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,,,SNTA <br />NA <br />PLI$IIC <br />&luut\c <br />lcilcl <br />Planning and Building Agency <br />Planning Oivision <br />20 Civic Center Plaza <br />P.O. Box 1988 (M-20) <br />Santa Ana, C492702 <br />(7r4) 647-s804 <br />www.santa-ana.or9 <br />GERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUESTIONNAIRE <br />Please turn in this completed form with your Cedificate of Occupancy application. <br />Company Name (Print):5 MN Lt A 9si a <br />contact Name: zuo Ll N <br />City:SAr^t'i+ Lt/E <br />Phone No A,.b -z5l-7o7t-E-mail Address t>932 kAtv?aw <br />r_-tE Change of PropertV Owner p change of Occupant E ChangeofUse E Additional Occupant <br />'1. The following best describes my operation: <br />D Otfice Only ! Rotail Sales E MedicauDental <br />n Warehouse/Manufacturing/Oistribution ! RestauranUTake Out Food <br />p otner{aescribel lL4*<5++e €s(PtLtSA He'r1 ' <br />2. Please provide a brief description of how the business operates at this site (for example, please <br />describe the qeneral natute of the business. what activities occur on-site, the hours of operation, <br />open to the iuoticl. 77teQ EP t I Pc< AR u u*t t AS? FoR. C a!(on eR .uiatK w1 hrT <br />1a4csh+e tueL. Bot>/, F-oor, Str(pte4, Flhr , veep Tsrue <br />3. What was the former type of business or use of facility? (Please contact the leasing agent or building <br />owner to delermine p,or buslness use.)rAu€ Tl?e <br />4. Has the building or space been vacant or is this a new building? Yes ! f.lo B <br />lf vacan't, for how long?l'/o y*cktvT . <br />5. Are you an independent contractor? Yes [i No E <br />6. Location of the business and suite number <br />( to floo,. ! 2tfloor <br />ze <br />" <br />I qRA4.,b I veb I. sN'at! *, t+ %lo c <br />floor <br />7. Do you share the floor or business entrance with another business? Yes n *" F <br />8. What is the amount of square footage leased?4,eo <br />9. How much of the space, which you lease, is office? <br />! 1oo%n so"z,X 30%o <br />S:Planning\Clerical-Counler Forms\ <br />ColO Oueslionnaire 08-27-18 <br />!Less than 30% <br />Address (business naiting aaoressl. 24U 4.4-r,,/.o AvL U\JtT k <br />state: Lk zio: f u7" ( <br />tr <br />lf other than 100%, how is the remaining space used?