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Home My WebLink About10028 Adams Ave - CofO (2)�+ z' � y HUNnNGM KACF CERTIFICATE OF OCCUPANCY - 020 - CITY OF HUNTINGTON BEACH - DEPT. OF PLANNING & BUILDING APPLICATION Business Address / 000 Q1 -sr, Business Owners Name IV, gnu Business Name Business Type (3'd Floor — The Applicant Must Apply In -Person) h Ce 9W 'it Date S -h —/ 3'- 7o,ne C4 Zip Code P Vit `r a 5T v tZ!�,f-r—%t P-c Telephone No. - fa Bus. Phone S..-. Property Owner Information (required) Tenant/Emergency Contact (required) Name 4 c. l A4 � �Z I - Name c t 5 Address sw A,�orr .k,f' Pbkc 5k Home Address CityeJc,,,n,,,1 8�,� t,, /State/Zip C,4 0a6 City •3a� State/Z p (�( S '3 7/ 7 Telephone No. 5 y Q - 6 c16 - coos Telephone No. C�45 r IM r F000 THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or 75QExisting Buil 'ng IS THIS BUILDING FIRE SPRINKLERED? ❑ Yes o CHECK ALL THAT APPLY: ❑ Change of Business Owner Nahange of Occupant ❑ Change of Use ❑ Additional Occupant ■ Indicate former type of business ■ Are you requesting that the electricity be turned on? ❑Yes Flo ■ Will operations produce dust/wood shavings or similar material?Yes ❑No ■ Will operations involve the repair or replacement of automobile parts? ❑Yes Wo 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 'KNo ■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? ❑Yes �No ■ The following best describes my operation: El Office Only ❑ Retail Sales fiWedical/Dental ❑Warehouse /Manufacturing/Distribution ❑ Restaurant/Take-Out Food ❑ Other ■ Will any meat products including beef, poultry, and/or fish bee cooked or fried onsite? ❑ Yes JoNo 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 o For Official Use Only Occ Group: Occ Group: Occ Group: Total Sq Ft Occupied: Bldg. Permit # � ! Planning Ini Conditions Area: Area: Area: No. of Stories: Entitlement #: 2L Occ Load: -33 Occ Load: Occ Load: TIF Review: N Zoning: Building Reviewed By Initials: ate_*1e iq�' , Grease Interceptor Verified Inspected By Initials: Date: f South Coast n Air Quality Management District 21865 Copley Drive, Diamond Bar, CA 91765-4182 +r,::e, it,j (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: PropertyAddress: 111zJ13 City: � �i-�� Zip Code: 513 7/ % Contact Person: - '!io( Title: C �--v- Type of Business: D rD C4ir% Telephone: 10 " Fax Number: e-mail address: J$ % c- i d^-CF Applicant (print name): J°< <-S Signature: Date: • Will the facility have any of the following equipment? Yes ❑ NP 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❑ C v Application of paints or adhesives C v 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- Entered By IChuor, Phillip ( Date Entered 1010212006 Default Inspector Benbow, Jeff Status Expired , fr Permit Type Certificate of Occupancy Issue Permit?`Z mate ,02/2112007 Origin Counter Issued By jMacLympn, Jean Building Use -City . Planner Gonzales, Andrew Building Use - Gourtty New Building? Plan Checker Chuor Phillip N Description DENTAL OFFICE ****ADD'L OCCUPANT TO "DAVID F.WILHELM**** Internal Notes CofO Number CO2006-007328 Choose Print All CofO Type Permanent Fees and Payments Sheets to Issue __ w Issued By Madtyman, Jean Single C/O CofOStatus Issued Inspections _ CofO Date Issued 02/21/2007 : j Temp. CofO Issued Date Printed Utility Release Date Temp. COFO Expiration 02/21/2007 _ ... - License Number A263805 Click the « button to copy the Business License information into the Certificate Occupancy,, of Business Name SUBODH SWAROOP DDS' Business Licenses Business Name Business Type Professional / Other' A013024 DAVID WILHELM DDS A257420 BUSINESS PROPERTIES PTNR #1 Business Phone (714) 862-4070 1 Al7720 •r REFINISHING DOCTOR' A183426 PERFECT IMAGE VIDEO PRODUC' Proposed Use SAME .. � ApprovedOccupiedArea(Sq Ft), ........ x ...__. Former Use SAME # of Stories Conditions MEDICAL OFFICE****ADD'LOCCUPANT TO "DAVID F.WILHELM**** x Change of Owner? Elec. Available? " Drinking ! Dining> 60 Occupants? Change of Use? w Want ElectricityOh? Welding I Open Flame? Change of Occupant? Sprinkiered?Automobife Repairs? Additional Occupant? Dust Woody Auto Parts Desc. Group Description - Area Construction Type Occupancy;- Load - B MED OFFICE 1700 17 B MED OFFICE 1700 - 17 Group Definit Abuilding or structure, or a portion thereof, for office, professional or service -type transactions, including storage of records and accounts; eating and drinking establishments with an occupant load of less than 50: