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Home My WebLink About1118 Pacific Coast Hwy - CofO (5)J� HUNi1NGM MAO CERTIFICATE OF OCCUPANCY 020IL- 7 CITY OF HUNTINGTON BEACH - DEPT. OF PLANNING & BUILDING APPLICATION Business Address 1118 Pacific Coast Highway, $ait�A 4F 10 3 Business Owners Name Donald Povieng Business Name Povieng Corporation Business Type Real Estate (3A Floor — The Applicant Must Apply In -Person) Date 06/30/16 Zip Code 92648 Telephone No. (619) 520-2856 Bus. Phone (619) 520-2856 Property Owner Information (required) Tenant/Emergency Contact (required) ]Marne Thomas and Debbie Andrews Name Dina Randazzo Address 1118 Pacific Coast Highway Home Address 407 18th Street City Huntington Beach State/Zip CA, 92648 City Huntington Beach Telephone No. 714-336-3396 Telephone No. (916) 316-0269 THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or E Existing Building IS THIS BUILDING FIRE SPRINKLERED? ❑ Yes *No State/Zip 92648 CHECK ALL THAT APPLY: ❑ Change of Business Owner ❑■ Change of Occupant ❑ Change of Use ❑ Additional Occupant ■ Indicate former type of business Insurance Agency ■ Are you requesting that the electricity be turned on? ❑Yes ❑■ No ■ Will operations produce dust/wood shavings or similar material? ❑ Yes K No ■ Will operations involve the repair or replacement of automobile parts? ❑Yes END 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 9 No ■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? ❑Yes END ■ The following best describes my operation: ❑■ Office 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 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 Onl Occ Group: Occ Group: Occ Group: Total Sq Ft Occupied: _ Bldg. Permit # Planning Initia DatAO _12� J Conditions of Approval or Other Notes: Area: Occ Load: Area: Occ Load: Area: Occ Load: No. of Stories: Entitlement #: TIF Review: Y/ NC Zoning:' ❑■ No Building Reviewed By Initials: Date: Grease Interceptor Verified Inspected By Initials: Date: 6 f 0[�_gq&j South Coast Air Quality Management District 21865 Copley Drive, Diamond Bar, CA 91765-4182 arl (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). Company Name Povieng Corporation Property Address: _ City: Huntington 1118 Pacific Coast Highway, St6 e At 03 Beach Contact Person: Donald Povieng Title: CEO Type of Business: Real Estate Telephone: _ Zip Code: 4,; (619) 520-2856 Fax Number: e-mail address: donald@povieng.com Applicant (print name): Donald Povieng Signature: Will the facility have any of the following equipment? Yes ❑ No ❑■ Charbroiler Date: 06/30/16 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 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- O(G4W �i1XT 6 . 714/536-5271 Certificate of Occupancy No. 020,1 p- APPLICATION FOR CERTIFICATE OF OCCUPANCY CITY OF HUNTINGTON BEACH — DEPT. OF BUILDING & SAFETY (3rd Floor - Must Apply In -Person) Business License # IWA13�Z- V Date Business Address 41 ` !�(rj -zip Code Business Owners Name bo,,J Telephone NoZY fee Business Name ir��rv��,��c r�,�cT%'.,/C— Bus. Phone7tgf6a !��&v Business Type i A��,zf-,rc.�' Property Owner Information (required) Tenant/Emergeng Contact (required) Name v- 147x d e--y, Name C (.rt c- b,,- f , Address i A /' /_ 0 A� Home Address 5rT 4'r-- City - State/Zip CA f ib City gn..n 'ea State/Zip CzI:� 4,ei Telephone No. Telephone No. --7/V 35 C/ &Ih d THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or JkSxisting Building CHECK ALL THAT APPLY: ❑ Change of Property Owner x Change of Occupant ❑ Change of Use ❑ Additional Occupant ■ Indicate former type of business ■ Are you requesting that the electricity be turned on? YesQNdV ■ Is the building sprinklered? Yes QNoM ■ Will operations produce dust/wood shavings or similar material? YesQNo* ■ Will operations involve the repair or replacement of automobile parts Yes QNoV If yes: Describe the components repaired or replaced ■ Does the operation involve the use of welding or open flame? Yes QNo ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? Yes QNo V ■ The following best describes my operation: b Office Only ❑ Retail Sales ❑ Medical/Dental ❑ Restaurant/Take Out Food ❑ Warehouse /Manufacturing/Distribution (describe process and end product) ❑ Other (describe) For Official Use Onl Occ Group: Area: Occ Group: Area: Occ Group: Area: Total Sq Ft Occupied: No. of Stories: Bldg. Permit # Entitlement # Plnr lniti s: Date, - 6- Plan Chkr Initials: Conditions of Approv 7 �Other NQtes: TO x_'Q_ Inspection Date: Occ Load: Occ Load: Occ Load: TIF Review: Y/ N Zoning. 25 -CZ... Date: Insp Initials- Date• (G Building/Forms/document id goes here)