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P/ease turn in thts completed form with your Ceriiflcate of Occupancy appllcation.Company Name (print):B indery <br />contact,.r.. Anthony Estrada <br />Address (business mailing address):833 S. Grand Ave <br />Crty:Santa Ana <br />state: CA 92705 <br />Phone No,: 71 4-935-7342 Zitt <br />E-mall Address: <br />! ChangeofPropertyOwner [E Changeofoccupant D CnangeofUse E AddllonalOccupant <br />1. The followlng beet deacrlbea my operaflon: <br />E otttce Onty E Retallsates D Modtcal/Dental <br />fu warehouserManufacturrng/Drrtrrbuilon E Reatauranurake out FmdD Ottrer (dercrtbe) <br />2' Please provlde a brlef descrlptlon of how the buslness operates at thlr slte (for example, plee'edescrlbe lhe general nature oi itru orsln-;ss, what actrvltre! occui on-6tte, the hourr of opera,on,open to the publc). ti" J c ;1 oud 'r,",r,,t,^t;A* <br />;,s/, e,g.-5 p^3' mln:ff f:Tiljfr#j"0"'r"J!].t or use of tacttitv? (p/eese conract the teastns asent or buitdins <br />6,)-Je, y ,-J boakAtu:L,.A, bu,,r, nrtg. (g:r*rc r.ritJ <br />4' Has the building or spacs been vacant or rs this a new buildrng? yes ! No F <br />lf vacant, for how long? <br />5. Are you an lndependent contractor? yes D No F6. Location of the buslness and suite numbe r: t13 S GRcpn ovE <br />E latfloor tr 2ndfloor ! _floor <br />Do you shere the floor or busrness entrance wlth another busrness? yee E No EI8. What is the amount of equare footage leasod? <br />9. How much of the space, which you lease, is offlce? <br />tr looo/o tr 5oo/o D aoo/, <br />lf other than 100%, how ls the remaining space used? <br />S:P16nnh0\ClErtcclCountor Forms\ <br />CotO Ouosilonnrirs 09.27-iS <br />BJ <br />7 <br />E Less than B0% <br />0110t sANTA <br />ANATHffi <br />f[Xxll3 and"Burl<tr ns Ase ncv <br />20 Clvlc Cenler plara <br />P.O, Box lgOS (M.2Ol <br />Sante Ana, CA'S?7Oi <br />(714) 0{7.CSO4 <br />www.8antt.rn!,org <br />CERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUESTIONNAIRE <br />-