HomeMy WebLinkAbout2111 PALOMAR AIRPORT RD; MULTI-PERMIT FILE; CO83-149; Certificate of Occupancy(
ATTACHED.ARE VARIOUS
CERTIFICATECIF OCCUPANCY
PERMITS FOR
2111 PALOMAR AIRPORT RID.
S VARIOU S SUITE #"S
,
BY YEAR '•• •
OLDEST TO MOST RECENT .
THRU 1990
VALIDATION
City of Carlàbad
CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
1200 ELM 438.5525 You are required by law to complete and return this form to our office.
Address where Business __________
willbeconducted 2111 Palomar Airport Road Buildina
Permit'o. 83-149
Name Occupant. Graham International, Inc. Business
Phone (619) 4381545
Address of Home Office of
Occupant if different from above Same as above . .
Home Office
Phone
Owner of Building Graham International, Inc. A Same as Address above Phone
Typeof Business Investment, Real Estate -
Describe exact use of all portions of each building and lot Leasing Office Space
Previous use of Building None
Type of flammable or explosive liquids to be used, if any None
I certify that I have read the statements contained in this application; that they are true and correct, and that I make this statement under penalty of perjury.
Dated this day of 19 In the City of Carlsbad, State of California
Signature of Applicant
Use Zone -PM
FOR DEPARTMENTAL USE ONLY
Occupancy Group /'_.. 2..... Type of Construction j?// S, i.'
Planning
Department Date Approved By IL 1A-
Engineering
Department Date///?/t Approved By
: Prevention
/
Date Approved By
Health
Department Date Approved By
Building
Department Date Approved By
Signature of Building Official
White - Building Dept. Yellow - Applicant Pink - Finance Gold - Fire Dept.
VALIDATION
City of Carlsbad
APPLICATION FOR CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
1200 ELM 438-5525
Address where Business ,1/// will be conducted I 00 Oe
FrA Mtn
Buildina
Permit'-1o. 93'
Name of Occupant TACAN CORPORATION
11 f
( i_,) Business Phone 438-1010
Address of Home Office of
Occupant if different from above see above Home Office Phone see above
Owner of
.
Phone is,is
Type of Business Corporate Offices
-Describe exact use of all portions of each building and lot NJA - office. building
Previous use of Building NIA -
Type of flammable or explosive liquids to be used, if any NIA
I certify that I have read the statements contained in this application; that they are true and correct, and that I make this statement under penalty of perjury.
Dated this , 19 city of r lsbad, State of California
Signature of
Applicant a
Use Zone
-
/7iY\ Occupancy
USE ONLY
Department Date jL-7fJ"1
Type of Construction
Planning
Approved p Disapproved By
Department
Engineering Date 7/'?j/y Approved Disapproved By
Prevention
Fire
. Date'7'ak7 Approved Disapproved By
Health
Department Date Approved
.
Disapproved By
Builing
Department Date Approved sapproved By
V/-
White - Building Dept. Yellow - Applicant Pink - Finance Gold - Fire Dept. . '1
VALIDATION
City of Carlsbad -.
APPLICATION FOR CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
1200 ELM 438.5525
dress where Business 79'1-'&-r,La,..., be conducted ,4X- #200 Buildin 0 .-.Si7 Permit
me of Occupant Rushall, McGëever. & Iappington Business Phone 38-6855
dress of Home Office of cupant if different from
[Type
Home Office
Phone NJA
ner of Building 2121 Palomar AirpotneRd., #300
of Business attorneys Carlsbad, California
Describe exact useof all portions of each building and lot N/A. - office building
Previous use of Building N/A
Type of flammable or explosive liquids to be used, if any NIA
I certify that I have read the statements contained in this application; that they are true and correct, and that I make this statement under pnaity of perjury.
Dated this in the City of Carlsbad, State of Californ
Signature of Applicant Signature of /f)j,,,,,, Building Official
Use Zone ffYls
FOR DEPARTMENTAL USE ONLY
Occupancy Group Type of Construction /11.-A1 £
Planning
Department Date f//3 / fa Approved Disapproved By
Engineering
Department Date Approved Disapproved By
Fire
Prevention Date Approved Disapproved By
Health
Department Date Approved Disapproved ' By
Building Department Date,12_-./7_..r4 Approved Disapproved By
White - Building Dept. Yellow - Applicant Pink - Finance Gold - Fire Dept.
