HomeMy WebLinkAbout10106 Adams Ave - CofO (2)APPLICATIOO T FOR CER-yFZCATE Off' OCCUPANCY
CITY OF r1.11UN INGTON BEACH - DEPARTMENT OF BUILDING & SA ETY
(3`1 Floor- Must Apply .ilz-Persoti)
i
Business License =`
Business I*'Iame & Telephone L r •��j' yP ,7
Business Type-�'A-}i'� L � Y �� r—`T
Pr000erty Orvi rInformation Business ier
N aerie s-�b r '' Name _ ACM A f 14 to D Pf t
Address Home Address �1
City ii l tt* Tel.. qw— yT�[_ Cit'�Ab,,
THIS USE WOULD BE IDESCRIBED AS: j?' ?DO
❑Newly Constructed Building or R,Existinng Building
CHECK ALL THAT APPLY:
UChange of Owner QChange of Occupant Change of Use ❑Additional Occupant
i7dicate former use, if any
Does the building have electricity? Yes No0
If 1,To, are you requesting that the electricity be turned on? Yes Tr '
The building is sprinklered? Yes a No 0
Operations will product dusthvood shavings or similar material? Yes Q N o
Operations will involve the repair or replacement of automobile parts Yes No
If yes: Describe the components repaired or replaced.
Dogs the operation involve the use of welding or open flame? YesEl J" Tom!
The business _s drinking, dining or assembly use that will result in an occupant load
of more than 50 persons. Yes Q No
The following best describes my operation;
❑ Office Only QRetail Salcs Mvledical/Dental ❑Restq-arant/Take Out Foos ❑ Warehouse
QManufacturing/llistribution (describe process and end product)
Other (describe)
Off,Ce us. a o7! M1 : �
Zoning: •2-_ Sq Ft Occupied: Occ Group: �7_ Occ road:
Stories: V. Parking Spaces:
Building Permit # Oq
Coilu rents: 1'"G u �
Planuier Initials:_ B1d5
TIF Raviezv: YI Ni
Entitlement ':
"ian Checker Initials:
Anil' Paid$:
Paid BEFORE Find Inspec'00n
CofO m
s
. e
South Coast
Air Quality Management District
21865 E. Copley Drive
Diamond B:.r, CA 91765-4182
(909) 396=31529 htpp://Nvw-w.aq.nd.gov
Air Quality Permit Checklist
California Government Code 65850.2 prohibits pities from issuing a Certificate of Occupancy to a business
without clearance from the local, air quality a,-ency. This checklist will determine if you iiecd to obtain
clearance from the South Cowt Air Quality Mana-cment District (AQMD).
1,4 Company Names i dS S
Property Address: ZOID / { A U-e- _ l..Q,fa
City: GE Ci�C,(� Zip Code;
Contact Persosx: ,%) P 1>A U' j Title: 6 r-r �k, ,l tIA14 0 e,o
r—
Type of Business: 1). r-,kr/,) f_ 0Fj'�YC E Telephone: {) �� �l{ — ' ' f
Applicant: (print name) Signa? ure:` D,.,
• Will the facility have any o,: the following equipment? Yes ❑ NQ 19
Charbroiler
Dry cleaning macnine
Spray Booth
Printing Press (screen/lithographic/flexographic)
Internal combustion engine (greater than 50HP) (excluding motor vehicles,)
Boiler/combustion equipment (greater than 2 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 per.tormed? Yes No 0
Application of paints or adhesives
Etching, plating,.casting, or melting of metals
Molding and blending of liquids and/or powders
Storage of -ac ds, solvents, organic liquids or fuels
Production 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 que-scion, you must contact AQNID to determine if air quality permits ape:
required. If permits are needed, AQ.1%FD will assist you in submitting permit application(s) and the, pro', ide you
with a clearance leuc-,n You can call AQiTNM at thzir Small Business ,Assistance office at (800) 388-2121.
