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HomeMy WebLinkAbout17111 Beach Blvd - CofO (63)CERTIFICATE OF OCCUPANCY OZo'- CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION 71 1 P BEACH B LV C> f* 20 S W V NT 1 N GT0 N(3`e Floor � The Applicant Must Apply In -Person) Business Address MP-4X-H t �� c� 2 6 y % Date l 2t2 o Business Owners Name IDA 41 E L A N S 6 Lm 1 Zip Code 1 9 Z 6 y 7 Business Name G v t D1 N G C-,MPA-FHy Telephone No. " Business Type MC-NTAi, N5_ALj-H SEPACC-5 HOZAPY Bus.Phone 71q 966 Property Owner Information (required) Tenant/Emergency Contact (required) Name LGnI L(C H T*5 rC Name LAURA D W S AC. f-i Address f 71 11 BEACH B LV © Home Address ? 16 3 KE S T W I CK 0 2 City NVNT1NGIoN 36AC,f tate/Zip CA 9 6 y 7 Ciry Ny�14616fl) State/Zip CA q;L6L1 & Telephone No. C.o NTAC f KA N DR OCAl C 2 Telephone No. f3 E A C H ? j y"316 319 8 140t G29 Cysv THIS USE WOULD BE DESCRIBED AS: O Newly Constructed Building or Existing Building IS THIS BUILDING FIRE SPRINKLERED? KYes []No CHECK ALL THAT APPLY: ❑ Change of Business Owner ❑ Change of Occupant ❑ Change of Use X Additional Occupant ■ Indicate former type of business ■ Are you requesting that the electricity be turned on? ❑Yes ;KNo ■ Will operations produce dust/wood shavings or similar material? O Yes Wo ■ Will operations involve the repair or replacement of automobile parts? El Yes XNo If yes: Describe the components repaired or replaced. ■ Does the operation involve the use of welding or open flame? ❑ Yes X No ■ Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? ❑ Yes X No ■ Will there be storage racks, gondolas, or shelving exceeding 5feet 9 inches in height? El Yes XNo ■ The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑Medical/Dental ❑Warehouse /Manufacturing/Distribution ElRestaurant/Take-Out Food % Other P4E NTA L H EA u 04 ■ Will any meat products including beef, poultry, and/or fish bee cooked or fried onsite? ❑ Yes X 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 X No . For Official Use Onl Occ Group: Occ Group: Occ Group: Total Sq Ft Occupied: _ Bldg. Permit # Planning Initials:_[�2 Date: t-22- 19 Occ Load: Occ Load: Occ Load: No. of Stories: TIF Review: Y/ N Entitlement #: Zoning: F Use Permitte Y / N Parking Meets Code (for Building Reviewed By Initials: Date: Area: Area: Area: Conditions of Approval or Other Notes: (OFFICA--i -ro nC—:F 1 0_,E_ AFE - Grease Interceptor Verified Inspected By Initials: Date: South Coast Air Quality Management District 21865 Copley Drive, Diamond Bar, CA 91765-4182 P (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: Gut _D I IJ G Fm PAY 4 Y Property Address: I-7 1 1 1 BEACH 8 LVD tf.20 5- city: N V NTI N G-FO N IBEAC H Zip Code: Contact Person: JDA N II✓l. A N S El_W1 I Title: 0u1 NGI- M �-r,t_ q�Fi-t'H 11 q8� �y5,q Type of Business:_ f1 DV Telephone: Fax Number: e-mail address: 9 it I d i r , em, cU��y g n� (.1 ,. C0 W, DAWIe(_ AMSELMo Applicant (print name): 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 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 • Will any of the following operations be performed? Yes❑ NoX 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- 019 -0433 Department or Planning & Building f 2000 Main Street Huntington Beach, CA 92648 I' Phone: (714) 536-5241 Fax: (714) 374-1647 Occupancy Application 17111 1 Beach Blvd 208 LIGHTER LEONARD E 17111 APN 165-364-03 of Occupancy Application ADDllcation Binder Num Street Unit Bld Job Address 17111 Beach Blvd 205 APN 165-364-03 RD 3315 Zoning CG-H Lot = Tract 436 Block File Number CofO? 02010-005730 Yes Entered By Niemczyk, Sandy Date Entered 08/19/2015 02011-002244 Yes 02011-002571 Yes Default Inspector I Moreno, David Status I Pending B2011-003518 No Permit Type Certificate of Occupancy Issue Permit? Date 82011-003519 No 02011-003919 Yes Origin Counter Issued By 82011-004820 Yes 02011-006488 Yes Building Use -City Planner 02012-000263 Yes Building Use - County ❑ New Building? Plan Checker B2012-004492 • No 02015-005049 Yes Description " INSIGHTFUL MI S FAMILY COUNSELING PROFESSIONALS"" 02015-006005 Yes M A-M5 P. S Internal Notes of Occupancy CofO Number CO2015-006005 Choose Print Al! CofO Type Permanent Fees and Payments Sheets to Issue Issued By Single C/O Cof0 Status I Pending Inspections CofO Date Issued Temp. CofO Issued Date Printed Utility Release Date Temp. COFO Expiration 7 License Number A293549 Business Name INSIGHTFUL MINDS FAMILY COUNSE Business Type I Professional / Other Business Phone ( ) - Proposed Use 1OFFICE Former Use 1OFFICE Conditions JOFFIEC TO OFFICE Click the « button to copy the Business License information into the Certificate of Occupancy. Business Licenses Business Name A068734 CORDIAL COLLECTION AGENC A075796 SEAWIND ESCROW CO INC A209778 COMPASS MORTGAGE A080370 JAMES SUNSERI ATTORNEY Approved Occupied Area (Sq Ft) 0.00 # of Stories aChange of Owner? Elec. Available? Drinking Dining > 50 Occupants? _ Change of Use? Want Electricity On? Welding / Open Flame? ® Change of occupant? Sprinklered? Automobile Repairs? F1Additional Occupant? Dust/Wood? Auto Parts Desc. �- Pccupancy Group/Load Group Description Area Construction Type Occupancy Load