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,,SANTA <br />A]\tA,'ii',iffi <br />\/Planning and Building Agency <br />Planning Division <br />20 Civlc Genter Plaza <br />P.O. Box 1988 (M-20) <br />Santa Ana, C492702 <br />(7141647-5804 <br />www.santa-ana.org <br />t CERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUESTIONNAIRE <br />Please turn in this completed form with your Certificate of Occupancy application. <br />Company Name (Print)lov ?oo[. 1- C)utcrl zr^f,\;ro. <br />Contact Name: 4 oon Toi ? a/L TI- <br />Address (business mailing address):T <br />City:tfln State C,PT zi o <br />Phone No.lb-&c Fax No.( 16, t/, - %?g <br />1 <br />(F/D tlz-o7 q9 <br />What was the previous use of the space you wish to lease? (Please contact the teasing agent <br />or building owner to determine prior business use./ <br />LJaruhoule . <br />2. Has the building or space been vacant or is this a new building? Yes No ,Klf vacant, for how long? <br />3. <br />4. <br />5. <br />6. <br />Are you the primary tenant? Ves ffi No Et\ <br />Do you sublease from an existing tenant? Yes f No <br />Are you an independent contractor? Yes E ruo E <br />Location of the business and suite number: <br />K <br />+v e.4> <br />K 1't floor tr 2nd floor tr floor <br />7. Do you share the floor or business entrance with another business? Yes E No ( <br />8. <br />9. <br />What is the amount of square footage leased?I cpds e+ <br />How much of the space, which you lease, is office? <br />100%tr soo/o tr 3eo/o <br />lf other than 100%, how is the remaining space used? <br />cm\cntr-frm\C of O questionnaire <br />07 t2012 <br />Page 1 of4 <br />E Less than 30% <br />I <br />t t,l.c-ht <br />E