°ig+t!Lrk11xiat=_ Ctt;d.lcQif.ladon D-.atfut-'. iJ.1?,. e.el'. rr0�
F,.� iai cenuer rinnie (it appli ,ablc): Bi-oolc.hurst & Adams (Center 213)
Tmari�, Adams, Fenni�y Denial
Standard: -
No. of)c�_ rkiD T�i'LCjtl:l c 7U
S tandarcl:
_ fonant namr.
a7ecupaney
Area
Parking
Parking I Parking I
Remark
use
ratio
required provicl�cl
! ate L't �nit`fca ,i a~--
Retail -Tanning
),26U
i=?OU
7
1 0;U dalt � .` 'c-.
Salon
_
L .3 Pt'iino.. Cantina
Restaurant 11,586
i 1-100
to
K. 16.1:9•ans Avr•
1
• 2 ;
'
f
1
3 ana' . Svn etbrend Y
i j OS ;dans Ave
Non -Retail 1,20E
hiwnen
So Cal `vied Assoc. -TLC --
Medical 4,386
1+175
26 31
Retail -Dance 2,063
Studio
1 ? Y200
11 ltl
`!orris Uaitce. 5ludio `
a54 Adains Ave.
'.[vulut t.ouge L;<tru
101 12 Adapts A vL.
Restaurtnt G,368
I
1=1U0
64 65
1?estattrant 5,502
1-100
56 60�__
i ! `.'atrr
Rotall-I', U 1,596
1-200
. )+17'. ,� eattt:: Avc.
___
s ,blot Situp -�
:�tC1I'(;
Retail -Tailor 920
__
1-250 — (4
1
i
:'J•)il r�dalllS fiVt;.
tic, tuts^� - -
�
detail->7onuts 2,100
1.-200
1
11
1
_ _ I
j.J56 Acl.uns Ave,
_
.ttant
2,074
1-200
11
1l
+)j2Adams Ave.
1p-I" "ell, Reel xstatt:
Office 1.060
1 �2J0
S
E
�ttna's Td�:i1s + _
10046 .".&,ms A vr.
Retail -Nan' °1jop 954 i
1•-200
S
S_��...-
l etail- 1 4nn
�_
1-200
7
�,
C :16 :,.tialu,; ilv:.
Haircutting i
-
C- 120 Adams Ave.
i R Cleaners
Retail-Cleaners1
,400 1 .200
10 118 Adams Ave.
I
11.13. Coin Exchancle
0
Retail -Coin
1 540 8
1+200 0
0 122 Adams Ave,
Shop
I
Coin Laundry
Retail-
--I I -
2,i00 00 11 I
10 It 32 Aclarns Ave.
Laudroniat
11-
1,260 10
7 5
Ada,lis Pet Cflilie
Retail-
'()INAdanis Ave.
Vetefinary
Platinum Plus Records
Retail -Records
7501200 4
10*126 Adarns Ave.,11B
I
I
.S;11-ione & Soils Jewelry
10 1 24-26A(lanis Ave., VA
Retail -Jewelry
2,610 1-.200 14 17
Sauter Bros #0147
tOl 14 AdanisAve.
Retail -Grocery
Store
41,975
1200
21 ' 0
Vacant
10112AdernsAve.
3 500
L
1-200
18
2,000
1+2-13
0
1
"icant
10 110 Adanis Ave.
If
(,'uas, Cities Escrow
Office 11,750
1+ 250 1
7 v
9
10104 Adams Ave.
Adanis fitnifly Denfn]
Dentist
3,500
1-175
28
10100 Adains Ave.
_)O "5
jj
T.B. Beauty Si pply
Retail-Deauty
5,865
1-200
10090 Adonis Avc.
Supply
LanipposL Pizza
Restaurant
3,452
1+100
10084 Adains Ave.
2•,CI O
i --')-0 0
11 14
F
j Deacliside Optometry
Eye Doctor
10088 Adains Ave.
Shinia R.estallrant
Restaurant
2,358
1 ln0
24 27
10076 Adams Ave,
1 Affordable Kids Inc.
Retail -Clothing
1,173
20U
8
1008( ) Adams A,,,.
loll King
Restaurant
1,035
+ 0 0
IT 2C
T
1007!� Adpnis Av,_
35 39
Knaoen Auto 011468
Retail -Auto
7,006
-203
i 10072 Adains Ave.
