HomeMy WebLinkAbout80426520 - Certificate of OccupancyPlannlng & Building Agency
Building Safety Division
20 Civic Center Plaza
P.O. 1988 (M-19)
Santa Ana, CA 92702
(714) 647-s8ts
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No. 804-2G520
OCCUPANCY INSPECTION
APPLICATION
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BUSINESS
1 tr-zl PHONE NO.
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BUSINESS PHONE NO.LEASING AGENT OR PROPEBTY MANAGEMENT NAME
NG
BUSINESS PHONE NO.EMERGENCY PHONE NO.
[ ] Yes [ ] No No. 1 Will you be storing and/or ulilizing hazardous materials at
this facility?
[ ] Y€s [ ] No No. 2 Does your production process produce hazardous waste?
ll you have answsred Yes to sithor question you musl contact Orange County
Fir6 Authority's Hazardous Material Disclosu16 Section at (714) 573-6000.
It YES. olease describe
BUSINESS DESCRIPTION
I, MANUFACTURING
! OFFICE
IRETAIL SALES
IT WHOLESALE
i] WAREHOUSE
1. GBOUP ASSEMBLY
r AUTO REPAIR (NO WELDING, NO OPEN
FLAMES, NO SPRAY PAINTING
iAUTO BODY (SEE ATTENTION BELOW)
WOODWORKING (SEE ATTENTION BELOW)
EATING ESTABLISHMENT (SEE PWA)
OTHER (DESCRIBE ABOVE)
3
ATTENTION: ALL GROUP "H" OCCUPANCIES (INCLUDING, BUT NOT LIMITED TO, AUTO BODY, AUTOMOTIVE WORK OR STORAGE
INCIDENTAL TO WELDING WITH OPEN FLAME, WOODWORKING, CUTTING, SHAPING OR SANDING WOOD) SHALL NOT BE CONDUCTED IN
ANY BUILDING OR STRUCTURE UNLESS THERE IS AN APPROVED FIRE SPRINKLER SYSTEM INSTALLED.
/
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DATE
DEFARTMENT USE ONI.Y IL lrITS?
NO Date of report:
PRIOR APPROVED USE
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PRIOR APPHOVAL DATE
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PRIOR OCCUPANCY GBOUP
taA
PRIOB CONSTRUCTION TYPE
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PLANNING s(LZONE CUP \rAPPROVED DENIED DATE
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S$PleOCC. LOAD OCCUPANCY GROUPB CONSTFIUCTION TYPEVe DENIED DATE
321-21
Note: One of lhe lollowing must be checked by the C of O lnspector.
[ ] Yes [ ] No Has the insp€ctor identilied any hazardous materials at this lacilitl,[ ] Yes [ ] No ls hazardous waste being generated at this site?
NOTES: (LIMITATIONS OF APPROVED OCCUPANCY)r e.t",, t
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*-SANIA
NA-"'ffi
Planning and Building Agency
Building Division
20 Civic Center Plaza
P,O. Box 1988 (M-20)
Santa Ana, CA92702
(714) 647-5800
www.sa nta-a na. org
CERTIFICATE OF OCCUPANCY
SUPPLEMENTAL
QUESTIONNAIRE
I
-
Please turn in this completed form with your Certificate of Occupancy application.
companyName(print): Anqie llt,fi;h'o: C), hJ
Contact Name:
Address (business mailing address):qll N. Hr*rrhov n lul 4 D
City:State: C A. Zip OaTn?
Phone No.(l t,i,1,\f--8: 3 .!E-mailAddressw! Change of Property Owner fi Change of Occupant ! Change of Use ! Additional Occupant
1. The following best describes my operation:
E Ofice Only fl Retailsales E Medical/Dentat
! Warehouse/Manufacturing/Distribution E RestauranUTake Out Food
E Otner (describe)
2. Please provide a brief description of how the business operates at this site (for example, please
describe the general nature of the business, what activities occur on-site, the hours of operation,
open to the public).
