HomeMy WebLinkAbout2720 S Bristol St Unit #100 - Certificate of OccupancyPlrnnlng & Bulldlng Agcncy
Bulldlng Sefcty Dlvblon
20 Clvlc Center Ptrza
P.O. reEE (M-19)
Snntr Anr, CA 92702
(7t4) 647-sils
coo-2020-275-CO
OCCUPANCY INSPECTION
APPLICATION
BTN 55
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2720 South Bristol St,92704
Santa Ana BristolAltaMed
EEE 499 -9303 323
Castulo de la Rocha & President and cEo
2040 Camficld Ave., Los es, CA 90040 cdelarocha@altamed. org
ONo
603 603 ft.
N/A N/A N/A-
N/A
Castulo de la Rocha - 9303 323 558 - 7666
2040 Camfield Ave., Los cA 90040
O IIIANUFACTURING
O OFFICE
E RETAL SATES
OWHOTESATE
OWAREHOUSE
OGROUPASSEMSIY
o ArTo REPAIR (NO WELOING, NO OPEN
FI.^UES, NO SPRAY PAINTII{G
EAUTO BODY (SEE ATIENTIoN BEI-owI
owooovvoRKtNG (SEE ArrEtlT|ON gEl.ow)
O EATING ESTABTISHMENT (SEE PWAI
o oTHER (OESCR|EE
^BO/E!
SUSINESS OESCRIPTION
El Yr. El No No. t ll,tr yo{ b. rbfie .ndror utlt|e hu.n os. m.b.t |. .thlrt clny4
El Ya. E No No. 2 ooa.,olr$ldrclon P,u.. plduca h.,rr!ou.w.lt ?
l, yorr hrw an!*c.cr, 'l!l to a{har qurdloa mu nrust contact Orangc {lo[nty
f{n Authdrly s Hrrardorr tdlalcnat Dieeloturo Slc_tkJn at (?,14, 57S.BoOo
, YES, pl..r
ALLATTENNON:H'GROUP OCCUPANCIES (rNctuDtNG,NOTB('T IMITEO TO AUIO zuuY AUIOMOTIVE ORVTORKINCIDENTAI.STORAGETOWITHWELOINGFIOPENAI\4E.WOODT^ORKING,SIJAPICUTIING.ORNG SANDING wooD)NOTSH^I.L 8E CONDUCIED IN
5 zoDEPENT USE YES NO Dtbotr.poit
zo tz b
C 207DbI
rl thlE
S
g.n.nt.d at thb aitr?Yat I lt{o l.hrzrfltoulwarlr b.lnO
I lY.r I I No H.! thc lmpc6b] U.ntifild .n, hrr.rdou.
NOTES: (LlMlTATtOt{8 OF AppROVEO OCCUPANCy)
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Plannlng and Bulldlng Agency
Plannlng Dlvlrlon
20 Clvlc Centsr Phze
P.O. Box 1988 (M.20)
Srnta Anr, CA 02702
(714) 647.5104
tvlffUt .!antr{ns.otg
Please tum in thls compteted form wtth
CERTIFICATE OF OCCUPANCY
SUPPLEMENTAL
QUESTIONNAIRE
Company Name (print):AltaMed Health Services Corporatio n
contacr 1,1"r" Genevieve Lloyd
Address (business mailing address):2040 Camfietd Avenue
City:Los Angeles
state, CA
Phone No.: 323-559-7666
E-mail Address:glloyd
your Certiftcate of Occupancy appltcatlon.
90040
@altamed.org
Q Change of Property Owner E Change of Occupsnt ffi Crrange of Use E Additional Occupant
1. The following bort dsscrlbar my operatlon;
I Offtce Onty fiJ Retalt Satee E MedtcattOcntat
E warchouee/Manufacturing/Drrtrrbuaon ! Restauranurake out Food! Otner (descrtbe)
lf vacant, for how long?
5 Are you an independent contractor? yes fl No E
6. Location of the busineea and euite number:
E ldfloor D 2nrfloor !