VALIDATION
City of Carlsbad
APPLICATION FOR CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
1200 ELM 438.5525
Address where Business
will be conducted 2./,// 1 'a4 - AXXR #300
a Buildin
Permit'f'lo. ' 0
Name of Occupant Luce, Forward, Hamiltn ~-'scripps Busi 438-7333ness
Phone
Address of Home Office of
Occupant if different from above N/A Home Office
Phone N/A
-
Owner of Building )1&g..&ress
Type of Business attorneys
-
2121 Palomar AirpotneRd., #300
Carlsbad, California
Describe exact use of all portions of each building and lot NIA -. Office building
Previous use of Building N/A
Type of flammable or explosive liquids to be used, if any N/A
I certify that I have read the statements contained in this application; that they are true and correct, and that I make this statement under penalty of perjury. gz
Dated this ,aq7:,Sday of 1984 in the City of Carlsbad, State of Calif
Signature of
Applicant Signature of
Building Official
Use Zone
FOR DEPARTMENTAL USE ONLY
Occupancy Z- Type of Construction /'
Planning
Department Date /r'i Approved Disapproved By
Engineering
Department Date 114 1 Approved Disapproved By
Fire
Prevention Date Approved Disapproved By
Health
Department Date Approved Disapproved By
Building Department Date 7- Approved Disapproved By
White - Building Dept. Yellow - Applicant Pink - Finance Gold.— Fire Dept.
VALIDATION
City of Carlsbad
APPLICATION FOR CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
1200 ELM 438.5525
Address where Business
will be conducted 2-/(( /I94( )' ( , J' 2.0) Buildina
'permit 1'jo. '' / 3 2)
Name of Occupant ,41Pi.j £1. S'VSTIY3 Business
Phone F
Address of Home Office of
Occupant if different from above /YM Home Office
Phone
Owner of Building 6,44tIA.s4&. /,4_)724)437 212-1 Oô17SI9I- Mh91_ Address cAgi.-s lb f4'°D.T'flD
i, gz.oR Phone
Type of Business COn7 Pc' -t s /C3k_Z 7'6
Describe exact use of all portions of each building and lot
Previous use of Building
Type of flammable or explosive liquids to be used, if any
I certify that I have read the statements contained in this application; that they are true and correct, and that I make this statement under penalty of perjury.
Dated this (3J day of 841- in the City of Carlsbad, State of California
Signature of
Applicant Signature of
Building Official
Use Zone t''91
FOR DEPARTMENTAL USE ONLY
Occupancy Group 15 2.- Type of Construction
Planning
Department A.J J Date Approved 4 Disapproved By
'Engineering
Department J j
Date /4f/O,,'e ApprovedI#'f' . Disapproved By
Fire
Prevention Date /0— 9-8'f Approved 'C4j'..' / Disapproved By
Health
Department Date Approved Disapproved . By
Building Department Date 16111okf iIapproved By Approve-7.7
White - Building Dept. Yellow - Applicant Pink - Finance Gold - Fire Dept.
iv..
VALIDATION
City of Carlsbad
APPLICATION FOR CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
1200 ELM 438.5525
Address where Business
will be conducted Buildiflo Permit 'f'io. 945' 3 7
Name of Occupant /1Jü4) 'I'V6AA& Business Phone 438-522 I
Address of Home Office of 4,. Occupant if different from above Home Office
Phone Vlw
Owner of Building
,4
Address d.4g(S&4b) CA1 2OOPhone 4c38 -/4s
Type of Business
Describe exact use of all portions of each building and lot 1,
Previoususe of Building
Type of flammable or explosive liquids to be used, if any
I certify that I have read the statements contained in this application; that they are true and correct, and that I make this statement under penalty of perjury.
Dated this 3 day of 0 CT T,_19 R 4-in the City of Carlsbad, State of California
Signature of
Applicant Signature of
Building Official -IkUL"
Use Zone .
