HomeMy WebLinkAbout10090 Adams Ave - CofO (9)J�
HUNTINGTON BEACH
CERTIFICATE OF OCCUPANCY 020p-
CITY OF HUNTINGTON BEACH
DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION
(3rd Floor — The Applicant Must Apply In -Person)
Business Address,(00 qD AbAM AVE, fkjA1nAt(iTjA1&i
&14 C Date % �/9
Business Owners Name Zip Code go26�
Business Name (',if-�L� L jE S Telephone No �� ��a-%��9
Business Type 0UE-L/}� 63 '�nl�'T� LjrjrJ� 41i�C. Bus. Phone L7_i ix) t/o7-7&q
Property Owner Information (required) Tenant/Emergency Contact (required)
Name 6 Py A4 A SA-1-am S(t 7?_='S Name ��s0_ ya
Address d D Home Address I:Z P I R,1.r ti UkI - b QP4-
City u,wkh State/ City )TQA n �Gi/t!2�/ State/Zip (��, V70 P
Telephone No. /L� �'�02 Telephone No. -7 9
THIS USE WOULD BE DESCRIBED AS:
❑ Newly Constructed Building or Existing Building
IS THIS BUILDING FIRE SPRINKLERED? Yes ❑ No
CHECK ALL THAT APPLY:
❑ Change of Business Owner ❑ Change of Occupant ❑ Change of Use KAdditional Occupant
• Indicate former type of business
• Are you requesting that the electricity be turned on? Kyes ❑ No
• Will operations produce dust/wood shavings or similar material? ❑ Yes ZNO
• Will operations involve the repair or replacement of automobile parts? ❑Yes ZNo If yes: Describe the
components repaired or replaced.
• Does the operation involve the use of welding or open flame? ❑ Yes XT No
• Will the business be a drinking, dining or assembly use with an occupant load of more than 50 persons? 'Yes `bg. No
• Will there be storage racks, gondolas, or shelving exceeding 5 feet 9 inches in height? ,KYes ❑ No
• The following best describes my operation: Office Only P' Retail Sales ❑ Medical/Dental
❑ Warehouse/Manufacturing/Distribution ❑ Restaurant/Take-Out Food ❑ Other
• Will any meat products including beef, poultry, and/or fish be cooked or fried onsite? [:]Yes XNO
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
Grease Interceptor Verified
For Official Use Only
Occ Group: r
Occ Group:
Occ Group:
Total Sq Ft Occupied:
Bldg. Permit #
Planning Initials: Date:
Conditions of Approval or Oer Notes:
t16 11<
Inspected By Initials: Date:
Area:
Area:
Area:
No. of Stories:
Entitlement #:
Use Permitted: 1Y / N
Occ Load: s 1
Occ Load:
Occ Load:
TIF Review: Y/ N
Zoning: �4'
Parking Meets Code (for use):,O Nq
Building Reviewed By Initials: Date: 1,6 I
South Coast .
Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182
Phone Number (909) 396-3529 http://www.agmd.gov
(+ G
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: OQZ-/ M,q vrWLdAl 9�z279.
