HomeMy WebLinkAbout126 Main St - CofO (25)He
E3
HUNTINGTON BEACH
Business Address
CERTIFICATE OF OCCUPANCY 020
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION
Business Owners Name D,4gl J
Business Name VE 22E7 }' C6=L-
Business Type
"he Applicant Must Apply In -Person)
Date �O
Zip Code
Telephone Nor-6-4 6 f% k-11d 0
Bus. Phone
�3rlr Information (required) mergency Contact (required)
Name k22 Name Z e [a.e �& ?
Address6AeO'ylG� S77 Home Address L,;� G a4a f-1, A/
City 1e&4Cff State/Zip�'/�/�� City MAiC;e g Aid State/Zip
Telephone No. d 2 6 06 Telephone No.
THIS USE WOULD BE DESCRIBED AS: ,_,,,//
El Newly Constructed Building or [d Existing Building
IS THIS BUILDING FIRE SPRINKLERED? Yes ❑ No
CHECK ALL THAT APPLY:
0 Change of Business Owner , nChan e of Occupant ❑ Change of Use ❑ Additional Occupant
• Indicate former type of business GCS E,9"
• Are you requesting that the electricity be turned on? KYes ❑ No
• Will operations produce dust/wood shavings or similar material? ❑ Yes T No
• Will operations involve the repair or replacement of automobile parts? ❑Yes kNo 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 N No
• Will there be storage racks, gondolas, or shelving exceeding 5 feet inches in height? 'yes ❑ No
• The following best describes my operation: ❑Office Only ❑ Retail Sales ❑ Medical/Dental
❑ Warehouse/Manufacturing/Distribution F.iestaurant/Take-Out Food ❑ Other
• Will any meat products including beef, poultry, and/or fish be cooked or fried onsite? ❑ Yes 2�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 06
Grease Interceptor Verified Inspected By Initials: Date:
For Official Use Only
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied:
Bldg. Permit #
Planning Initials: -TP Date: L o � l � d
Area: bCJ
Area:
Area:
No. of Stories:
Entitlement #:
Use Permitted: Y / N
Occ Load:
Occ Load:
Occ Load:
TIF Review: Y/
Zoning:
Parking Meets Code (for use): Y / N
(3
Building Reviewed By Initials: --P6 Date:
Conditions of Approval or Other Notes: I"wlr 12- Lca7
South Coast
: iQ Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
_ Phone Number (909) 396-3529 http://www.agmd.gov
Ia o
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:
Property Address: fdb �'S`i�L�E�; /�
City: �(%/%%2��1/ irrCr—. Zip Code: IaG le
Contact Person: Title: r7t t//Vc
Type of Business: / ��Clj'�% Telephone: 462i Gas
Fax Number: - E-mail Address:
Applicant (print name): ,,?DXXIIt/ ��N/ Signature: Date: [b/�
1. Will the facility release air pollutants, including but of limited to, dust fumes, gas, mist, odors, smoke, vapor, or a
combination of these to the atmosphere? ❑Yes No
2. Will the facility result of fuel -burning equipment including, but not limited to, boilers, generators, and internal combustion
engines? ❑Yes JZNo
3. Will the facility result of hazardous material6, including but not limited to, chemical, plastics, rubber, resins, solvents,
paints, and other parts cleaners? ❑Yes Mo
4. Will the facility have use of above or underground storage tank? ❑Yes VNo
5. Will the facility consist of manufacturing, fabrications, finishing, or treatment of wood, metal or plastic products? ❑Yes VNo
6. Will the facility result in the use of the equipment listed below? ❑Yeslo
(Select all that apply)
❑Abrasive Blasting Cabinet/Room ❑Internal Combustion Engine (rated > 50 bhp; e.g. back-up generator)
❑Air Conditioning System (containing > 50 Ibs of refrigerant)
❑Application of Paints/Adhesive/Resins
❑Baghouse/Dust Collector
❑Bakery Oven (gas fired)
❑Boiler/ Vater Heater (max. heat input = or > 1 million BTU/hr)
❑Charbroiler/Smoker
❑Mixing/Blending of Liquids and/or Powders
❑Molding /Extruding/Curing of Plastic
❑ Pharmaceutical/Nutraceutical
❑Plasma/Laser Cutter
❑ Printing/Coati ng/Drying
❑ Production of Fumes/Dust/Smoke/Odors
❑Coffee Roaster/Afterbunner ❑Refrigeration Systems (containing > 50 Ibs of refrigeration
❑Deep Fryer (excluding equipment located at eating establishment) []Soldering Oven
❑Dry Cleaning Equipment
❑Electrostatic Precipitator
❑Fermentation
❑Gasoline Storage & Dispensing Equipment
[]Spray Booth
❑Storage of Acids/Solvents/Organics Liquids/Fuels
❑Storage Silos (sugar, flour, etc.)
If you answered "No" to any of the above questions and your facility will not have the following
equipment listed, 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).
113
Department of Planning & Building
2000 Main Street
Huntington Beach, CA 92648 '
Phone: (714) 536-5241 Fax:(7141374-1647 "
Main 024-154-01 t104 ZEIDANADELM
126
Num Street Unit Bid
126 1 Main St 1104
Zoning
File Number CofO?
15-004016
15-004247
17-000533
17-006518
17-008121
18-000486
18-000942
18-001570
18-001900
18-002167
Occupancy Application
Application Binder
APN 024-154-01 RD 4014
Lot 26 Tract 352 Block 103
Entered By IFlores-Hemandez, Armalen
Default Inspector Andino, Richard
Permit Type Certificate of Occupancy
Origin Counter J
Building Use - City
Building Use - County I New Building?
Description — THE ROLL '---
Internal Notes
Date Entered 105/11/2018
Status Issued
Issue Permit? Data 05/11/2018
Issued By Permit4
Planner Bourgeois, Nicolle
Plan Checker Lee, Eddie
CofO Number CO2018-003053 Choose Print All CofO Type Permanent Fees and Payments
Sheets to Issue
Issued By Permit4 Single C/O
CofO Status Issued Inspections
CofO Date Issued 05/11/2018
Temp. CofO Issued
Date Printed
Utility Release Date
Temp. COFO Expiration
05/11/2018
Click the « button to copy the Business License
License Number
information into the Certificate of Occupancy.
Business Name
Business Licenses Business Name
Business Type
A209912 HUNTINGTON SURF AND SPORT
A189086 SURF CITY CANDY
Business Phone ( ) -
A205164 MAIN STREET OPTICAL & BOUTIOI
A210810 PSYCHIC BOUTIQUE
Proposed Use
ICE CREAM SHOP
Approved Occupied Area (Sci Ft) 600.00_
Former Use
# of Stories!` I1
DONUT SHOP
Conditions MAX 12 SEATS
Change of Owner?
Change of Use?
I®I Change of Occupant?
0 Additional Occupant?
Group Description Area
Elec. Available? Drinking / Dining > 50 Occupants?
Want Electricity On? Welding / Open Flame?
H,
Sprinklered? Automobile Repairs?
IL
Dust / Wood? Auto Parts Desc.
Construction Type Occupancy Load
B
RESTAURANT
1600
1
1113
B
RESTAURANT
600
13
Group Definitio Business Use - Building or structure, or a portion thereof, used for office, professional or service -type transactions,