HomeMy WebLinkAbout15171 Pipeline Ln - CofO (7)t
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CERTIFIQATE OF OCCUPANCY
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i:1T" OF HWNTINr'i1CN i3rkl1 C 7
DEPARTMENT OF DEVELOPMENT
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IturmNcroK wAc7r SERVICES Dale
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Address --------
Business Nam o Z �''-.l=_.�`�x.r"�" "�'+ zap '3." �--�._._.,....,.. ,_. District ------
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Business Type— Tel 7" 4�261- Q12 y
fBUrLiiit�pin�N
it . --- —. — Occ. Group_ _- __ —
. ' d F< :, t BU_„SINESS CiW_ERf�� MANAGER }
Name ,.� .:t i" s Us:i�.ik�."Y rF
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Name
Address r ' x i�L .,
HorneCiiy r
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Cty a . 's ct.i.3 a AK!Iis 4 fl �g 34
CcInstruction — =— -- Nome TsL
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No. of S craew _ _ `CccuReet i.:ad - _____� Spunkiered
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This Certificate. of OC upancy DEPARTMENT OF DEVELOPMENT SERVICES
SHALL BE posted in 1 Cansprouous
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Place on
the premises and shall nor be removed
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cept by the Building Official. a
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SUPPLSMENT,AL INFORMATION
1.
BUSINESS ADDRESS � "
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2.
Person to contact in case of emergency:
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Telephone number
3�
Does the building in question have electric.,,.y?
0 Yes
,
a. If No, are you requesting that the electricity be
No
MYes
turned on?
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4.
The building is sprinklered?
0Xes
F.
5.
Operations will produce dust/wood shavings or ,similar
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material?
Mes
hEl
No
6.
Operations will invv_t>e the repair or replacement of
f7Xes
automobile parts?8No
If yes:
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(a) Describe the components repaired or replaced.
OYes
(b) Does the operation involve the use of an open flame?
"
Q No
7.
The business is drinking, dining or assembly use tsat will
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result in an occupant load of more 'than '5 persons.
WNo
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8.
The following best describe, myoperation:
Office only
''
Re�ni1. Sales
�Tarehouse: )/Vti
i�arsufacttrringbstri utio t3e$cribe process and end
}product) _,. A.
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Restaurant/Take Outpo821
A,
Medical/Dental-
Other (describe)
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- (0562D) (12/8/86)
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SUPPLEMENTAL INFORMATION
(Continued)
Does the operation involve any of the following materials? ❑Yes
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if YeS, in iC?te quk ll.titles.
Material
Quantity
1. Flammable liquids
Class I --A
Class I-B
Class I- C
2. Combustible liquids
Class II
Class III -A
3. Combination flammable liquids
4. Flammable cases
5. Liquefied flammable gases
6 Flammable ble fibe,:s -loose
7. Flammable fibers - baled
8. Flammable solids
9. unstable materials
10. Corronive liquids
11. Oxidizing material gases
2. Oxidizing material - liquids
1.3. Oxidizing material. solids
14. organic peroxides
15. 'Witromethane (unstable materials)
-16. Ammonium nitrate
17. Ammonium nitrate compound mixtures
containing more than 60% nitrate
by weight
18. Highly toxic material and
Poisonous gas
1.9. Smokeless Powder
20. Black sporting porgy,'er
I hereby,iertif� that the above informati:,rr is true and correct to the
best of my "know,ledge.
Signature
Date
F ,
(056221))
12/8/86j