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,--SANTA <br />ANAqHffi <br />a <br />I <br />Planning and Building Agency <br />Planning Division <br />20 Civic Center Plaza <br />CERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUESTIONNAIRE <br />P.O. Box 1988 <br />Santa Ana, CA <br />(7141 647-s804 <br />(M-20) <br />92702 <br />www. sa nta-ana.org <br />application. <br />Com <br />Contact Name ..d <br />Address (business mailing address):3cT Lt r* t* ta;k /^L <br />City:f-*+- A*.^State: c'A Zip 1:-1. I <br />Phone No.:E-mail Address: <br />I Change of Property Owner E Change of Occupant ! Change of Use E Additional occupant <br />1. The following best describes my operation: <br />E ottice only p Retail Sates E Medical/Dental <br />! Warehouse/Manufacturing/Distribution E RestauranUTake Out Food <br />n Otner (describe) <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, . - - r. <br />open tothe public). P.\*i\ )r^.{.r'*.r1- F'\1a:f f.5<fi7r}r"s''5, fettic5 G'TC r'^(J\ <br />f,\o'r - ii'|- 1-6;'-" ( hSP13i S'-'l-7 <br />3. What was the former type of business or use of facility? (Please contact the leasing agent or building <br />ownerto determine pior business use.) C \-;6= S+.le <br />4. Has the building or space been vacant or is this a new building? Yes [[ frlo E <br />lf vacant, for how long?(. 9*<,*|\n-! <br />5.Are you an independent contractor? Yes E No E Jvl lc , -S <br />Location of the business and suite number, 3a* E \si 5)- J**l.* 4{.r- (' }4 ?L <br />f t"ttoor tr 2ndfloor E __ftoor <br />7. Do you share the floor or business entrance with another business? Yes E ruo E <br />8. What is the amount of square footage leased?\ >5c <br />9. How much of the space, which you lease, is office? <br />tr loOo/o tr 50% tr 30Yo F Lessthan 30% <br />lf other than 100%, how is the remaining space used? <br />?.F,, fy,, , 5 l*,cae, (e*5.1 [-ftc w' 5le <br />)<r l <br />6 <br />S: Planning\Clerical-Counter Forms\ <br />Cofo Questionnai r e 08-27 - 1 I <br />Please turn in this form with