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.-*SA}[TA <br />ANAJiiilffi <br />Planning and Building Agency <br />Planning Division <br />20 Civic Center Plaza <br />P.O. Box 1988 (M-20) <br />Santa Ana, CA92702 <br />(71416/.7-5804 <br />www.santa-ana.org <br />CERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUESTIONNAIRE <br />Please turn in this completed form with your Certificate of Occupancy application. <br />Company Name (Print):1st STREET BURGER HOUSE INC <br />Contact Name:PETE BOYAKIS <br />Address (business mailing address):2029 E FIRST STR <br />City:SANTA ANA state' CA 9270s <br />Phone No.(714) 417-0810 E_maitAddrerr. lstreet.burgerhouse@gmail.com <br />! Change of Property Owner E Change of Occupant E Change of Use E Additional Occupant <br />1. The following best describes my operation: <br />E Ofice Only D Retail Sales E MedicaUDental <br />E Warehouse/Manufacturing/Distribution [] RestauranUTake Out Food <br />E Ottrer (describe) <br />2. Please provide a brief description of how the business operates at this site (for example, please <br />describe the general nature of the business, what activities occur on-site, the hours of operation, <br />open to the public)' <br />SERVTNG BURGERS/FooD. HRS 6:30AM To 7:00 pM <br />3. What was the former type of business or use of facility? (Please contact the leasing agent or building <br />owner to determine prior business use.) <br />SAME <br />4. Has the building or space been vacant or is this a new building? Yes ! No E <br />lf vacant, for how long? <br />5. Are you an independent contractor? Yes E No E <br />6. Location of the business and suite number:2029 E FIRST STREET <br />tr lstfloor tr 2"dfloor @ _ftoor <br />7. Do you share the floor or business entrance with another business? Yes I No E <br />8. What is the amount of square footage leased?2578 <br />9. How much of the space, which you lease, is office? <br />tr 1oo% tr 5oo/o tr 30% E Lessthan3o% <br />lf other than 100%, how is the remaining space used? <br />ENTRANCE DINING AREA, KITCHEN AREA, BATHROOMS <br />S:Planning\Clerical-Counter Forms\ <br />CofO Questionnaire 08-27-1 8