FOR DEPARTMENTAL USE ONLY
Occupancy Group Type of Construction
Planning
Department Date/2.f17L/ Approve Disapproved By
Engineering
Department Dat
AAV
Approved - Disapproved By
Fire
Prevention Date /it Approved Disapproved By
Health
Department pate Approved Disapproved - By
Building
Department Date /tii1/'tp Approve Disapproved By
White - Building Dept. Yellow - Applicant Pink - Finance Gold - Fire Dept.
VALIDATION
City of Carlsbad
CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
1200 ELM 438.5525 You are required by law to complete and return this form to our office.
Address where Business
will be conducted 2111 Palomar Airport Rd. D-1 (tenant Improve.) P.rm Build
iitno. 84-588-Dl
Name of Occupant rPrLE..fltE7L unneess
Address of Home Office of
Occupant if different from above Home Office
Phone
Owner of Building //l)3 I)91jt./#t(._Address xS4S
Type of Business
Describe exact use of all portions of each buildig and lot
Previous use of Building
Type of flammable or explosive liquids to beused, if any
I certify that I have read the statements contained in this aplication; that they are true and correct, and that I make this statement under penalty of perjury.
Dated DV
Signature of Applic ant e
FOR DEPARTMENTAL USE ONLY
Occupancy Group 2... Type of Construction ,j2'>4/le
FFire
J f Date 1(10 1 Approved By
/
Date // 7,'i. Aproved By
Date <91 ,,1/Approved 44~~
Department
V_ -
Date Approved By
Building
Department Date /—/c_rcAPProved :By -
Signature of Building Official
White - Building Dept. Yellow - Applicant Pink - Finance Gold - Fire Dept.
.11. . -; ••V V - -.
V.
VALIDATION
City of Carlsbad
CERTIFICATE OF-OCCUPANCY .•
BUILDING DEPARTMENT
1200 ELM 438.5525 You are required by law to completeand returlithis form to our office:
Address where Business ,/ . will be conducted 2111 Palomar Airport Ro d C-3 Building
PermitNo. 84559
Name of Occupant PA —L& T1 )Jl 4j7 444_7
Address of Home Office of
Occupant if different from above /.t' /i'J F V1 C&L c mneeOflic , , Pho
Ownr of Buil1ing Address 214A~A~~~P/h~oTe /Z&
Type of Business RV . V
Describe exact use of all portions of each building and lot .._. . -
Previous use of Building )- CV
V _i
Type of flammable or explosive liquids to be used if any
I certify that I have read the statemnts contained in this application; that they are true and correct, and that I make this statement under penalty of perjury.
Dated this t'1 tiay of 1Yi'J.V _19 .•-lf,-the CIt b tate àf California
Signature of Applicant
FOR DEPARTMENTAL USE ONLY
Use Zone . OccupancyGrotp Type of Construction .Z,v
Planning . j / ....... 4 V V &3 Department Date 11/0! Approved ByC.A.._ f V—
Engineering .
Department Date//..,,/f' Approved By
Prevention Fire
Date i2-2" 9y Approved By
Health
Department
- .
- Date V
V . Approved By•
Building /-/c ..73: Department Date Approved By
toll , L3/14
Signature of Building Official
White — Building Dept. Yellow — Applicant •Pink - Finance Gold'—' Fire Dept.-
1A11 1ALIDATION
City of Carlsbad
CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
1200 ELM 438.5525 You are required by law to complete and return this form to our office.
Address where Business will be conducted 2111 Palomar Airport Road Suite D3 Buildin
Permit,. 84560
Name of Occupant FICL1 ( Rj,71 IVy Business
Phone pAiK1uM) 7Z)
Address of Home Office of
Occupant if different from above ' c 'j47f Home Office
Phone
Owner of Building 5 EP3.fr%1i&.. f/L)-T'.(e,4)-f77 2 / z I flfrt-o'i_
Ot)1\t..._- Address ø4-_ I44)J i .g2JgPhone
Type of Business 7O '),g_T C-i7L1tJ
Describe exact use of all portions of each building and lot 1_.,
Previous use of Building
Type of flammable or explosive liquids to be used, if any
I certify that I have read the statements contained in this application; that they are true and correct, and that I make this statement under penalty of perjury.
Dated this /J-0-day of 19 —ln the City of Carlsbad State of California
Signature of Applicant
e4a ('..)
