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Please turn in <br />Company Name (PrinQ <br />this completd form with your Certificate of Occupancy application. <br />. Choices Cafe <br />contact Name: Mounir Hilmi <br />Address (business malling address)611West Civic Center Drive, Suite 100 <br />City:Santa Ana state, CA zip,9270L <br />Phone No.:s62-400-289L E_mait Addre.". choicescafesa@ gmail. com <br />I Cnange of Property Owner fl Change of Occupant E Change of Use E Additional Occupant <br />1. The following best describes my operation: <br />E Otfice Only ! Retait Sates ! trrtedicat/Dentat <br />I Warehouse/ManufacturingrDistribution I RestauranUTake Out Food <br />E ottrer (describe) <br />4. <br />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)' We are a coffee shop. We will be selling cotfee, chips, soda and <br />sandwiches. We will be open to the public 6am-6pm Mon-Fri <br />What was the former type of business or use of facility? (ptease contact the teasing agent or building <br />owner to determine prior business use.) <br />Coffee shop <br />Has the building or space been vacant or ls this a new building? yes Q No D <br />lf vacant, for how long?2 months <br />5. Are you an independent contractor? Yes ! No E <br />6. Location of the business and suite number' <br />611u'esrciuccenteloaw'surte100'siltaAna'cA'e2701 <br />E lstfloor D 2nd floor floor <br />7. Do you share the floor or business entrance with another business? yes E No E <br />8. What is the amount of square footage leased?405 <br />2. <br />3. <br />9. How much of the space, which you lease, is office? <br />tr looo/o tr sovo tr 3oo/o <br />lf other than 1000/0, how is the remaining space used? <br />F Less than 30ozt <br />S:Planning\Clerical-Counter Forms\ <br />Colo Questionnaire 08-27-18 <br />,,,*SA}[TA <br />ANAqll,* <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)il7-58,04 <br />urww.santa.ana,org <br />CERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUESTTONNATRE