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i <br />I Plannlng and Building Agency <br />Planning Dlvision <br />20 CIvic Center Plaza <br />P.O. Box 1988 (M-20) <br />Santa Ana, CA92702 <br />(7',t41il7-5804 <br />www.santa€na.org <br />CERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUESTIONNAIRE <br />*,,SANTA <br />ANA,',liffi! <br />Please turn in this completed form with your Certificate of Occupancy application. <br />Company Name (Print)Law Offices of Stephen S. Falk <br />contact Name: Sandra Dietz <br />Address (business mailing address)1820 E. 1st Street, Suite 430 <br />City:Santa Ana <br />phone No.: (71 4) 647-9444 E-mailAddress <br />S:Planning\ClericaFCounter Forms\ <br />CofO Questionnaire 08-27-1 I <br />state: CA 2i0,92705 <br />sdietz@sfalklaw.com <br />! Cnange of Property Owner E Change of Occupant fl Cnange of Use E Additional Occupant <br />1. The following best describes my operation: <br />I Office Only E RetaitSales f] Medical/Dental <br />E Warehouse/Manufacturing/Distribution E RestauranUTake Out Food <br />D 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 />open to the public)' <br />Law firm specializing in work comp defense 8:30 - 5:00 <br />3. What was the former type of business or use of facility? (Please contact the leasing agent or building <br />owner to determine pior business use.) <br />It was Precision Manufacturing lnsurance Services <br />4. Has the building or space been vacant or is this a new building? Yes E No E <br />lf vacant, for how long?vacant since 4130119 <br />5. Are you an independent contractor? Yes E No E <br />6. Location of the business and suite number: 1820 E. 1st Street, Ste. 430 <br />tr lstfloor tr 2ndfloor E 4fhoo, <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?1465 <br />9. How much of the space, which you lease, is office? <br />E 1oo% tr soo/o tr 3oYo <br />lf other than 100%, how is the remaining space used? <br />tr Less than 30%