-ttoor
2. prease provido a brief description of how the bueinese operates at this erte (ror examprs, preaeedegcribe the general nature of the ousinesi, what acriviriel ;ccii illi; the houra of operatton,open to the publlc)'
This wiil be a pharmacy: gpgn Monday-Friday gam - 7pm, saturday9am - 1pm, and Sunday is closed. ' --'
3' m*;?lH:;:H:l?#i*Xg:ss or u'o or racititv? (ptease contac*he /eas,ns asent orburctins
Medical
4. Has tho building or space bean vacant or is thrs a new building? yes D No il
7 Do you share the froor or business entrance wirh anorrer busineee? yes E No E
8. What is the amount of square footage lgaged? fh! bu'ttog tr 6mod by AtrMn, H..tth E.fric.r Co|Eorlm
9. How much of the space, which you lease, is office?
tr looo/o ;1 so% tr 30%
lf other than 100%, how is the remaining space used?
space is not leased
B Lese than 30%
S: A!nningtChm!Counlcr Fotrnr\
ColO Clurluonn.im O&ZZ-t I
.,N'ISANIA
ANArlilir
10. ls the bulldlng sprlnklered? yes n No E
11 Do you plan on making any improvements tinterior tenant improvements? yes n *o h-n"
building such as: exterior painting, signage,
lf yes, please describe:
12. Will your business include a lobby or wailing area? yes ffi No E
lf yes, what will be the dimensions?
13' Do you store equipment, materiars, or products within the buirding? yes E No !
a. wiil there be outdoor storage of eguipmenr, materiars, or producte? yes f] No u
tf yes, ptease describe: g feet by 15 feet
b' wlll there be storage racke, pallets rnd/or shelvlng exceedlng 6 feet g lnchec lnhelght? Yec I No [ 6crmli nqu,ndtott?cha/rhetn]ovorc,,tnqu,nwnhpermltc,o,mterl
14. Do you manufacture a product at the site? yee E No E
lf yes, please describe (including process and end product):
3' wil operaflons produce duet/wood ehavrnga or srmilar meteb. o"erlre operation rnvorvsirr" ri" or*rroTng ;;il;rffi:1Y""'E F" H *
15' Does the proposed uge involve a pationt care profession, such as doctor, denilst, chiropractor,acupuncturist, or physicat therapiel? yes E iVo D '
a. ls the proposed use within the mental health profession, such as:
m!Socialworker E
No/Not Applicabte tr Psychologist n Psychiatrist
Other
16. ls counseling proposed as a parl of your business operation? yes n No E
a. Does your counsering business contract work with a pubric agency? yes E No E
lf yes, please descrlbe:
17. Will your business be offering the following services:
E Abotrot sales, -D Smoking Lounge E Tettoosl perman€nt make-up! Body piercing/ Ear piercrnj s ---"s- p None of the above
18. Wilr your business be offerrng masssges as part of your businege rmassage as ancirary ro peoicnLs, mani"ri"i, .no other services. ,". ffi"*tlutl?
This includes
19 ls cannabig or cannabis related product stored, cultivated, distributed, tested, manufactured ordispensed at your buslness? yeg n t.to m
20' Do you pr€pare or se, food for consumption on or off the proporty? yes f] No fl
lf yes, do you provide sit down service [, drive-through f], or orders to go/pick_up D?
S: Plenning\ClBncrt.Countar Fo.ms\
ColO Ouo.llonnriro 0&.AZ-1 6
Please explain:
21. Does your buelnese sell automobiles or motorcycles? yer D No U
lf yes, pleaae explain:
" ?::"fi"" i:t'ffi* service or repair vehiclee or instal equtpmenr and accossoriec into vehicteo?
lf yes, please explain
23. I acknorledge that I have requested and
requlrenrenls pcrtaining to my businese and
received all zoning and Sente Ana Munlcloat
occupancy appticetion./Fi/ Mitieti
Code
I OECLARE UNDER PENALTYOF PERJURY, THATTHE FOREGOTNG ETATEMENTS ARE TRUE ANDCORRECT TO THE BEST OF TIY KNOWLEDOE AND BELIEF.
