HomeMy WebLinkAbout10110 Adams Ave - CofO (2)HUNTINGTON BEACH
CERTIFICATE OF OCCUPANCY &0201� -
CITY OF HUNTINGTON BEACH. —
DEPT. OF PLANNING & BUILDING APPLICATION
714/536-524I
(3'd Floor —Must Apply In -Person)
Business License # A 271 0 V5 Date
Business Address 10 ( (0 A aO.A VIA-� Zip Code
Business Owners Name JGr-ervath lChri.5 De F,-c !o Telephone No. 9'f9- 892- 3sia
Business Name LAM TE •KC,.4 (-THG kot"O Bus. Phone 919- ?9Z -351v
Business Type, M cb 1C:JvL Ct, I tA1L
Property Owner Information (required) Tenant/Emergency Contact (require(l)
Name JONES LANG LASALLE Name UNITEDHEALTH GROUP
Address 7061 GRAND MONTECITO PARKWAY Home Address 7061 GRAND MONTECITO PARKWAY
City LAS VEGAS State/Zip NEVADA, 89149 City LAS VEGAS State/Zip NEVADA, 89149
Telephone No. 952-905-7602
THIS USE WOULD BE DESCRIBED AS:
Telephone No. 952-905-7602
❑ Newly Constricted Building or IX Existing Building
CHECK ALL THAT APPLY:
El Change of Property Owner iXChange of Occupant XChange of Use ❑Additional.Occupant
• indicate former type of business N/A
• Are you requesting that the electricity be turned on? YcsL',] NoX
■ Is the building sprinklered? Yes No❑
■ Will operations produce dust/wood shavings or similar material? Ye: No)( .
■ Will operations involve the repair or replacement of automobile parts Yest,j NoX1 If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use ofwelding or open flame? Yes[] No1X
■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons?
Yes []NoK
■ The following best describes my operation: [_a Office Only 0 Retail Sales X Medical/Dental
Warehouse AManufacturing/Distribution ❑ Restaurant/Take Out Food
(describe process and end product)
Other (describe)
For O icial Use Onh
Occ Group: Area: ---- Oce Load: r�
Occ Group: — Area: Occ Load: 4 S
Occ Group: Area: Oce Load:
Total Sq Ft Occupied: No. of Stories: TIF Revie YIN
Bldg. Permit # Entitlement M Zoning:
Plnr Initials: Date: Plan Chkr Initials: Date: lnsp Initials: Date:
Conditions of Approval or Other Notes:
Inspection Date:
06 - GA50
South Coast
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
(909) 396-3529 • http:// wv� Av.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: "_K_j 1 EjQ f-( Li l �r2C7�--P
Property Address: i o110 tl d"0 41►-e .
City: A4 tLgAr1 Bch Zip Code: 92,& S &
Contact Person: , J S+CjJ,L Title:
Type of Business: GtfrUraul CantYacto'('
f'ax Number: 9�Fq' 2iZ ' S 2 `F $
Applicant (print name): fist; MaxfinI Signature
0# LL tMnwx3e( Date:
Telephone: '911- 30 -%FT8 9
e-mail address:
v&& e cd3bw 1AM •cow+
Will the facility have any of the following equipment'? Yes ❑ No
Charbroiler
Dry cleaning machine
Spray booth
Printing press (screen/lithograpliie/flexograplhic)
Internal combustion engine greater than 50 HP (excluding motor vehicles)
Boiler/combustion equipment (greater than l 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[�]
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-
01 C-3 - d-,-75
Department of Planning & Building
.2000 Main Street `
Huntington Beach, CA 92648
Phone: (714) 536-5241 Fax: (714) 374-1647 Occupancy Application
Permanent
Issued
10/17/2006
FISH STORE Approved Ocoupied Brea (Sq Ft} 2,000.00
FISH STORE''.: #ofSf4ries
M STORES
1080
36
M STORES
4,11
920
4 i-
"
A binlcti ors uc�ure
Grow Nfinlpo n9 ., f�
p
yr a onion
;_ P
thereof, forthe dis P�
a and sale'of merchandise and involvin stocks o aods-,
Y 9 f 3
1
�.vvaresormerchandlsejnudental
to such �urnasesarxfac+ssuhie
e. e
1a, ha
y,�xnxc a
� Q
yycf�cuxn �P``4 x`
Department of Planning & Building
2000 Main Street
Huntington. Beach, CA 92648
Phone:(714) 536-5241 Fax: (714) 374-1647
CERTIFICATE OF OCCUPANCY
GREG HORVATH / CHRIS DE FAZIO
UNITEDHEALTH GROUP
10110 ADAMS AVE
HUNTINGTON BEACH CA 92610
Cert. Number CO2015-006756
Date Printed 05/27/2016
Address:
10110 Adams Ave
Issue Date: 05/27/2016
Permit Number:
B2015-006756
TCofO Issue Date:
Business Name:
TCofO Expiration:
Business Type:
Approved Sq Ft.: 0.00
Current Use:
MEDICAL CLINIC
# of Stories:
Occupant Groups:
Description: Area:
Occupant Load:
A-3
673
45
B
MED OFFICE 4610
47
Conditions of Approval:
Contacts:
Contact Type: Name:
GREG HORVATH / CHRIS DE FAZIO
Phone: (949) 892-3510
Business Owner Address:
10110 ADAMS AVE
Cell: ( ) -
City / State:
HUNTINGTON BEACH CA
Fax: ( ) -
Zip:
92610
Pager:
Contact Type: Name: ]ONES LANG LASALLE Phone: (952) 905-7602
Property Owner Address: 7061 GRAND MONTECITO PKWY Cell: ( ) -
City / State: LAS VEGAS NV Fax: ( ) -
Zip: 89149 Pager: ( ) -