HomeMy WebLinkAbout10180 Adams Ave - CofO (2)-k
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HUNTINGTON BEACH
CERTIFICATE OF OCCUPANCY 02013 - (900
CITY OF HUNTINGTON BEACH —
DEPT. OF PLANNING & BUILDING APPLICATION
714/536-5241
(3rd Floor — Must Apply In -Person)
Business License # co 1 k Date 1 ( I q / 12D
Business Address_ In O c' c,vy-\ S Zip Code 7 G _
Business Owners Name C— Telephone No.91if -:35. I OY
Business Name for i G Bus. Phone
Business Type My c� �SSca1S
Property Owner Information (re uired),rr Tenant/Emergency Contact (required)
NameI`�?SpP Name SCkcc
Address Home Address 5o8a y, (6a,- d r. f�
City f r ��; ,�-L State/Zip- City'{ State/Zip qr, k q
Tele hone No. Telephone No. 9(6(-
THIS USE WOULD BE DESCRIBED AS: �
❑ Newly Constructed Building or t"Existing Building
CHECK ALL THAT APPLY:
❑ Change of Property Owner [I�hange of Occupant ❑Change of Use ❑Additional Occupant
■ Indicate former type of business.--I� � p
■ Are you requesting that the electricity be tume on? Yes 0 No
■ Is the building sprinklered? Yes • No'Ql----
■ Will operations produce dust/wood shavings or similar material? Yes❑ NoO----'
■ Will operations involve the repair or replacement of automobile parts Yes NoV�' If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? Yes 0 No
■ Will the busine be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes ONo
■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? Yes ONO ❑---"
■ The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑ Medical/Dental
❑ Warehouse /Manufacturing/Distribution ❑ Restaurant/Take Out Food
(describe process and end product)
Other (describe) V) US i C- Sa nj S
For Official Use Only
Occ Group:
Occ Group:
Occ Group:_
Total Sq Ft Occupied: 20
Bldg. Permit #
-, I �- [4 M an,►'
Area:
Area:
No. of Stories:
Entitlement #:
Plnr Initials:_ Dater-JS Plan Chkr Initials: Date: l� I
Conditions of Approval or Other Notes:
AMLe!6D Pr- 2 ►? -n I y -
Occ Load:
Occ Load:
Occ Load:
TIF Review: Y/ N
Zoning: 10.
Insp Initials: Date:
Inspection Date:
a►-
South Coast
7,111 Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
(909) 396-3529 • http:// www.aqmd.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:
Property Address: (0(60
City: Zip Code:
Contact Person: �S rZ-c o N_Q_ M a Y-,e .Title:
Type of Business: (M v SC (ASS o,t S Telephone: `
Fax Number: e-mail address:
Applicant (print name): Signature:
G-7E-CAnr—Q-0" V__ Date:I2—
• Will the facility have any of the following equipment? Yes ❑ No
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[—] Nq❑�
Application of paints or adhesives VV
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).
M
Department of Planning & Building
2000 Main Street
Huntington Beach, CA 92648 `
Phone: (714) 536-5241 Fax: (714) 374-1647
CERTIFICATE OF OCCUPANCY
GHOLAM ALI ADIBI Cert. Number CO2005-008554
PALM BEACH TANNING
10180 ADAMS Date Printed 01i18rz013
HUNTINGTON BEACH CA 92646
Address:
10180 Adams Ave
Issue Date: 11/22/2005
Permit Number:
02005-008554
TCofO Issue Date:
Business Name:
PALM BEACH TANNING
TWO Expiration:
Business Type:
Professional / Other
Approved Sq Ft.: 1,200.00
Current Use:
TANNING SALON
# of Stories: 1
Occupant Groups: Description: Area: I I Occupant Load:
Conditions of Approval:
Contacts: 71
Contact Type: Name: GHOLAM ALI ADIBI Phone: (714) 962-6013
Business Owner Address: 10180 ADAMS Cell: ( ) -
City / State: HUNTINGTON BEACH CA Fax: ( ) -
Zip: 92646 Pager:
Contact Type: Name:
BUSINESS PROPERTIES
Phone:
(714) 962-6013
Property Owner Address:
17631 FITCH
Cell:
( ) -
City / State:
IRVINE CA
Fax:
( ) -
Zip:
92614
Pager:
( ) -