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,,-SANTA <br />ANA,',ti)ffi <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 />(714) 647-5804 <br />www.santa-ana.org <br />) <br />CERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUESTIONNAIRE <br />with your Ceftificate of Occupancy application. <br />Eit rL rersz <br />Contact Name OL€J- Ttla./ <br />Address (business mailing address):btlct - €d;C <br />City:{*,n4 Rlvft'State:C* zip, q>?of <br />Phone No., (- OIOO E-mait Address: A r'O LE @ Scx pt-Q.e rn ov4(-- ( ta <br />fl Cnange of Property Owner I Cnrng" of Occupant ! Cnange of Use E ROOitional Occupant <br />1. The following best describes my operation: <br />E Omce Only ! Retail Sales fl ruedical/Dental <br />(yVaretr ouse/M an ufactu ri n g/D istri buti o n ! Restau ranUTake Out Food <br />,d otn"' (describe)o [(ret- 0^) ,s+-tzc h ^ <br />rtg .1o-t5 <br />. <br />2. Please provide a brief description of how the business operates at this site (for example, please <br />describe the general naturg of the business, what activities occur on-site, the hours of operation, <br />open to the public). Tlll b rr -( A L-c ?e31-r-z4rti.-r.z <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.) /. A f <br />g khce lrr' lu o-e- J n t--f -( <br />4. Has the building or space been vacant or is this a new building? Yes E( No E <br />lf vacant, for how long?A bnr*tL-t <br />5. Are you an independent contractor? Yes n No Ef <br />ber: U i/ ,Y C- <br />K 1.t floor tr 2nd floor fl _ floor <br />7. Do you share the floor or business entrance with another business? Yes n No d <br />8. What is the amount of square footage leased?l,>Vo S F <br />9. How much of the space, which you lease, is office? <br />d 100%tr soo/o tr 3oYo <br />lf other than 100%, how is the remaining space used? <br />S: Planning\Clerical-Counter Forms\ <br />CofO Questionnaie 08-27 -1 8 <br />Less than 30%