Property Address: /Oct 170 2WA7/ i.S 4-Vie 000 _I"9� S'>3_Z_VA,) S'Gfi Figr,r- leorx-1
City: �h Z'A 4 A > jgEA�jd Zip Code: (S44- qa 6 4�4 6
Contact Person: �/�i/�15 -- 1/1L{ Title: 66UiV15k
Type of Business:/ . F}l Nd Del gg la;Telephone: T/aG) P102 — 7111
Fax Number: AV114 _ E-mail Address: (:�-A-eJ `-A/14 n R �a i'hc►�; �• Co 4yi
Applicant (print name): �'1H�fgZ4-- 1/`U Signature: e �a. Date:C�l
1. Will the facility release air pollutants, including but not limited to, dust fumes, gas, mist, odors, smoke, vapor, or a
combination of these to the atmospherE ''es C<No cN
2. Will the facility result of fuel -burning equipment including, but not limited to, boilers, generators, and internal combustion
engines' 'es 9No 01
3. Will the facility result of hazardous materials, including but not limited to, chemical, plastics, rubber, resins, solvents,
paints, and other parts cleaners? ❑Yes Po
4. Will the facility have use of above or underground storage tank? ❑Yes RNO
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? ❑Yes j No
c�
(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/Water Heater (max. heat input = or > 1 million BTU/hr)
❑Charbroiler/Smoker
❑Coffee Roaster/Afterbunner
❑Mixing/Blending of Liquids and/or Powders
❑Molding /Extruding/Curing of Plastic
❑ Pharmaceutical/Nutraceutical
❑Plasma/Laser Cutter
❑ Printing/Coating/Drying
❑ Production of Fumes/Dust/Smoke/Odors
❑Refrigeration Systems (containing > 50 Ibs of refrigeration
❑Deep Fryer (excluding equipment located at eating establishment) ❑Soldering Oven
dory Cleaning Equipment ❑Spray Booth
❑Electrostatic Precipitator ❑Storage of Acids/Solvents/Organics Liquids/Fuels
❑Fermentation ❑Storage Silos (sugar, flour, etc.)
❑Gasoline Storage & Dispensing Equipment
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).
Department of Planning & Building _
2000 Main Street 1.140 i
Huntington Beach, CA 92648
Phone: (714) 536••5241 Fax: (714) 374-1647 �`- Occupancy Application
10084
AdamsAv
APN 155-181-28
Certificate of Occupancy Application
Application Binder
Num Street Unit Bid
Job Address 10090 Adams Ave IAPN 155-181-28 RD 3920
Zoning CG Lot E:::�:] Tract Block
File Number CofO?
E2018-006159 No
M2018-006160 No
02018-006821 Yes
02018-006844 Yes
B2018-006845 No
02018-006909 Yes
02018-006910 Yes
B2018-007031 No
02018-007077 Yes
02018-007102 Yes
P2018-007121 No
02018-007340 Yes
Entered By Woo, Melanie �� Date Entered 11/05/2018
Default Inspector Stewart, Vic �� Status Issued
Permit Type Certificate of Occupancy Issue Permit? � Date 12/13/2018
—_
Origin Counter T W� Issued By Woo, Melanie
Building Use - City Planner Bui, Jessica]
BuildingUse - Count �L J New Building? Plan Checker Woo, Melanie
Y 9 • �I
Description
Internal Notes
CofO Number CO2018-007340 Choose PtintAll
Sheets to Issue
Issued By 1woo, Melanie Single CIO
S & LASHES*"" (ADD'L OCCUPANT TO OPTIMA SALON SUITES)
CofO Type Permanent -� Fees and Payments
CofO Status Issued Inspections
CofO Date Issued 12/13/2018 Temp. CofO Issued Date Printed
Utility Release Date Temp. COFO Expiration 12/13/2018 j
License Number
Business Name
Business Type
Business Phone
Proposed Use
1HAIRSALON
Former Use
SALON
Conditions
IPERSONAL
Click the « button to copy the Business License
information into the Certificate of Occupancy.
Business Licenses Business Name
A124412 WATER SOURCE
A180558 WATER SOURCE
A222042 LIVING WATER
A119122 MAIL BOXES ETC
Approved Occupied Area (Sq Ft) 5,645.00
# of Stories lrl
RM 3 & 4, APPROX 150 SF
o Change of Owner?
I Elec. Available?
Drinking / Dining > 50 Occupants?
11
0 Change of Use?
I Want Electricity On?
LLL�JJJi
� Welding / Open Flame?
0 Change of Occupant?
Sprinklered?
Automobile Repairs?
DAdditional Occupant?
Dust / Wood? Auto Parts Desc.
,occuparlcy Group/Load
Grouo Description Area
Construction Type Occupancy Load
B
SALON
5645
95
B
SALON
5645
95
Group Definitiol Business Use - Building or structure, or a portion thereof, used for office, professional or service -type transactions,
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