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Home My WebLink About10035 Adams Ave - CofO (6)H HUNTINGTON BEACH CERTIFICATE OF OCCUPANCY ID20 CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION Business Address iy5`, Business Owners Name Business Name oWgj Business Type rzTd Fiirtr _ The Applicant Must Apply In -Person) i Date % - zV - lk Zip Code ��Air Telephone No,9 .�.�• S•SZ Bus. Phone IKJY- 4Z?&6 Property Owner Information (required) Tenant/Emergency Contact (required) Name NrPre� Co ,r,Q�/� Name .Zrp? Were eti Address 2 7�00 �'. S/'f� .r�+"eCf S�ZAF,&ew Home Address /� J r- / 0AV-2 Ate. Cityl ., {r`.G��State/Zip CA la8b.4 City A&is . A&1 State/Zip �a Telephone No,rg Z • y90 •004v Telephone No. %Z`y1 THIS USE WOULD BE DESCRIBED AS:, O Newly Constructed Building or IS THIS BUILDING FIRE SPRINKLERED? CHECK ALL THAT APPLY: ❑ Change of Business Owner ■ Indicate former type of business ❑ Existing Building 'Yes []No WChange of Occupant ❑ Change of Use ❑ Additional Occupant ■ Are you requesting that the electricity be turned on? ❑Yes 14 No ■ Will operations produce dust/wood shavings or similar material? ❑ Yes ')ENO ■ Will operations involve the repair or replacement of automobile parts? ❑Yes �No If yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? ❑ Yes X No ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? ❑ Yes XNo ■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? ❑Yes XNo ■ The following best describes my operation: ❑ Office Only ❑ Retail Sales ;Wedical/Dental OWarehouse /Manufacturing/Distribution ❑ Restaurant/Take-Out Food ❑Other ■ Will any meat products including beef, poultry, and/or fish bee cooked or fried onsite? ❑ Yes JWNo 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 C,'10 For Official Use Onl Occ Group: Oce Group: Occ Group: Total Sq Ft Occupied: Bldg. Permit # Planning Initials: Date: 7 2L Conditions of Approval or Other Notes: Area: Area: Area: No. of Stories: I Entitlement #: Use Permitted: Y / N Occ Load: , Oce Load: Occ Load: TIF Rebviex✓: j'/ N Zonin- �o�� Parking Meets Code (for use): Y / N Building Reviewed By Initials Date: 7�6� ase Inteerceptor Verified Inspected By Initials: Date: WX r South Coast Air Quality Management District 21865 Copley Drive, Diamond Bar, CA 91765-4182 P e (909) 396-3529 • http:// www.aqmd.gov r• 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 airquahty agency. This checklist will -determine if you need to obtain clearance from the South Coast Air Quality Management District (AQMD). Company Named Property. Address: • /eO30". .i 400` S AYe: City: K v/erg ! ' ' Code: 26 ,k ` ��Ll�' Zip Contact Person: Ve`i Title: Type of Business: AiC�f Telephone: 2$1 2X 9Z Fax Number: e-mail address: Applicant (print name):✓ 1At*X �� Signature: Date: • Will the facility have any of the following equip ? 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❑ No Application of paints or adhesives 1gr 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- South Coast Air Quality Management District g 21865 Copley Drive, Diamond Bar, CA 9176514182 ,G p (909) 396-3529 • http:H www.agmd.gov Air Quality Permit Checklii t California State Law Code 65850.2 prohibits cities from issuing an occupa business without clearance fi-om the local air quality agency. This checkli,, need to obtain clearance from the South Coast Air- Quality Management Di Company Name: Messenger Orthodontics Property Address: 10035 Adams Ave #103 City: Huntington Beach Zip Code: 92646 Contact Person: Jennifer Messenger Title: Owner/Orthodontist Type of Business: Orthodontic Office 949-433' 2592 Yp Telephone: Fax Number: e-mail address: doc@messen Applicant (print nam .)Jennifer MessengerSignature: frZ" ncy permit to a t will determine if you strict (AQMD). r-smiles.com Date: 6-20-18 • Will the facility have any of the following equipment? Yes ❑ No ❑X Charbroiler Dry cleaning machine Spray booth Printing press (screen/lithographic/flexographic) i Internal combustion engine greater- than 50 HP (excludin(Y motor vehicles) Boiler/combustion equipment (greater than 1 nvllion 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 ,o I If you answered "No" to both questions, this checklist is your clear�nce ft-om AQMD. If you answered "Yes" to either- question, you must contact AQMD to dbternune if air quality pe.rnuts are required. If permits are needed, AQMD will assist you in submitting pernut 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-