Use Zone
FOR DEPARTMENTAL USE ONLY
Occupancy Group . Type of Construction 22A'
Planning
Department Date Approved By
Engineering
Date 1 (lb IK Approved By
Fire
Prevention- Date /. s... Approved By
[Depa
Department
Health Department Date Approved By
Building
rtment Date 1,'/0.-pproved By
Signature of Building Official
White - Building Dept. Yellow - Applicant Pink - Finance Gold - Fire Dept.
VALIDATION
City of Carlsbad ,
CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
1200 ELM 438.5525 You are required by law to complete and return this form to our office.
Address where Business - will be conducted 2111 Palomar Airport Road Suite D-2 (T.I.) Building
PermitNo. 85-9
4 Name of Occupant C 4AS 41Z-1', Business
Address of Home Office of A Occupant if different from above V Home Office
Phone
Owner of Building /?.i4b1iW'.._. //1}74/rq)tWfZ.ddress 2j 2-/ , 11?Vb4g4T hone
Type of Business '7.A-iJ1..-t.. ,9ç) dt)' ./ •
Describe exact use of all portions of each building and lot £?C '5L......_-' -
Previous use of Building Al/n
Type of flammable or explosive liquids to be used, if any
I certify that I have read the statements contained in this application; that they are true and correct, and that I make this statement under penalty of perjury.
Dated 19 In the 94!Y-2!:"b~~of California 7- — day of 1yWy ,
Signai:e
Use Zone
FOR DEPARTMENTAL USE ONLY
Occupancy Group 1i8 .2.. Type of Construction - / i*-• i/ft
• Date Approved By
Engineering
Department - Date Approved •
•: •
Fire -
Prevention Date 5/(a7'5 Approved By
Health Department .
Date
*
j Approved By
Building
Department Date
110, e-t;10.
Approved BY,lf frtg/'
signature of Building Official
White - Building Dept. Yellow - Applicant Pink •- Finance Gold - Fire Dept. •
VALIDATION
City of Carlsbad
CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
1200 ELM 438.5525 You are required by law to complete and return this form to our office.
Address where Business
will be conducted 2111 Palomar Airport Rd. Suite E2 Buildina (T.I)permito. 85-209
Name of Occupant Business 4-38-380 Phone
Address of Home Office of
Occupant if different from above Home Office
Phone
Owner of Building (a_P 414-(, L( ?-I irv&R' LLf1 Phone .42,9, I
Type of Business
Describe exact use of all portions of each building and lot c5
Previous use of Building
Type of flammable or explosive liquids to be used, if any
I certify that I have read the statements contained in this application; that they are true and correct, and that I make this statement under penalty of perjury.
Dated this c:; -t;';; of _______ arlsbad, State of California
Signature of Applicant
Use Zone ?r'(\
FOR DEPARTMENTAL USE ONLY
Occupancy Group —z.... Type of Construction 7/
Planning
Department Date By
Engineering
Department Date
",S 'APProved
Approved By
Fire
Prevention Date Approved By
Health
Department Date
Building
Department Date
Approved By
. Approved By
Signature of Building Official AW . .. .,
White - Building Dept. Yellow - Applicant Pink - Finance Gold - Fire Dept:
VALIDATION
City of Carlsbad
APPLICATION FOR CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
1200 ELM 438.5525
Address where Business
will be conducted 2111 Palomar Airport Rd. Suite .2SO - Building
Permit o. 8532if
of Occupant / 4?77i) 'T/Vt BusName Oinneess cj o
Address of Home Office of
Occupant if different from above Home Office
Phone
Owner of Building 4.-% Ji.iL (à-3tf' Address J2\ cLOb4M IfT I?Phone
Type of Business LYReDIMUS 4G6tQA-0c1R1C.S
Describe exact use of all portions of each building and lot )cPi I Mt}L) U"rl ,Ab A'TL. 5'( 4 1,AJAiJ
Previous use of Building
Type of flammable or explosive liquids to be used, if any
I certify that I have read the fmentscontained in this application; that they are true and correct, and that I make this statement under penalty of perjury.
