review: / 1 .
Zoning: J
Parking Meets Code (for use): Y / N
Building Reviewed By Initials: rAti Date:
of Approval or Other Notes: — os� oa�TK' y
F
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.tiusiness 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
Prop,
City:
Cont;
Type
Fax f
Appli
1. Will
combination of these to the atmosphere? ❑Yes ONo
i 2. Will the facility rt of fuel -burning equipment including, but not limited to, boilers, generators, and internal combustion
engines? ❑Yes 50 -
3. Will the facility result of hazardous material , including but not limited to, chemical, plastics, rubber, resins, solvents,
paints, and other parts cleaners? ❑Yes 14No
i 4. Will the facility have use of above or underground storage tank? ❑Yes V0
b. Will the facility consist of manufacturing, fabrications, finishing,
or treatment of wood, metal or plastic products? ❑YesANo
16. Will the facility result in the use of the equipment listed below?
❑Yes lknwo
(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)
❑Mixing/Blending of Liquids and/or Powders f
❑Application of Paints/Adhesive/Resins
❑Molding /Extruding/Curing of Plastic
❑Baghouse/Dust Collector
❑Pharmaceutical/Nutraceutical
❑Bakery Oven (gas fired)
❑Plasma/Laser Cutter
�Boiler/Water Heater (max. heat input = or> 1 million BTU/I-r)
❑Printing/Coating/Drying
❑Charbroiler/Smoker
❑ Production of Fumes/Dust/Smoke/Odors
❑Coffee Roaster/Afterbunner
Refrigeration Systems (containing > 50 Ibs of refrigeration
Queep Fryer (excluding equipment located at eating establishment) ❑Soldering Oven
❑Dry Cleaning Equipment
❑Spray Booth
❑Electrostatic Precipitator
❑Storage of Acids/Solvents/Organics Liquids/Fuels '
❑Fermentation
❑Storage Silos (sugar,iflour, 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).
41 kl
Department of Planning & Building
2000 Main Street
i
Huntington Beach, CA 92648 anc Occu Application
Phone: (714) 536-5241 Fax: (714) 374-1647 Occupancy pp
15471 1 Edwards St B QUAN SACK LEM
15471 APN 145-165 55
Application Binder
Num Street Unit- Bld
Job Address F5471 Edwards St I F APN 145-165-55 RD 2912
Zoning JCG Lot 296 Tract 3846 Block LLJ
File Number CofO?
02002-010415 Yes
02006-005003 Yes
02010-003461 Yes
P2010-003476 No
M2010-003477 No
E2010-003503 No
C2010-003678 No
82010-004065 No
02010-004989 Yes
02012-001760 Yes
02013-006102 Yes
02016-001721 Yes
Entered By ]Woo, Melanie
Default Inspector Ford, Bill
Permit Type Certificate bf Occupancy
Origin Counter
Building Use - City 1 F_
Date Entered 03/08/2016
Status Issued
Issue Permit? ®' Date 03/14/2016
Issued By jPermitl
1 Planner jKelley, Jason
Building Use - County �;Lj New Building? Plan Checker Woo, Melanie
Description ""RANCHO VIEJO MEXICAN & SEAFOOD GRILL' —
Internal Notes i3/14/16 DS -PER INSPECTION ON 3/9/16 BY VS ON COFO # 013-6102, ALL
ITEMS APPROVED.
CofO Number CO2016-00172Ij Choose PfintAll CofO Type I Permanent
Sheets to Issue
Issued By IPermitl Single C/O CofO Status Issued
Co'0 Date Issued 03/14/2016 Temp. CofO Issued
{
Utility Release Date Temp. COFO Expiration r�
License Number
Business Name
Business Type
Business Phone ( )
Proposed Use
RESTAURANT / FAST FOOD
Former Use
RESTAURANT n
Conditions
CHANGE OF OWNERSHIP/ t
Fees and Payments
Inspections
Date Printed
03/14/2016
Click the « button to copy the Business License
information into the Certificate of Occupancy.
Business Licenses Business Name
A166472 OCEAN BREEZE CLEANER
A122660 GRANDY'S DONUT
A118332 GRANDPA G'S BAR B Q
A190806 OCEAN BREEZE CLEANERS
Approved Occupied Area (Sci Ft) 1,375.00
# of Stories 1I
Change of Owner?
U Elec. Available?
Drinking / Dining > 50 Occupants?
Change of Use?
Want Electricity On?
Welling / Open Flame?
Change of Occupant?
❑ Sprinklered?
❑ Automobile Repairs?
Additional Occupant?
Dust / Wood? Auto Parts Desc.
Occupancy ...
Grouo Description Area
Construction Type Occupancy Load
B
RESTAURANT
1375
25
B
RESTAURANT
1375
25
Group Definitio
Business Use - Building or structure, or a portion thereof, used for office, professional or service -type transactions,
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