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SANTA <br />Alfi <br />lv I <br />Phnning and Building Agoncy <br />Phnning Divlrion <br />20 Clvlc Contcr Plaze <br />P.O. Bor 1988 (ll-20) <br />llrnlr Ana. CAS27O2 <br />(7ra) r7-5t04 <br />wwr.aanta{na.org <br />CERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUESTIONNAIRE <br />Please tum in this completed lorm wfth your Certilicate ol Occuryncy applbafion. <br />Company Name (Prinl)lloml aearn gardt TacT- <br />Contact Name c <br />Address (busrness marhng address) <br />C,ly {dnb Ail- <br />r <br />9 How much of the space, wtrich you lease. rs office? <br />I looo/o D 5o9o tr nh <br />tf olher than 1000,6. how rs lhg rcrnatning space uscd? <br />sarcefr zip gzl <br />Oflice Only D Retattsalcr fl tledlcal/Dental <br />Warchouc./llanufacturing/Dictribution D RertauranUTate Out Food <br />I Otrcr (dcscrib€) <br />lf vacant, for how long? <br />5 Are you an rndependent conlractor? Yes ! No E[ <br />t, s N. SlanAare 40L <br />ol <br />phone No ? tt-gt a aaU E-malArJdres, -T-o t t' C homel-tm0^r4, tDfi <br />E cnange ot Prog.rty Owner ! Change ol Ocanpant I Cnangc ol use E Mdrtirnal Occupant <br />l. Thc followlng b.rt d6crlbc. my oporedon: <br />2 Please provrde a bnel descnplon ol how the busrness op€ratos at lhts site (lor example, pbase <br />descnbe the general nalure of the busrness. what actrvrlres occur en-srle lhe houn of opcration^ - , -, <br />opcn to rhc iubric). Fabri catt ?v c ,y14;kn'al €-r v,'4fl on<. ;nstall. <br />Proviue rurthei-details, i.e. days of operadon, etc. l4pn - f ri '8'5 2 n <br />3 What was the former type of busrness or use of facdrtyz (Ploaso contrcl the leas/ng agent or buldrng <br />oilnct lo determrne oro, Dugness use ,U lomolrtrc napir s hsP <br />4 Has the buildrng or sp€rce been vacant or is this a new burldingz Yes D ruoE <br />6 Locatron ol the business and surte number <br />flf t"nmr D 2-ioor tr _noor <br />7 Oo you shar€ the floor or busrness enlranca wrth another business? Ves E no E <br />8 What rs the amount of square toolag€ leased?tSooo <br />( t-"r. than 3oo/o <br />S Plmr^g' Cl.nct.Conlrr Fo.mt <br />CotO O6tffirrc 0&?r.lE