HomeMy WebLinkAbout15061 Springdale St - CofO (12)CERTIFICATE OF OCCUPANCY 020_t_-
CITY OF HUNTINGTON BEACH -
DEPT. OF PLANNING & BUILDING APPLICATION
NulpIiINGM 1EACF
Business Address 15061 Springdale Street, Suite 107
Business Owners Name 0sama Ay and Michelle Khun
Business Name Advanced Financial Services Inc.
Business Type Medical Billing,Bookkeeping, and Consulting
(3d Floor - The Applicant Must Apply In -Person)
Date 11/04/2015
Zip Code 92649
Telephone No. 7143791100
Bus. Phone 7143791100
Property Owner Information (required) Tenant/Emer ency Contact (required)
Name0sama Aly Name Michelle Khun
Address248 Saint Vicent Street Home Address 4759 Blackthorne Ave
Citylrvine State/Z1pCA 92618 City Long Beach State/Zip 90808
Telephone No. 9493467744
Telephone No. 5628264164
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or El Existing Building
IS THIS BUILDING FIRE SPRINKLERED? 0 Yes ❑No
CHECK ALL THAT APPLY:
■❑ Change of Business Owner ❑ Change of Occupant ❑ Change of Use ❑ Additional Occupant
■ Indicate former type of business
■ Are you requesting that the electricity be turned on? ❑Yes ❑E No
■ Will operations produce dust/wood shavings or similar material? ❑Yes ONo
■ Will operations involve the repair or replacement of automobile parts? ❑Yes NNo If yes: Describe the
components repaired or replaced.
■ Does the operation involve the use of welding or open flame? ❑ Yes On 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 ❑■ No
■ 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 p 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 N No
For Official Use Onl
Occ Group:
Occ Group:
Occ Group:
Total Sq Ft Occupied: _
Bldg. Permit #
Planning Initials:�_Date: ) V- - i
Area:
Area:
Area:
No. of Stories:
Entitlement #:
Occ Load: _
Occ Load: _
Occ Load: _
TIF Review
Zoning: —
Y/ N
cc
Building Reviewed By Initials: Date:
Conditions of Approval or Other Notes: o fi--,& . ^r-� Q-�C64':
Grease Interceptor Verified Inspected By Initials: Date:
wr'? - S>5z&
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: Advanced Financial Services Inc.
Property Address: 15061 Springdale Street, Suite 107
City. Huntington Beach
Contact Person: Michelle Khun
Zip Code: 92649
Title: Secretary
Metliml Billing. Bwkkee7trq, and Consulting rp 714 379-1100
Type of Business:
Fax Number:714 379-1101 e-mail address: m.khun@advfins.com
Applicant (print name): Michelle Khun Signature: —Date:
• 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 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
11 /04/2015
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).
s0A
Department of Planning & Building
2000 Main Street
Huntington Beach, CA 92648
Phone: (714) 536-5241 Fax: (714) 374-1647
CERTIFICATE OF OCCUPANCY
Cert. Number
Date Printed
C01994-007350
11 /05/2015
Address:
15061 Springdale St 107
Issue Date: 04/04/1994
Permit Number:
01994-007350
TCof0 Issue Date:
Business Name:
FIRST EMPIRE FINANCIAL CORP
TWO Expiration:
Business Type:
FINANCIAL SERVICES
Approved Sq Ft.: 3,400.00
Current Use:
# of Stories: 0
Occupant Groups:
I Description: Area:
10ccupant Load:
B-2
34
Conditions of Approval:
Contacts:
Contact Type: Name: EBM INVESTMENTS
Phone: (714) 379-1718
Property Owner Address: 15548 GRAHAM ST
Cell: ( ) -
City / State: HB, CA
Fax: ( ) -
Zip:
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