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3. What was the former type of business or use of facility? (Please contact the leasing agent or building
owner to determine piol business use.)
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4. Has the building or space been vacant or is this a new building? Yes p No E
lf vacant, for how long?
5. Are you an independent contractor? Yes E No E
6. Location of the business and suite number:
R l"floor tr 2dfloor ! _ftoor
7. Do you share the floor or business entrance with another business? Yes E f.f o E
8. What is the amount of square footage leased?
9. How much of the space, which you lease, is office?
tr 1oo% ! so% K 30%
lf other than 100%, how is the remaining space used?
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tr Less than 30%
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10. lsthe buildingsprinklered? Yes ft No E
11. Do you plan on making any improvements to the building such as: exterior painting, signage,
interiortenantimprovements? Yes ffi No E
rf yes,pleasedescribe: lrtlurioy llo-tffi3 '/'*nW >'in
12. Wlll yourbusinessincludealobbyorwaiting area? Yes I No E
lf yes, what will be the dimensions?
13. Do you store equipment, materials, or products within the building? Yes E ruo E
a. Will there be outdoor storage of equipment, materials, or products? Yes E No E
lf yes, please describe:
b. Will there be storage racks, pallets and/or shelving exceeding 5 feet 9 inches in height?
Ves Q No E @ermit required for racks/shelving over 6', inquire with permit counter)
14. Do you manufacture a product at the site? Yes n ruo ,&
ff yes, please describe (including process and end product):
a. Will operations produce dusUwood shavings or similar material? Yes E ruo Eb. Does the operation involve the use of welding or open flame? Yes ! No K '
15. Does the proposed use involve a patient care profes.qion, such as doctor, dentist, chiropractor,
acupuncturist, or physical therapist? Yes fl *o R
a. ls the proposed use within the mental health profession, such as:
5 No/Not Applicable tr
Socialworker E Other
Psychologist IPsychiatrist
A/,tl/ O _
16. ls counseling proposed as a part of your business operation? Yes E No E
a. Does your counseling business contract work with a public agency? Ves [i No E
tf yes, ptease describe: 1+e,vn"li {e_
17. Will your business be offering the following services:
E Alcoholsales E Smoking Lounge
E AoOy piercing/ Ear piercing
operation?^This includestr NorE
19. ls medicalmarijuana stored or dispensed at your business? Yes E to k
20. Do you prepare or sell food for consumption on or off the property? Yes E No h
lf yes, do you provide sit down service fl, drive-throush E, or orders to go/pick-up !
Please explain
cm\cntr-frm\Supp. Quest.
0712016
E Tattoos/ Permanent make-up
Q ruone of the above
18. Will your business be offering massages as part of your business
massage as ancillary to pedicures, manicures, and other services. Yes
21. Does your business sell automobiles or motorcycles? Yes E No
lf yes, please explain:
your business service or repair vehicles or install equipment and accessories into vehicles?n *oR
lf yes, please explain
I DECLARE UNDER PENALTY OF PERJURY, THAT THE FOREGOING STATEMENTS ARE TRUE
AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF.
lL-l? -ZoLRDate
Print
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Title
lnformation
The Planning Division's Public Counter is open for walk-up customers from 8:00 a.m. to 4:00 p.m.,
Monday through Friday, except Wednesday 10:00 a.m. to 4:00 p.m. The Planning Division is located
within City Hall - Ross Annex, 20 Civic Center Plaza, First Floor. Additionally, you may call us at (714)
647-5804 should you require any general information.
The Planning Division reviews Certificate of Occupancy requests for change of address, new businesses,
or expansions to ensure that the proposed use is consistent with the established zoning regulations of
Santa Ana. Please check with the Planning Division's Public Counter prior to signing a lease or
committing your business to a certain location to determine the feasibility.
lf a nonconforming use is discontinued, or if a nonconforming building is vacant, unused or unoccupied
for a period of 12 consecutive months, any subsequent use must conform in every respect to the
provisions of the Municipal Zoning Code, and a nonconforming building may not thereafter be used or
occupied until it conforms in every respect to the provisions of the Code.
