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Home My WebLink About15201 Connector Ln - CofO (3)- fuAj APPLICATION FOR CERTIFICATE OFOCCUPANCY CITY opxownmoromBEACH DEPARTMENT opDEVELOPMENT SERVICES HU"MNGTON MACH gv,/nrxumamy__Rzcxa/^el'_��~�^�' '�*-------'----- -------- `,p ~__�u��==_�-�=_------___-^-~-------__ na ' �mEmmA*��n ------ -. �vmp C, 7��^� xorn*Ti« THIS USE WOULD asDESCRIBED AS: 0w6w//cQNeTnv�TF�Rvx` [� u/«uaeu+wv^En [j ��ur�upotC�.p^wT NTEx/!nmnRu:|xNo �l co�u�ec* Auomoma'o{zupom� NOTICE: 1!!V will not t !A No electrical service Change of'occupa'ncy or use inspection fee. ' /140 i Huntington Beach Fire Code Secti:)n 5. Huntington Beach Fite Code Section (FOA OFrICE USE ONLY) SUPPLEMENTAL INFORMATION SUPPLEMENTAL INFORMATION 1. BUSINESS ADDRESS 2. Person to contact in case of emergency:��,,�� Tel phone number: s9a - a, 9 1.P 3. Does the building in question have electricity? M-Yes ONO a, if No, are you requesting that the electricity be C1Yes turned on? D No 4. The building is sprinklered? Oyes ;�-NYo 5. Operations will produce dust/wood shavings or similar material? ❑ Yes QrNO 6. Operations will involve the repair or replacement of Oyes automobile parts?No If yes: (a) Describe the components repaired or replaced. (b) Does the operation involve the use of an ov,"n flame? ❑Yes ONO 7. The business is drinking, dining or assembly use that will resglt in an occupant load of more than 50 persons. Dyes ONO 8. The following best describes my operation: Office Only Retail Sales LHEr e"hZiu s e Manuf� c ur'ng/Disf,ribut'0n (de cribe process and end product) , � y,: 12,72 ljo'e- ' Restaurant Ta a ut Foo Medical/Dental. Other (describe) (0562D) (12/8/86) SUPPLEMENTAL INFORMATION (Continued) Does the operation involve any of the following materials? ©ges NO if Yes, in icate quant t1es: Material Quantity 1. Flammable liquids Claims I -A Class I-B Class I-C 2. Combustible liquids Class II Class III -A `..^ 3. Combination flammable liquids 4. Flammable gases 5. Liquefied flammable qases 6. Flammable fibers —loose 7.FFlammabl� a fibers - baled 8. Flammable solids 9. Unstable materials -- 10. Corrosive liquids ------ 11. Oxidizi c,)_material - gases 12 Oxidizing material - liquids— 13 Oxidizing material - solids 14. organic peroxides 15. Nitromethane (unstable materials) 16. Ammonium nitrate --- 17. Ammonium nitrate compound mixtures containing more than 60% nitrate by weight 18. Highly toxic material and oisonous gas 19. Smokeless powder 20. Black sporting powder I hereby certify that the above information is true and correct to the best of my knowledge. signature (0562U) Date (12/8/86)