Parts
1-250
Centry 21
Office
T NO
20100 Brookliurst St.
arlt
3,2-
1-200
fi' 17�
10172 Adains ikve.
1I
yy
Vacant
1,300
1-- 290
10158 Adams Ave.
'o
M/NTMGTON SEw01
Address io 106
APPLICATION FOR CERTIFICATE OF OCCUPANCY
CITE" OF HUNTINGTON BEACH
DEPARTMENT OF BUILDING & SAFETY
(PRINT OR TYPE ONLY)
Business Name_{
Business Type �►° ��
4414q4eb
District
Tel.
OcC. Group
BUILDING OWNER r` Q BUS(NESS OWNErJMANAGER }�
Name [-%LY��f�� �L.� 3�(Name ()t U
Home
Address � � � Nut g �/j "'� � p,,� Address j�,,1 t( �O (Z)J ��,. �f �`ytr,� '
City- 1�t4� "[ 4—E—F tv� City) t t,�l`t< L `I o�' L `�J'�L+P"�►V.Home Tel.
THIS USE WOULD BE DESCRIBED AS:
�
❑ NEWLY CONSTRUCTED BLDG. E❑ CHANGE OF OWNER ❑ CHANGE OF OCCUPANT
IYJ EXISTING BUILDING le CHANGE OF USE ❑ ADDITIONAL OCCUPANT
Indicate former use, if any I:�/'tL Occupancy Gr.t Div.._
SQUARE FT. OF BUILDING TO BE OCCUPIED?32" )
NOTICE: 1. Occupancy of any building is prohibited and a business license will not be issued until the building has been
inspected and a certificate of occupancy is issued.
2. No electrical service will be released for any existing building until the service has been inspected and
certified safe. All applicants for occupancy in an existing building are required to schedule an electrical
'fuse up' inspection in the Department of Community Development at the time this application is filed.
3. Change of occupancy or use inspection fee. Whenever it is necessary to make inspection of a building or
premises in order to determine if a change may be made in the character of occupancy or use of the building
or premises which would place the building in a different division of the same group of occupancy or in as
different group of occupancy, a change of occupancy inspection fee of $ shall
be paid to the city.
4. HuntingtonBeach Fire Cone Section 10.208 requires that building numbers must be a minimum of four (4)
inches in height with one half (1/2) inch stroke, and of a contrasting color from tine background. These
numbers must be posted on your building in a location that is visible from the street.
5. Huntington Beach Fire Coale Section 10.301 requires fire extinguisher selection and distribution per the
National Fire Protection Association pamphlet 10 (see reverse side).
T�Ar;r;r; Eril^Prnr
EiV`D.__,._._.,.._._-_.._ ._-__
OCCUPANCY GROUP
OCCUPANT LOAD _
NO. OF STORIES
—Y_ t)lz)(=. 4 / {o Ice 7
(FOR OFFICE USE ONLY) ZONING
FLAN CHECK No 03 S �TNO PARKING SPACES —
PERMIT PERMIT NO. --:) a S HEALTH DEPT APPROVAL
ADMIN. ACTION - - UTILITIES REiEASED —
CERTIFICATE OF OCCUPANCY FEE $
APPROVED BY DATE CHANGE OF USE OR OCCUPANCY FEE
TOTAL $
FORMS 75-039 REV 2102 RE -ORDER: SAND DOLLAR 71y-842-1148_,
APPLICATION FOR CERTiFICATE OF OCCUPANCY
'ITY OF HUNTINGTON BEACH
,,. DEPARTMENT OF BUILDING & SAFETY
s
Address
Business Name
LBusiness Type
BUILDING OWNER
Name 1'' 1 (1
Address
F,
r11V
(PRINT OR TYPE ONLY)
DATE
District i
Tol
Occ. Group
BUSiNESS OW'NERIMANAGER
Name }
Home I.