Generally, the following uses will require further documentation or an extended review and may or may
not be permitted: office uses within an industrial zone; medical, restaurant, laundromat, trade or technical
schools, and automotive repair and service uses within spaces that were not previously used for such
purposes; a building that does not meet the parking demand for the proposed use; or a use which
generates a higher parking demand or adherence to development standards than the previous uses.
You may need to provide floor plans, site plans, or document the prior use before obtaining a Certificate
of Occupancy to determine the grandparented rights of a nonconforming use, or a use which has
additional Code requirem ents.
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22. Doesyes
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GREASE INTERCEPTOR MEMORANDUM
To:Torria Zerba. Planning & Builcling Date: Decernber I I 201 8
From: Behrooz Sarlak - Assistant Engineer Il
Location: 5l I N HARBOR B #D - ANGIE NUTRITIOI\ CLUB
The above referenced food service establishment (FSE) must comply with Ordinance NS-26-70 as
follows:
X A gravitl' grease interceptor is not required at this FSE for the following reason(s):
x The proposed FSE FOG discharges are projected to be negligible and will not likely cause
a significant impact to the sewer system.
A grease interceptor cannot be installed due to physical site limitations or inadequate
slope between the interceptor and private and/or public sewer lines.
The proposed remodeling work does not increase the current amount of FOG generated
The proposed remodeling work does not require: I ) under the slab plumbing in the
kitchen area,2) an increase in the net public seating area, 3) an increase in the size of the
kitchen area, or 4) any change in the size or type of food preparation equipment.
This is an existing FSE involving a change of ownership that will not result in an
increase of FOG discharged to the sewer system.
Special comments/conditions :
The Developer/owner acknowledges that no tenant improvements that include change of plumbing in the
kitchen area, change of kitchen equipments, expansion of dining area, and or change in type of
operations or use, are being performed at this time. The developer/owner has been notified that any
improvements, that include that which is mentioned above, will result in the revocation of this waiver to
install a grease interceptor.
Clc Taig Higgins, PWA
Julie Amsden, P&BA
( ('scrs t6ulak Dsklop F(X; GI - ).i() Joc
MEMORANDUM
TO:
FROM:
SUBJECT
Finance & Management Services Agency
Planning and Building Agency
Miscellaneous Cash Transaction
MCT # 42294
Vednesday, December 12, 2018
I
All fees are subject to change at any time and may also be affected by scheduled adjustments on July 1 of each year. The Payee must
pay the prevailing rate at the time payment is made.
ISSUED TO: Angie Nutrition Club
ADDRESS: 511N Harbor Blvd Unit D
Santa Ana, CA 92703
TOTAL AMOUNT RECEIVED $ 463.51
Comments:
co 804 26520
lssued By: Flores, lvan (Planning and Building Agency)
GL Account #
01116002 51605
Total
$463.51
PROJECT NAME:
PROJECT ADDRESS:
co 804 26520
511 N Harbor Blvd Unit# D, Santa Ana, CA 92703-2757
MASTER tD#2018-148252
AP #198-162-24
Application # MISC-2018-216-CO Permit #
ITEM DESCRIPTION QTY UNIT RATE AMOUNT FUND NO.
'l Certificate of Occupancy (Fee Purposes Only)1 0000 $463.51 $463.51 01 1 16002 51605
Bot,:hi:47355
0ff ice: CTYH
Acct,*:
Rcpti:t-t24691,
Transoct i on
2/12/2015 ID: CC
'ansi: 28 I
Ref t: 42?_9 4- LZil2/2(tl8 10:.tI t964. r
AI{6IE HUTR u$
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t461.
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$15 .4
NOTES: For payment to be considered complete, a
Mrscellaneous Cash Transaction (MCT) must be paid
in full. Applicant must return to Planning with
stamped cashier validation of the paid MCT for
closure in the Planning system.