Dated this ( ,)9 f in the City of Carlsbad, State of California
Signature of //( Signature .AZ..4.L1 Applicant Building Official c_/1V
L / L
Use Zone
FOR DEPARTMENTAL USE ONLY
Occupancy Group ' 2.Type of Construction
Planning Department Date Approved Disapproved By
Engineering
Department Date &1/0_ApprOVed Disapproved By
Fire Prevention Date Approved Disapproved By
Health
Department Date Approved Disapproved By
Building
Department Date Approved 7/3/K ,,vr ePi ed By
White - Building Dept. Yellow - Applicant Pink - Finance Gold - Fire Dept.
-
VALIDATION
City''ofcarIsbad
CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
1200 ELM 438-5525 You are required by law to complete and return this form to our office.
Address where Business will be conducted 2111 Palomar Airport Rd. Suite F-2 Building
PermitNo. 85327
Name of Occupant Consolidated Solar Systems Business
Phone 438-3811
Address of Home Office of
Occupant if different from above Home Office
Phone
2121 Palomar Owner of Building Graham International Inc. Address Ste 300
Airport Rd Phone 438-1545
Type of Business Solar Systems
Describe exact use of all portions of each building and lot Office space
Previous use of Building
Type of flammable or explosive liquids to be used, if any
I Certify that I have read the statements Contained in this application; that they are true and Correct, and that I make this statement under penalty of perjury.
Dated this 12th day of 19 85 in the City of Carlsbad, State of California
Signature of Applicaj_.._....'
Use Zone
FOR DEPARTMENTAL USE ONLY
Occupancy Group Type of Construction 41 ...,/,ç •. 1•(_j
Planning
Department Date 5. Approved By
Department
Engineering
Date Ore Approved By
Fire
Prevention Date '- Approved By
Health
Department Date Approved By
Building
Department Date Approved By
Signature of Building Official
White - Building Dept. Yellow - Applicant Pink - Finance Gold.— Fire Dept.
VALIDATION
City of Carlsbad
CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
1200 ELM 438.5525 You are required by law to complete and return this form to our office.
Address where Business
will be conducted 2111 Palomar Arpt. Rd. #}33O (T. I..) Building
Permit No. kk 85576
Name of Occupant L_c;rl::c=,. -
Phone
Business
Address of Home Office of
Occupant if different from above -
Home Office
Phone
Owner of Building 41 ,J 17 Addressf J
Type of Business
Phone 'j3'i Sfc
Describe exact use of all portions of each building and lot
Previous use of Building
Type of flammable or explosive liquids to be used, if any
I certify that I have read the statements contained in this application; that they are true and correct, and that I make this statement under penalty of perjury.
Dated this ),øt day of , 19 City of Carlsbad, State of California
Signature of 7J4
Use Zone
FOR DEPARTMENTAL USE ONLY
Occupancy Group Type of Construction l7"_ /19~z.
Planning
Department Date 2/.5 Approved By
Engineering
Department Date Approved By
Fire
Prevention Date Approved By
Health
Department Date Approved By
Building
Department Date"/,' Approved By
Signature of Building Official
........... _....__1,7 111
/ White - Building Dept. Yellow - Applicant Pink - Finance Gold — Fire Dept
FOR DEPARTMENTAL USE ONLY -. .
Use Zone '- ri, • ' Occupancy Group - Type of Construction $ ..5' I t''• '
Planning . . .
Department - Date -Io (J( Approved By
Engineering
Department / 5
Date Approved By -.
Prevention Date f—à..5"O JO Fire
Approved By
Health
Department Date Approved By
Building
Department Date Approved By
Signature of Building Official
White— Building Dept. Yellow —Appiicant Pink— Finance Gold - Fire Dept. I
I—''
"-'" '• '
I
VALIDATION
City of Carlsbad
CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
1200 ELM 438.5525 ' You are required by law to- complete and return this form to oür'office;
Add re ss where Busineswill be. conducted
s C)
Name of Occupant .
Business
Phone
Address of Home Office of - .Home Office Occupant if different from above . Phone
Owner of Building 1) j4&ires J ' fjIf*Lgle. A4jL Phone /
Type of Business
Describe exact use of all portions of each building and lot
S S
,-
Previous use of Building
'Type of flammable or explosive liquids to be used, if any
I certify that I have read the statements contained in this application; that they are true and correct, and that I mike this statement under penalty of perjury..
