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8855 Adams Ave - CofO (3)
J� HUNTINGTON BEACH CERTIFICATE OF OCCUPANCY 020- D CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION (3`d Floor — The Applicant Must Apply In -Person) Business Address 5 $ S % A 04H-5 >ivg Hr�llcll- /3g-10-f Date O/- 2- 9- 20/'r Business Owners Name C,05k/f-�- 7110 t','O Zip Code ?Z t—, V6 Business Name 0674/CX AA)t- tl-l(uyw bcYa T Telephone No. 7141--cf4Y ZYo? Business TypeUi/"i�� �' des e[�, Sd�°L��'�r�'t Bus. Phone Property Owner Information (required) Tenant/Emergency_Contact (required) Name 41fJI5 lk/ C L -7-k © ( U Name ;Fclrei.-i-c ca' do G Address f S 0!Y 1o4A6X4,-LuJ S Home Address i.7 a/,r >�crrc�- mad City 14 10U10,v7 f State/Zip G4 . -7/ 7-94 City X, r1W State/Zip ql q /-L4 - Telephone No. q 6 �- G X 5 K % `',C Telephone No. 6Z 6 "? F U S `t THIS USE WOULD BE DESCRIBED AS: O Newly Constructed Building or ❑ Existing Building IS THIS BUILDING FIRE SPRINKLERED? ❑ Yes ❑No CHECK ALL THAT APPLY: ®-Change of Business Owner ❑ Change of Occupant 0 Change of Use ❑ Additional Occupant ■ Indicate former type of business ■ Are you requesting that the electricity be turned on? ❑Yes dNo ■ Will operations produce dust/wood shavings or similar material? ❑ Yes 0'No ■ Will operations involve the repair or replacement of automobile parts? ❑Yes 2 o If yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? ❑ Yes Cl"No ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? ElYes ®'(NO ■ Will there be storage racks, gondolas, or shelving exceeding 5feett 9 inches in height? ❑Yes 21�0 ■ The following best describes my operation: ❑ Office Only E 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 El -No For O 'cial Use Onl Occ Group: Occ Group: Occ Group: Total Sq Ft Occupied: Bldg. Permit # Planning Initials: V 1 Date: f' L 9' 19 Conditions of Approval or Other Notes: Occ Load: 21 Occ Load: Occ Load: No. of Stories: 1 TIF Review: Y/ N Entitlement #• Zoning:C Use Permute Y / N Parking Meet Code (for use : Y N Building Reviewed By Initials:_y__QDate: 1 • Area: $8o Area: Area: Grease Interceptor Verified Inspected By Initials: Date: -, South Coast Air Quality Management District 21865 Copley Drive, Diamond Bar, CA 91765-4182 p .�o (909) 396-3529 • http:// www.agmd.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: I v-t aV- 2) 1- /�, ?i Property Address: 79 6 dr9 .41)12tt 5 at,- 4 City: /4rv716�v 9- l-,f-"" G Zip Code: Contact Person: 4*01ei C& 7i" °-c Title: Caw. N'�' -- Type of Business: V,) 7,'0 n/ Telephone: - sp./,T "ZqU C/ Fax Number: e-mail address: -0-_441 9'-v • 9 Applicant (print name): 4 +,�,V- Z� Signature: Date: • Will the facility have any of the following equipment? Yes ❑ No E . 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❑ NaEj__�' 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- oia-0691 Department of Planning & Building 2000 Main Street Huntington Beach, CA 92648 Phone: (714) 536-5241 Fax: (71,4)374-1647 8839 APACIFIC PLNASHOPPINGCENTER 8835 APNs 153-243-09 Occupancy Application Application Binder Num Street Unit Bld Job Address 8859 Adams Ave APN 153-243-09 RD 3817 Zoning CG Lot 83 Tract 4339 Block u File Number CofO? M2010-005290 No M2010-005291 No 82010-005723 No P2010-005810 No E2010-006211 No 02012-005373 Yes B2013-003689 Yes E2013-003690 No M2013-003693 No P2013-003696 No C2013-006911 No 02013-007765 Yes Entered By Diaz, Michele Date Entered 12/06/2013 Default Inspector Andino, Richard i Status jPending Permit Type Certificate of Occupancy ^ +�j Issue Permit? Date Origin. Counter—��—�Issued By Building Use -City Planner Nguyen, Tess ----� Building Use - County New Building? Plan Checker Chuor, Phillip �1J Description J—POWER NUTRITION DEPOT — Internal Notes CofO Number CO2013-007765 Choose Print All CofO Type Permanent Issued By Frisby, Chad Sheets to Issue Single C/O CofO Status Issued Fees and Payments Inspections Cof0 Date Issued 04/15/2014 Temp. CofO Issued Date Printed Utility Release Date Temp. COFO Expiration License Number A288144 Business Name POWER NUTRITION DEPOT s Business Type Retail Business Phone (714) 938-2409 Proposed Use RETAIL Former Use RETAIL Conditions Click the « button to copy the Business License information into the Certificate of Occupancy. Business Licenses Business Name A003360 BEALL M E DDS A161502 FONG THERESAT DDS A205580 PETER J ANDOR DDS INC A091048 DELTA LIQUOR Approved Occupied Area (Sci Ft) 880.00 # of Storiest� Change of Owner? D Elec. Available? Drinking / Dining > 50 Occupants? of Use? 0Change Want Electricity On? � Welling / Open Flame? Change of Occupant? Sprinklered? Automobile Repairs? Additional Occupant? Dust / Wood? Auto Parts Desc. Occupancy Group/Load Groun Descriotion Area Construction Type Occupancy Load B STORES 880 24 B STORES 880 24 Group Definitio Business Use - Building or structure, or a portion thereof, used for office, professional or service -type transactions, innh.�linn cfnr_ of'. —A. —1 ...--4c