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,",SANTA <br />NA,"i})tr <br />- <br />Planning and Building Agency <br />Planning Division <br />20 Civic Center Plaza <br />P.O. Box 1988 (M-20) <br />Santa Ana, C492702 <br />(714) il7-5804 <br />www.santa-ana.org <br />CERTIFICATE OF OCCUPA}.ICY <br />SUPPLEMENTAL <br />QUESTIONNAIRE <br />Please turn in this completed form with your Certificate of Occupancy application. <br />Company Name (Print):SAppU I pr MA(qAG F <br />contact Name: Kr t..t PUID N k THr tr[rUYelV <br />Address (business mailing address)tLYl thsDUTH M*iru sr" <br />City:SANTA ANA state: (A zip: qL7Ol <br />Phone No E-mailAddress <br />E Change of Property o*n", {c hange of Occupant E Change of Use ! ROOitional Occupant <br />1. The following best describes my operation: <br />E Ottice Only E Retail Sales n Medica!/Dentat <br />f] Warehouse/Manufacturing/Distribution ! Restaurantffake Out Food <br />d otn", (describe) MnSS4grp- SP+ <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 />opentothepubric)' 9Ru - q?M ll gA\s/ wr-E<. <br />MA$nGE sERvtcf sP# <br />3. What was the former type of business or use of facility2 (Please contact the teasing agent or building <br />owner to determine prior business use.) <br />MASsAcrr S P+ <br />4. Has the building or space been vacant or is this a new building? Yes E No <br />/ <br />V lstfloor tr 2ndfloor [ _floor <br />7. Do you share the floor or business entrance with another business? Yes E No { <br />8. What is the amount of square footage leased?iO DC) <br />,chm <br />{ <br />9. How much of the space, which you lease, is office? <br />tr 1oo% n soo/o tr 30% <br />lf other than 100%, how is the remaining space used? <br />AS A MAssAert sPt <br />E/ 1".. than 30% <br />S: Planning\Clerical-Counter Forms\ <br />CofO Questionnaire 08-27-1 8 <br />lf vacant, for how long? <br />5. Are you an independent contractor? Yes fl No VI <br />6. Location of the business and suite numbe ,, C r n*, An A I