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Home My WebLink About10061 Adams Ave - CofO (3)H CERTIFICATE OF OCCUPANCY C 20 Z- ?fit 2D Z CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION HUNTINGTON BEACH (3d Floor — The Ap licant Must Apply In -Person) Business Address o f gf)(I A D#AA AVf B ate J Business Owners Name (iu6 ' j k A H 41� 1 " q i 4 a ` ip Code Business Name Business Type S� u elephone Nol I q'lj C 4 615 Z QBus. Phone Property Owner Information (required) Tenant/Emergency Contact (required) Name 1ST lkoij0 yk� T ti APAH L LC Name f:bAG- T2AH Address 1-7 6 I f I TC 4 Home Address I a 41l Q. ►� City Tp V rj State/Zip E f� -NI C 1 h City State/Zip C A ! tK g B_ Telephone No.(04 a i4 'Fc o Q Telephone No. L-1 I L G i THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or Existing Building IS THIS BUILDING FIRE SPRINKLERED? ❑Yes ONO CHECK ALL THAT APPLY: X Change of Business Owner ■ Indicate former type of business ❑Change of Occupant ❑ Change of Use ❑ Additional Occupant ■ Are you requesting that the electricity be turned on? Wes ❑No ■ Will operations produce dust/wood shavings or similar material? ❑Yes 5 No ■ Will operations involve the repair or replacement of automobile parts? ❑Yes DiNo If yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? ❑ Yes NNo ■ 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 gjNo ■ The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑Medical/Dental ❑Warehouse /Manufacturing/Distribution CkRestaurant/Take-Out Food ❑ Other ■ Will any meat products including beef, poultry, and/or fish bee cooked or fried onsite? ❑ 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: ❑ Yes ®No For Official Use Only Occ Group: 15 Occ Group: Occ Group: Total Sq Ft Occupied: 16,36 Bldg. Permit # Planning Initials:ILDate: `' �' i'l Area: i C- 3 pig Area: Area: No. of Stories: j Entitlement #: Occ Load: Occ Load: Occ Load: TIF Revie to Y/ N Zoning: _ Building Reviewed By Initials:,��Date: Conditions of Approval or Other Notes: OA'( - (Z X-A-Ts Grease Interceptor Verified Inspected By Initials: Date: Air Quality Permit Checklist California State Law Code 65 85 0.2 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: P A k+' P O V Property Address: 9 ro 0 G I ADS A-v f . ,�+ t Y 0 City: Zip Code: 0 4� af- Contact Person: fl)A-G- Tip ^01 Title: owwx- Type of Business:Telephone: (`1 l 4) Fax Number: e-mail address: Applicant (print name): fiV T f RAO Signature: , �;l�Date: 011-7 • Will the facility have any of the following equipment? Yes ❑ No ❑g/ 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 I 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❑ 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 Nod 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- HUNTINGTON BEACH FIRE DEPARTMENT FIRE PREVENTION DIVISION 2000 MAIN STREET • HUNTINGTON BEACH, CA 92648 (714) 536-5676 • FAX (714) 374-1551 FIRE PREVENTION - BUSINESS DATA SHEET For new Certificates of Occupancy Business Name: Q o%i 6 K 1 Start Date: Fire Onlya File #: FP: Business Address: 1004 I Aa At-4 Aiy , c.,TL IO � , . 