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,,,*SANTA <br />NA-"'i[Ifi <br />a' <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) 647-s804 <br />www.santa-ana.org <br />CERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUESTIONNAIRE <br />Please turn in this completed form with your Ceftificate of Occupancy application. <br />Company Name (Print) <br />contacrName: /1Zfz- E1/vtE<ALDk Roiz- <br />Address (business mailing address)boo v/ lptf* AlAt E/,4, -f,td7 <br />City:4 f, a srate:4 () <br />, ?1? lVo' fu-7 t E-maitAddress: Fsrne ay cr(Ogt'no: I . Ctwn <br />ange of Property O*ne, fr Change of Occupant ! Cnange of Use ! Rdditional Occupant <br />1. The following best describes my operation: <br />E Ottice Only E Retai! Sales ! ttledical/Dental <br />Phone No. <br />E cn, <br />n Warehouse/Manufactu ri ng/Distri bution <br />E Otner (describe) <br />S: Planning\Clerical-Counter Forms\ <br />CofO Questionnaire 08-27-18 <br />\n"","rranUTake Out Food <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 />open to the public). Cl€ 0-O /no/?DA/- FKtOny' <br />3. What was the former type of business or use of facility2 (Please contact the leasing agent or building <br />owner to determine prior business use.) C*ff <br />4. Has the building or space been vacant or is this a new building? Yes n No E <br />lf vacant, for how long?C ,o?o,,r'r//g <br />5. Are you an independent contractor? Yes E No E <br />6. Location of the business and suite numbe r, /OO <br />\ 1",floor tr 2ndfloor ! _ftoor <br />7. Do you share the floor or business entrance with another business? Yes E <br />8. What is the amount of square footage leased?blo,rgr <br />9. How much of the space, which you lease, is office? <br />n looo/o tr soo/o tr 30% <br />lf other than 100%, how is the remaining space used? <br />*"\ <br />f, r-"tt than 3o% <br />+