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Please turn in this completed form with your Ceftificate of Occupancy application. <br />Company Name (Print): <br />*-SANTA <br />ANAJII}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-s804 <br />www.santa-ana.org <br />CERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUESTIONNAIRE <br />Contact Name <br />Address (business mailing address): <br />City:1o,'tl, A <br />^.^ <br />state: OA zip: c4'L1 A I <br />Phoner'to.: 7 I t-f 5'76'3 6 / 7 E-mailAddress: <br />{ ,o rroo, tr 2nd ftoor [ <br />- <br />ftoor <br />7. Do you share the floor or business entrance with another business? Yes E N" { <br />8. What is the amount of square footage leased? 6 eL <br />fl Cnangeof PropertyOwner WCn ng"of Occupant n Cnangeof Use E AdditionalOccupant <br />1. The following best describes my operation: <br />! Ottlce Only ! RetailSales E Medica!/Dental <br />E Warehouse/Manufacturing/Distribution E RestauranUTake Out Food <br />Ef ottrer (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, <br />opentothepubliQ. -q bUSl4C)J \.b h7't. CUt.finj balonOten 1,'OO An cto)e giofM <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.) t 5 h Ui r ggl { i n3 Sa lo n <br />4. Has the building or space been vacant or is this a new building? Yes E N"{ <br />lf vacant, for how long? <br />5. Are you an independent contract orZ yes d No n <br />6. Location of thebusinessandsuitenumber, l6?.o € I s(<'T un i+T 'anlq <br />qrl a <br />. cor^ <br />C'A qz'?o I <br />9. How much of the space, which you lease, is office? <br />tr looo/o n 5oo/o tr 3oo/o <br />lf other than 100%, how is the remaining space used? <br />S:Planning\Clerical-Counter Forms\ <br />CofO Ouestionnate 08-27 -18 <br />{ ,"rrthan 3o%