Nanre
lnformetlon
IHIn,iT,lHi'H$i,i'i'[:r'#l'J ffl"J t,'i yql", cuetomerg nom B:00,a.m to 4:00 p m , Monday
tr#Tfr 1i*tr#;,*":'*:1*#l*"i,13:,ft ,iix'"rl:$t,"l"y,Ht,[ffi l,w:;su
Thc Plannirp Dlvlalon revlews.ccrtlflcate of occupalgy llugltl..forchange.of addrosB, new burincrccc,or expancionr to enture that the proposcd ure ii consiatbil wfth tnJ iriiuirtrco zonlng reguhlons diiliiflli;I,ifl";Hllg,ff rJ155flf;;,ifJ,;_iilili;i"ilL|ff;fi orn,ns a rear-e oi.ffiilrhn!
lf a nonconforming urc is diccontinuod, or if a nonconformlng bullding b vacant, unured or unoccupbd fora pedod of 12 consecutlve months, any suorquent uge_muc-t confor;'r-n'ilry.r"rp"ct to thc prwlrlone ofg?#Hflli,:",1'[1ffiLiil3;ffifffl,[,.'#,9il-;;f iiiil:hku;ffii i.'oiJuirli'ilii, n
Genenlly, the followlng ures wlll ruqulru further documentruon or rn onend.d rcvlew rnd mry ormay not be permtttcd: offtco urer wtihtn en tnouetrtei ioni.itii.i,'rLt urent, hundrornrr. tradcor tochnlce! rchooll, rnd automotlve repdr anJ rervtce urC w[rti" ii,ii* 0,] f:. not prwiourryured for ruch purpores; a bulldlng ttrri aocr not m;-Jrii" piriliiiiT"lend ror rhr prcpored ure;ff"1ffiXJl*.9cnr.tc e hlsheiparklns dcmand or eorrirunciio-Jeveropmcnt dtanoaur pren
You may need to provlde floor ptana' elte plana, or documcnt the prlor ur-e beforc obtrlnlng aff i:ff,::i;ffi :lE:[:,{T.,#Hg;sffi ;il;,nil;d;il;ilil""o;6;i;;ifi ;;L.
S:PlennkrglClcrtrt.Counlar Forma\
CoO O!.ttonmtr. oDlT-18
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MEMORANDUM
TO: Finance & Management Services Agency
FROM: Planning and Building Agency
SUBJECT: Miscellaneous Cash Transaction
MCT # 50090
Wednesday, June 17, 2020
All fees are subject to change at any time and may also be afiecled by scheduled adjustments on July 1 of each year. The Payee must
pay the prevailing rate at the time payment is made.
ISSUED TO: Genevieve Lloyd
AltaMed Pharamcy Santa ANa Bristol
ADDRESS: 2040 Camfield Avenue
Los Angeles, CA 90040
TOTAL MCT AMOUNT $ 481.68
Comments:TVaP crdl"
Altrnative Contact: Deisy Romero
Phone: (3231 477-3327
lssued By: Khang, Kathy (Planning and Building Agency)
GL Account #
01 I 16002 51605
Total
$481.68
PROJECT NAME:
PROJECT ADDRESS:
AltaMed Pharmacy Certificate of Occupancy
2720 S Bristol St, Santa Ana, CA 92704-6209
MASTER rD #2020-159191
AP #412-20'.t-O2
Application # COO-2020-27*CO Permit #
ITEM OESCRIPTION QTY UNIT RATE AMOUNT FUNO NO.
BoLchi:55657 ' 6/19/2t-tZlt ID: NGARCIA
0tfice: CTYH Trnnsi: 16 I of 1Accbi: Reli: 50r:19[r
Rcpti:029s4297 - 6/19/2lt?tr 1l:?5 All
Ironssct i on lotol t491.68
GENEVIEVT LLOYD
ALTANED PHARIIACY SAHTA AHA P'RI
$481 681 0000 $481 68 01 1 16002 51605I Certificate of Occupancy (Planning and lnspection)
$4S1.(:ertif icote ol 0ccupnncg
Ul I I611112- 516050110-t/isn
cc+: *x xrtrr*x*rr{556
$481.
Auth*:(169l36
NOTES:For payment to be considered complete, a
Miscellaneous 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.
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