14- b �1J"(0-4 G Number Street Unit Zip Code Billing Address: Elsame as business {64 li 01' pa �A`r , w &J rn0nS Fx✓ C�.o'P q du Business Contact: hvy, T rA n bc "Al 4 L Emergency Contact: I" n 14) � c 2- 6 ! - Z (24-hour) Name T Phone Email Description of Business: Will there be any of the following uses on the premise? ❑Storage >6 feet If yes, describe: _ ❑Welding [-]Special amusements (escape room or similar) ❑Motor vehicle repair Will there be any of the following equipment (E =existing equipment, A = adding or new equipment) Dry cleaning - list solvent Propane patio heaters -# of heaters, # of spares Backup generators - list fuel Spray booth or dipping tank Grinding/milling equipment that creates combustible dust If yes, provide details (e.g., number, fuel, size, etc.) _ _ Industrial oven - list fuel Cooking equipment (fryers, ovens, pizza conveyor, etc.) Walk in refrigerators or coolers - list size, refrigerant Tents or air supported structure Fuel dispensing (including storage tanks) Carbonated beverage system - list total pounds of CO2 Does the building have any of the following features (E =existing feature, A = adding feature) Sprinkler system _ Other fire suppression system Fire alarm system _ Smoke detectors _ Other detectors (e.g, methane) _ Other alarm system _ Private fire hydrants _ Battery systems _ Fire pump _ Methane barrier or other methane control installed If yes, provide details Does the business handle any of the following: YES NO 55 gallons or more of a liquid hazardous material or hazardous waste. ❑ C� Compressed gas (or liquid/cryogenic equivalent) of 200 cubic feet or more ❑ ❑ Inert compressed gas (e.g., argon, nitrogen, helium) of 1,000 cubic feet or ❑ ❑ more. 500 pounds or more of a solid hazardous material or hazardous waste. ❑ 9( Extremely hazardous material or radioactive material ❑ ❑ I certify, under the penalty of perjury, that the above information is true and correct to the best of my knowledge. Signature: � Tan'-'-- V Title: ow-r-L( Date: ® 1 1110 1, 1? 011-2oa3 Department of Planning & Building 2000 Main Street Huntington Beach, CA 92648 Phone: (714) 536-5241 Fax: (714) 374-1647 Occupancy Application Property • 10121 Adams Ave 101 COWGILL ROBERT H JR 10061 APN 155-051-06 PM-Mm. We Application Binder Num Street Unit Bldg Job Address 10061 AdamsAve 101 APN 155-051-06 RD 3820 Zoning CG 1 Lot !� Tract S0006 Block 10 File Number CofO? C2013-000494 No F2013-000608 No B2013-000818 Yes F2013-000839 No C2013-001739 No F2013-002188 No E2013-003496 No 02013-003741 Yes 02013-004386 Yes C2013-004821 No 02013-006436 Yes 02014-006136 Yes Entered By Chu;.,, Phillip - — Default Inspector ,Andino, Richard Permit Type 'Cei,ificate of Occupancy Origin Counter Building Use - City Building Use - County ` New Building) Description I"SURF CITY SOFT SERVE" Internal Notes CofO Number CO2014-006136 Choose PtiatA,, CofO Type Perr, avert Sheets to lssu - . __ - - Issued By Single C/0 CofO Status Issued CofO Date Issued 09/29/2014 Temp CofO issu-d Utility Release Date Temp. COFO Expiration License Number A290629 Click the «butt, ;nformaticnir+o' Business Name SURF CITY SOFT SERVE Business- Lr^e Business Business Type Retail _ WC -11- �A07 ,t -C Business Phone ( ) IA63691C ;A0390 ? Proposed Use I RESTAURANT Apl " Former Use RESTAURANT Conditions Change of Owner? .'.Iec. Availak'. Change of Use? ® Change of Occupant? SP., .1K-,,J'% Additional Occupant? I I tx st i ,/Vood*7 Auto r . Group Description Area C--Wruction Type Oc-upancy L-, B RESTAURANT 1716 49 B RESTAURANT 1716 i 9 I ;,crtic t, ,.-, f ••,:d fcr . Group Definiti Business Use- Building or struct, 'e, -,r a including storage of records and : counts Date Entered 09/29/2014 Status Issued ^� Issue Permit? Date 09/29/2014 Issued By �— Planner Arabe, Jill Ann Plan Checker IChuor, Phillip Fees and Payments --� Inspections Date Printed 09/29/2014 ropy the Business License .ertificate of Occupancy. Rusiness Name "-tt , : i.WELERS INC ISAV-ON DRUG #9483 :MR FISH N CHIPS 'WFK IR\/;N OD (`• iP na (Sq Ft) 1,716.00 # of Stories ring > 50 Occupants? Open Flame? -` -le Repairs? -tyre transactions,