'Dated this ( day of 1_ -if eitY of Carlsbad, State of California'
SignatureofA Ca _
City of Carlsbad
CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
Building Address %gU9Z Building Permit No.
Occupant Name C)t/' Business Phone
Building Owner L4- s- Business Phone
Owner Address // JO
Describe exact use of all portions of each building and lot "-i 7frt/4rL-1 I.-
\.-
I certify that this bUilding or portion complies with the Uniform BUilding Code for the group and division of
occupancy and the use for which the propOsed occupancy is classified. The above information is true and
correct, and I make this statement under penalty of perjury.
Dated this /3 day of _.SJ7L ., 19 kip in the City of Carlsbad, California
Signature of Applicant
/
Signature of Building Official
FOR DEPARTMENTAL USE ONLY
Date Routed
Use ZOne Oc upancy Group 6 Type of Construction /#&,
Inspected By DatJ//3/pproved isapprved
Inspected. By Date _____ Approved Disapproved
Inspected By Date _____ Approved Disapproved
SS
COMMENTS:
. WHITE: Applicant BLUE: Building GREEN: Engineering CANARY: Health Dept. PINK: Planning GOLD: Fire
' t
- 4 - - -
-
-.
- - -C'ERTIFIC'ATE OF OCCUPANCY
BUILDING DEPARTMENT
01/14/91 15:23 •- -. .- Cert of Occ#: C0900054
Page '1 of .1. . -. Status: ISSUED
'Type; CERTIFICATE OF OCCUPANCY --
Bldg Address: 2.111 PALOMAR AIRPORT-RD Suite# 100
Parcel No: 213-070--14-00
Bldg-Owner: GRAHAM INTERNATIONAL 619-438-1545
21.411PALOMAR AIRPORT ROAD #300 CARLSBAD, CA-92008
Related Bldg Permit# CB90180-3 -.
OôcupantNarne/Phone# : PLANNING SYSTEMS 0
•
Contact NarneyPhone# : SONIA/458-1919 ••
Description-*of,Use : OFFICES OR, LAND
.1 certify:thatJthis bui.lding or portion...complies with.the:
Uniform 'Build', fohe grôupd .div.rion\of.
occupancy and te_e/f or w2cth. proosd1dccupancy is
classified. lThe-above informati6n is true and_co±rect and - , - .
,.
I make this
13
statement under-penalt .-o. per'jury.. .• 0
Siqnatreóf -Buildiigfical
00 • ' ..j f1! * vci\i: j ( • - F 0 R •D'E P A RJT-'M EJNJT A'JL U'S E 0 N L Y •
- DateRouted
F
• •\ ç oo ,eo ' io •/' Use Zone •-_• - • Occupancy Grou?2-' Contruction Ty e: VM
Inspected By A4Ii1 roved ?D1 s approved
RCHI
Inspected Bye' Date Approved Disapproved -•
Inspec.ted -By' Date Approved. Disapproved
COMMENTS
•- S
S.-'
,-
•
CITY OF CARLSBAD
2075 Las Patinas. Dr., Carlsbad' CA 92009 (619),43.8-1161
City of Carlsbad
APPLICATION FOR
c 'r x ' x cr a' accwc
CITY OF CARLSBAD-BUILDING DEPARTMENT
2075 LAS PALMAS DRIVE
CARLSBAD, CA 92009
(619)438-1161 EXT 4208 or 4403
Building Address 2111 P omp Unit 1100
Building Permit Number (if any) 7Oi _- COI
Occupancy Group B2. construction Type __ One houR.
Building Owner Grocnivrno*Onat
NAME
2-1141 Pcc i4irpor't Rocc *300
ADDEESS
CITY,STATE,ZIP
43S —I5'I5
PHONE NUMEES
Occupant Name __PIcu'r
Contact Name and Phone Number Son%G..E.ckott'146EIdfl9
Describe exact use of all portions of each building area:
O4ic,e _Lo.ncscceM TecTS
FOR OFFICE USE ONLY
Entered by UY-1°t'0
Release to .D.G.E. Date & Time Tb
LO