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Planning and Building Agency <br />Plannlng Dlvlsion <br />20 Clvlc Center Plaza <br />P.O. Box 1988 (M-20) <br />Santa Ana, C492702 <br />(7141il7-5804 <br />www.santa-ana.org <br />CERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUEST!ONNAIRE <br />-,-SANTA <br />ANA,',iiiffi <br />your Ceftificate of Occupancy application. <br />contact Name: -\a.\^ ,u [ \ C"r.z- r <br />Address (business mailing address):t%tn Z t <br />So.-,.J*.^-- A r.--o.-.,r,"' tzt_ ,,r'Ql->O s*City: <br />Phone No.4q qr0o E-mailAddress:J nr (nz-l @- \,-Ao 0-, <br />E Ctrangeof Propertyo*n"r(changeofoccupant ! cnangeofUse E Rooitionaloccupant <br />1. The following best describes my operation: <br />F otti".only fl Retail sales f] Medical/Dental <br />E Warehouse/Manufacturing/Distribution E RestauranUTake Out Food <br />fl Otfrer (describe) <br />lf vacant, for how long?\)qs\o\D\-'-q- b \^-sJf.s <br />5. Are you an independent contractor? Yes E No <br />6. Location of the business and suite number: 5 V\,Lq-- SoC <br />tr 1st floor tr 2nd floor [ $"oor <br />7. Do you share the floor or business entrance with another business? Ves p No f] <br />8. What is the amount of square footage leased?<. <br />9. How much of the space, which you lease, is office?v 100%tr soo/o tl 3oo/o <br />lf other than 100%, how is the remaining space used? <br />S:Planning\Clerical€ounter Forms\ <br />CofO Questionnate 08-27 -'l I <br />2. Please provide a brief description of how the business operates at this site (for example, please <br />describe the general nature of the business, what activities occur on-site, the hours of operation, <br />open tothe nubtic)1flc=t\\tOw* SI"-.{f o^_- s b, oal0o_s.l"t wS1 <br />$rt,w - sg,uu Uo'.^^s{ - Y-r,ilq oLL ue- <br />3. What was the former type of busrnesb or use of facility? (Ptease contact the teasing agent or buitding <br />owner to determinezirffffiry*, blp.o_a=_ u sq_-, <br />4. Has the building or space been vacant or is this a new building? Y"rX No fl <br />U <br />n Less than 300/o