Address
_Tel. _ City I r - a - Nome Tel.
THiS USE WOULD BE DESCRIBED AS:
❑ NEWLY CONSTRUCTED BLDG. ❑ CHANGE OF OWNER ❑ CHANGE OF OCCUPANT
EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT
indicate former use, if any Occupancy Gr. Div.
SQUARE FT. OF BUILDING TO BE OCCUPIED —
NOTICE: 1. Occupancy of any building is prohibited and a business license will not be issued until the building has been
inspected and a certificate of occupancy is issued.
2. No electrical service will be released for any existing building until the service has been inspected and
certified safe. All applicants for occupancy in an existing building are required to schedule an electrical
'fuse up' inspection in the Department of Community Development at the time this application is filed.
3. Change of occupancy or use inspection fee. Whenever it is necessary to make inspection of a building or
premises in order to determine it a change may be made in the character of occupancy or use of the building
or premises which would place the building in a different division of the same group of occupancy or in a,
different grolip of occupancy, a change of occupancy inspection fee of $ shall
be paid to the city.
4. Huntingtont Beach Fire Code Section 10.208 requires that building numbers must 5e a minimum of four(4)
inches in height with one half (1/2) inch stroke, and of a contrasting color from t le background, These rl
numbers must be posted on your building in a location that is visible from the street.,
5. Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection and distribution per the
National Fire Protection Association pamphlet 10 (see revere side). 3'
e t
'FOR OFFICE USE ONLY)
ZONING
OCCLIPA.NCY GROUP PLAN CHECK NO 'NO PARKING SPACES
OCCUPANT LOAD PERMIT NO. � i `-$ ' -;'HEALTH DEPT APPROVAL
NO. OF STORIES - -- ACMIN. ACTION UTILITIES RELEASED
CERTIFIC'NTE OF OCCUPANCY FEE $
APPROVED BY DATE CHANGE OF USE OR OCCUPANCY FEE
TOTAL lz
PORM 75.039 REV 2W. PE -ORDER SAND DOLLAR 714-892-110 APPLICANT
SUPPLEMENTAL INFORMATION
f 1. BUSINESS ADDRESS _ 16106 �!D7"3LA(� >
2. Person to contact in case of emergency,
Telephone number: _
3. Does the building in question have electricity? @YYes
❑ No
(a? 't No, are you requesting that the electricity be ❑ Yes
turned on? ❑ No
4. The building is sprinklered? ❑ ez
N^
5. 'operations will produce dust/wood shavings or similar
material? ❑ Yes
M-A o
6. Operations will involve the repair or replacement of 0 Yes
automobile parts?' L'4'No
If Yes:
(a) Descriae the nomponents repaired or repiacedi.
(b) Does the operation involve the use of an open flame? �es.
0
7. The business is drinking, dining or assembly use that will
result in an occupant load of more than 50 persons. ❑ Yes
0
8. The 4Re
'no describes my operation;
ce Onl
i ales
Warehouse
Manurat,turing / Distribution (describe process and end product)
Restauran ke Jut Food
Medical Dental
Other (des , e)
of 0 P EMEibIYL INN C7RIVIA77,0� I
SUPPLEMENTAL INFORMATION (Continued)
Does the operation involve any'.'104"A'K6 follo*i6g -materials? 0 Yes
0 No
If Yes, lndjcatquantities:
Material Quantity
1. Flammable liquids
Class I -A
'Class I-B
Class I-C
2. Combustible liquids
Class 11
Ill -A
3. Combination f(ammable liquids
4.1Flammable gases
Liquefied flammable gases
6. Flammable fibers - loose
7. Flammable fibers - baled
8. Flammable solids
9. Unstable materiais
10. Corrosive liquidp
11. Oxidizing material gases
1Z Oxidizing material liquids
13. Oxidizing material solids
14. ?Organic peroxides
Nitromethane (unstable materials)
161' Ammonium nitrate
17. Ammonium. nitrate compound mixtures
containing more th8n 60% nitrate
by weight
18. Highly toxic material and
poisonous gas
19. Smokeless powder
20. Black sporting powder
I hereby certify that the above information is true and' correct to
the best of my knowledge.
