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Home My WebLink About126 Main St - CofO (36)o :t4 & CERTIFICATE OF OCCUPANCY 020 - CITY OF HUNTINGTON BEACH DEPARTMENT OF COMMUNITY DEVELOPMENT APPLICATION HUNTINGTON BEACH Business Address 12.6 M6;^ S+ Sie 104 Business Owners Name AA�� Business Name I� e'y1_ St-A�Cje go►( Business Type �v►� c j1��O (3rd Floor — The Applicant Must Apply In -Person) Date t %Id 1201°` Zip Code 1 Z 6 L' 9 Telephone No. S102 3 Bus. Phone Property Owner Information (required) Tenaht/Emergency Contact (required) Name ZC►jCAr\ yfope('�-'j Name R-CON04 1z Address 2.1g 5tr\ Sy "Q Home Address 1 6eiqnirep City }1upj)C jkn §KmX State/Zip 12.0 $ CitG06S State/Zip GA g01 Ile Telephone No. -114 Telephone No. THIS USE WOULD BE DESCRIBED AS: ❑ Newly Constructed Building or Existing Building IS THIS BUILDING FIRE SPRINKLERED? Yes ❑ No CHECK AFL THAT APPLY: d 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 EA No • Will operations produce dust/wood shavings or similar material? ❑ Yes [iNo • Will operations involve the repair or replacement of automobile parts? ❑Yes dNo 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 M/No • Will there be storage racks, gondolas, or shelving exceeding 5 feet 9 inches in height? ❑Yes [Rf No • The following best describes my operation: ❑ Office Only ❑ Retail Sales ❑ Medical/Dental ❑ Warehouse/Manufacturing/Distribution VRestaurant/Take-Out Food ❑ Other • Will any meat products including beef, poultry, and/or fish be cooked or fried onsite? [:]Yes [;Mo 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 [ONo Grease Interceptor Verified Inspected By Initials: Date: For Official Use Only Occ Group: Occ Group: f2 Occ Group: Total Sq Ft Occupied: sc% v Bldg. Permit # Planning Initials: '1 1--Date: 1—t 0 —10 Area: 5-1-0 Occ Load: 6' Area: Occ Load: Area: Occ Load: No. of Stories: TIF Review: Y/ N Entitlement #: Zoning: 5!e5 Use Permitted: Y / N Parking Meets Code (for use): Y / N Building Reviewed By Initials: Date: Conditions of Approval or Other Notes: LXIN 5�-\,Aq -\ill T_ \PaY ,, d-- Qwne 4 South Coast e Air Quality Management District t. 21865 Copley Drive, Diamond Bar, CA 91765-4182 Phone Number (909) 396-3529 http://www.agmd.gov PhM D Air Quality Permit Checklist r 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'cleararice from the South Coast Air Quality Management District (AQMD). Company Name: (fie kAer � FJ Property Address: 1 2-(o 2 City: txy\A 1 Y\ Zip Code: 9 2- (o4 Contact Person: A ►6VIA^CA 9-61; 1 r Title: VMn YVteir"W Type of Business: 1Ce— 6ca F Telephone: S 47 qrg Fax Number: E-mail Address: W% CO3 ti3 cXI` • COvf\ / Applicant (print name): VM Signature: Date: 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? ❑Yes [Jlo. 2. Will the facility res It of fuel -burning equipment including, but not limited to, boilers, generators, and internal combustion engines? ❑Yes 5ANo J 3. Will the facility result of hazardous material, including but not limited to, chemical, plastics, rubber, resins, solvents, paints, and other parts cleaners? ❑Yes o 4. Will the facility have use of above or underground storage tank? ❑Yes Rr No V 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 ❑No (Select all that apply) ❑//Abrasive Blasting Cabinet/Room ❑Internal Combustion Engine (rated > 50 bhp; e.g. back-up. generator) LdAir Conditioning System (containing > 50 Ibs of refrigerant) [Mixing/Blending of Liquids and/or Powders ❑Application of Paints/Adhesive/Resins ❑Molding /Extruding/Curing of Plastic ❑Baghouse/Dust Collector ❑Pharmaceutical/Nutraceutical ❑Bakery Oven (gas fired) ❑Plasma/Laser Cutter ❑Boiler/Water Heater (max. heat input = or > 1 million BTU/hr) ❑Printing/Coating/Drying ❑Charbroiler/Smoker ❑ Production of Fumes/Dust/Smoke/Odors ❑Coffee Roaster/Afterburner [Refrigeration Systems (containing > 50 Ibs of refrigeration ❑Deep Fryer (excluding equipment located at eating establishment) ❑Soldering Oven ❑Dry Cleaning Equipment ❑Electrostatic Precipitator ❑Fermentation ❑Gasoline Storage & Dispensing Equipment ❑Spray Booth ❑Storage of Acids/Solvents/Organics Liquids/Fuels ❑Storage Silos (sugar, flour, etc.) 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). C) Department of Planning & Building 2000 Main Street Huntington Beach, CA 92648 Phone: (714) 536-5241 Fax: (714) 374-1647 Occupancy Application Property Info 1126 1 Main St 1204 1 IZE16AN ZEL M .-J Certificate of Occupancy Application Application Binder Num Street Unit Bid Job AddressJ126 IMain St 1102 1 APN 1024-154-01 x RD 4014 .. .. ...... Zoning jSP5-CZ Lot 26 Tract 352 Block File Number COO? E2012-007321 No Entered By Bolls, Derek Date Entered 101/2612017 M2012-007321 No 02013-002339 Yes Default Inspector Benbow, Jeff Status IssuedB2013-004225 Yes Permit Type Certificate of Occupancy Issue Permit? 0 Date 101/26/2017 E2013-004226 No — C2013-004697 No Origin Counter Issued By [Permitl 02013-006443 Yes Building Use -City if— C2013-008244 No I Il. Planner Burden, Kimo Yes I Building Use - County New Building? Plan Checker Bolls, Derek C2015-004016 No E2015-004247 No Description ***NEKTER JUICE BAR'- 02017-00,0533 Yes ..... ..... Internal Notes iCertificate of Occupancy CofC, Number [CO2017-000533 Choose Print All CofO Type Permanent Fees and Payments Sheets to Issue . Inspections Issued By jPermitl Single CA) CofO Status Issued CofO Date Issued, 101126/2017 Temp. COO Issued Date Printed Utility Release Date Temp. COFO Expiration 01/26/2017 Click the « button to copy the Business License License Number information into the Certificate of Occupancy.. Business Name Business Licenses Business Name Business Type A209912 HUNTINGTON SURF AND SPORT A189086 SURF CITY CANDY Business Phone A205164 MAIN STREET OPTICAL& BOUTIQ A210810 PSYCHIC BOUTIQUE Proposed Use JUICE SHOP Approved Occupied Area (Sq Ft) Former Use JUICE SHOP # of Stories12 Conditions Change of Owner? D Elec. Available? 0 Drinking i Dining > 50 Occupants? Change of Use? Want Electricity On? 0 Welding /Open Flame? fit, Change of Occupant? Sprinklered? Automobile Repairs? Additional Occupant? Dust I Wood? Auto Parts Desc, ,Occupancy Group/Load Group Description Area Construction Type Occupancy Load B STORES 598 6 B STOR_ES_ 698 6 Group Definitic Business Use. -Building or structure, or a portion thereof, used for office, professional or service -type transactions, including storage of records and accounts. [Coiiitacts Type Name field must be blank to add/change Contractor, Designer or Engineer Same As Business Owner Contractor Designer / Engineer Mobile Phoneli Property Owner Business Owner Name BRANCAL, FAHREEN JON Pager Tenant Company NEKTER JUICE BAR State License Type Address 126 MAIN ST #102 0 Self Insured I Non -Employer? city I State I Zip HUNTINGTON BEACH CA 92648 F-1 Override Contractor Expiration Dates? Email Phone (949) 558-7764 x _j Fax E) Date Overridden Overridden By