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Home My WebLink About117 Main St - CofO (3)HUNTINGTON BEACH Business Addr( Business Ownc Business Name Business Type CERTIFICATE OF OCCUPANCY 020- 2u CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION (3d Floor — The Applicant Must Apply In -Person) Date , / - ) -7 Zip Code Telephone No.Wq- 7/57-07Z Bus. Phone Property Owner Information uired) Tenant/ mer enc Contact (required) Name O T11_ Name Address _ O - Home Ad ress City T--R V l t70, State/Zip 01 2 i City State/Zip Z� j Telephone No. q � 2- 750� -A3 0 � Telephone No. �Lq-- /c5 S Y�2- THIS USE WOULD BE DESCRIBED AS: O Newly Constructed Building or /ErE-xis�tl.ng Building IS THIS BUILDING FIRE SPRINKLERED? -'Yes E]No CHECK ALL THAT APPLY: ❑ Change of Business Owner ,,R'Change of Occupant ❑ Change of Use ❑ Additional Occupant ■ Indicate former type of business ■ Are you requesting that the electricity be turned on? ❑Yes D&o ■ Will operations produce dust/wood shavings or similar material? ❑ Yes '1No ■ Will operations involve the repair or replacement of automobile parts? ❑Yes ,moo If yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? ❑ Yes - - No ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? ❑ Yes 'Erlo ■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? ❑Yes eE�No ■ The following best describes my operation: Mice Only ❑ Retail Sales ❑Medical/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 O'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 ,ENo For Offlicial Use Only Occ Group: Occ Group: Occ Group: Total Sq Ft Occupied: Bldg. Permit # Planning Initials: Date: Conditions of Approval or Other Notes: Area: Area: Area: No. of Stories: Entitlement #: _ Use Permitted: / N Occ Load: Occ Load: Oce Load: TIF Revie • Y/ N Zoning. "C Parking eets Code (for use): / N Building Reviewed By Initials: Date: c& 4-o of vp, — RT) C 4 fj Grease Interceptor Verified Inspected By Initials: Date: 0 gg South Coast Air Quality Management ement 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). _ -72- Fax Number: e-mail address: / JQL r u io 4eomff Applicant (print name) LL<A Signatur . Date: • Will the facility have any of the following equipment? Yes ❑ Noz 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❑ N 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- C� �7 In 714/536-5241 b� p()50o I t Certiricate of Occupancy No. 02005'001`(q APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH - DEPT. OF BUILDING & SAFETY ( (P Floor — Must Apply In -Person) elf Business License # � Business Address liq MAIA ST- 20Z Business Owners Name G A 2y 0. M uu,t bA,,,) Business Name MVt-Li61iNS PrLge6'rljS Business Type ( F1s GMT-4- / L4-"4 6 Date 4- y Zip Code 2-6 Telephone No. 562 9?2-Z00�f Bus. Phone 7/ 6- - 4135' Property Owner Information (required) 1 i ::TenantBmergeney'Contact (required) Name 6 Pat u . pq OLL16A A) Name 6ARy . Q - lh Q t,g,6A . Address 6 5 5 S Wa Ae' Home Address '� -5g" ' sbgr�91 AGj City suggW State/Zip C� :5 9Q7 City SUM-9OC- ' l Sfate/ZioI/ dA gQW3 TelephoneNb,.' ,,ro,67,) lsq2.2.00`( Teleph6n6N6:r,i(7, y)',,.,,St3-SBI.b T1119-b9EV61h, i ' E DESCRIBED AS: ` ` 1 1 i•� NewlyCob.structed Building or %Existing Building i ;; V CHECK ALLTHAT APPLY: ❑ Change of Property Owner 0 Change -of Occupant 0 Change of Use P� Addijional_Occupant n Indicate former type of business �. oc , I , f a'-1"- '" i' '� "` f' ' n Are you requesting that the electricity be tuined on? Yes QTK ■ Is the building'sprinklered? Yes QNoP- n Will operations produce dust/wood shavings or similar material? YesQNo9 n Will operations involve the repair or replacement of automobile parts Yes QNo k� If yes: Describe the components repaired or replaced. n Does the operation involve the use of welding or open flame? Yes QNo 2�. ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? Yes QNo t-- ■ The following best describes my operation: ❑Office Only ❑ Retail Sales ❑ Medical/Dental ❑ Restaurant/Take Out Food 0 Warehouse /Manufacturing/Distribution (describe process and end product) ❑ Other (describe) For 0 lcial Use l Occ Group: Occ Group: Occ Group: Total Sq Ft Occupied: Bldg. Permit # Area: Area: Area: No. of Stories: Entitlement #: Occ Load: 2— Occ Load Occ Load: TIF Review: Y/ N Zoning: Plnr Initials:i(Date: H� &Ian Chkr Initials: s Date: Insp Initials: Date: Inspection Date: (G: Building/Forms/PermitAppl ication/Cof02006) South Coast Air Quality Management District 21865 Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-3529 • http:// www.agmd.gov . r Air Quality Permit Checklist ;. `Califgrnia State Law Code 65850.2 prohibits cities fioqi, issuing an occupancy permit to a business without clearance from the local air quality, a$�ncy,�,T)ii.5j6ecklisl;w(ll determine if you need to obtain clearance from the South Coast Air Quality,Mp< gement Piptoct (4QW). Company Name: M O LL b t8 Property. Address; 11'''7 'City: (gVa11N6101 ecA.,'., i 5'(' . Zo i J Zip Code: Contact Per"son: ` Ce ll +�`/ U ��. m U W bt Type of Business: "A 65Tg1�� "Q ,)6 Fax Number: ('71Y 9 6q-.2 ?66 Applicant (print name): Signature: 6A XV M DL-L 14/0 Date: Title: ' owa- Telephone: � �36 -10 ai jh t,LUlaAi' P/ZoP6rLf'f q pL-.Gam • 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 BP (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 No • 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 r' 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- Revised June 2005