Signature Date
South Coast
AIR QUALITY MANAGEMENT DISTRICT
21865 E. Cryley Drive, Diamond Bar, CA 91765-4182 (909) 396-2000
AM QUALITY PERNHT CHECKLIST
for nonresidential buildings only
Company Name:
Location of Property: 6. 6
City: I GCQ l 1 _ •��" Zip Code:
Contact Person: _ TV2�' rD Title: _
Telephone Number- - b q) ` 5— Fax. Number: _ t' �" ' 51
Type of Industry/Business: I-)" [i'St r
To apply for a nonresidential building permit, you must complete this checklist. If you have any
questions about completing this checklist, please call (800) 388-2121.
DES NO
1 Will the facility have a charbroiler? [ ] [
2. Will any internal combustion engine with greater than 50 horsepower
operate at the facility i excluding motor vehicles)? [ ]
3. Will operations at the facility involve mixing, blending, or processing of J
solve -its, adhesives, paints or coatings?
4. Will dust or smoke be generated at the facility?
5. Will refining of any liquids or solids be done at the facility? [ ] [
6. Will any plating or coating of materials be done at -the facility? [ ] [
7. Will any combustion equipment rated greater than 2,000,000 BTU/hr be
operated at the facility?
8. Will any acids, solvents, or motor fuel be used or stored at the facility?
9. Will any organic liquids or gases be reacted or produced?
10. Will anv ovens be used to dry or cure products at the faci i fy? 4 [ ] [
11. Will any CFC (Freon) recycling machines operate acthe f �ty. ] [ ]
Applicant: E-[l E'rw Signature: '
(Print name clearly)
If you have marked "NO" in all the boxes, an air quality permit is not needed at this time,
aid this checl lisi is your written release.
If you marked "YES" in any of the boxes, you must contact the South Coast Air (Quality
Management District (AQYID).. Please read the requirements on the back of the checklist.
(800) 38$ 212I
NOTIC%� OF 1k]PIQU-.I.diL1M�',l\TS
GOVERNMENT CODE ai%criON 65850.2 (AB3205)
California State Law (Government Code 65850.2) grqhilqs the Building Departments from
issuing, a final certificate of occupancy unless'all'requrieajents of the local air quality agency are
r'mep, All applicants are required to complete the;air,qualinr permit, checklist, The checklist is
designed to aid the applicant for a nonresidential b*Uildfhg permit only. "if the answer to any of
the questions is "YFS; Fthy Building Deparunen-t'ritist obtain a written release from the local air
quality agency verifying that the applicant is in compliance. ,
K
L All nonresidential building permit appljca s must complete this checklist.
2. if the answers to all questions are "Nh" the Building Department can accept the checklist
as the written release.
3. If any questions are answered "YES, the applicant must conact the AQNM by calling
(800) 388-2121 -to determine whether air quali,-Y mrmits are required for any equipment
which may be operated at the site. if the AQM?J- determines that air quality pennits are
not required or that all requirements have been met, a writtea release will be issued.
4, If air duality permits are required and applications have not been submitted, the applicant
raust submit the necessary permit application(s) and appropriate fees before a written
release will be issued.
AQMD is committed to expedit.na all clew-arce letter requests. However, it may take several
weeks to verify compliance with all requirerw� . its. Therefore, °ou are advised to contact AQ1
irn-nediately after applying for building permits,
mvised 8M