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Planning & Butlding Agency <br />Building Safety Division <br />20 Civic Center Plaza <br />P.O. re88 (M-r9) <br />Santa Ana, CA 92702 <br />(7r4) 647-5815 <br />coo-2020-473-CO <br />OCCUPANCY INSPECTION <br />APPLICATION <br />BTN 41"3 <br />q, <br />CLzmo <br />@ <br />oonmao <br />J <br />@(Jl <br />.-a <br />rn <br />@ <br />@,+ <br />-loor <br />@ <br />o <br />O)o) <br />.P <br />@of <br />o) <br />5 <br />.P <br />o <br />(o <br />N){o(rl <br />,,\\ <br />BUSINESS ADDRESS UNIT OR SUITE ZIP CODE <br />1851 E. 1st Street Suite 630 92705 <br />BUSINESS NAME <br />Pacific Counseling Solutions <br />BUSINESS PHONE NO. <br />o23\428 -1925 <br />EMERGENCY PHONE NO. <br />t714t730- 64,64 <br />BUSINESS OWNER'S NAME & TITLE <br />Stacey E. Cohn - President <br />BUSINESS OWNER'S DRIVERS LICENSE NO. & STATE <br />BUSINESS OWNER'S MAILING ADDRESS <br />SAA <br />EMAIL ADDRESS <br />staceycohn. pcs@gmail.com <br />DO YOU SUBLEASE? E Yes O No (lF YES, NAME OF SUBLEASOR) <br />Cohn & Swartzon, PC <br />SQUARE FEET <br />120 <br />FLOOR AREA <br />LEASING AGENT OR PROPERTY MANAGEMENT COMPANY NAME <br />Cohn & Swartzon, PC <br />BUSINESS PHONE NO. <br />(714\73O -6464 <br />EMERGENCY PHONE NO. <br />(714\547 -5100 <br />LEASING AGENT OR PROPERTY MANAGEMENT COMPANY ADDRESS <br />1851 E. 1st Street, Suite 630, Santa Ana, CA 92705 <br />PROPERTY OWNER'S NAME BUSINESS PHONE NO. <br />() <br />EMERGENCY PHONE NO. <br />() <br />PROPERTY OWNER'S ADDRESS <br />O MANUFACTURING <br />E OFFICE <br />E RETAIL SALES <br />D WHOLESALE <br />trWAREHOUSE <br />E GROUP ASSEMBLY <br />E AUTO REPAIR (NO WELDING, NO OPEN <br />FLAMES, NO SPRAY PAINTING <br />EAUTO BODY (SEE ATTENTION BELOW) <br />tr WOODWORKING (SEE ATTENTION BELOW) <br />tr EATING ESTABLISHMENT (SEE PWA) <br />E OTHER (DESCRIBE ABOVE) <br />]l Yes ;d No No. 1 Will you be storing and/or utllilng hazadous materials al <br />this facility? <br />Jl Yes Jl No No.2 Does your produclion process produc€ hazsrdous waste? <br />lf you have answered Yes to either question you musl contact Orange County <br />Fire Authority's Hazardous Malerial Disclosure Sectron at (714) 573-6000. <br />lf YES, please <br />ATTENTION: ALL GROUP'H" OCCUPANCIES (INCLUDING, BUT NOT LIMITED TO, AUTO BODY, AUTOMOTIVE WORK OR STORAGE <br />INCIDENTAL TO WELDING WITH OPEN FLAME, WOODWORKING, CUTTING, SHAPING OR SANDING WOOD) SHALL NOT BE CONDUCTED IN <br />AU(BUILDING OR STRUCTURE UNLESS THERE IS AN APPROVED FIRE SPRINKLER SYSTEM INSTALLED. <br />TITLE <br />Accountant <br />DATE <br />08t17t2p20 <br />DEPARTMENT USE ONLY irYES <br />PERMITS? <br />Dte of roeort f,{ <br />I <br />APPROVAL DATE <br />1 6 <br />PRIOR OCCUPANCY GROUP <br />R <br />PRIOR CONSTRUCTION TYPE <br />7B ,S(t< <br />PLANNING <br />PA-t",s <br />CUP APPROVED <br />d ?n**, <br />DENIED DATE <br />Q /{/aat <br />occ. LoAD a APPROVED <br />,4.C's'u <br />DENIED;P1 DATE?-Z{Z)Zd <br />Note: One of the following nrust be checked by lhe C of O lnspector. <br />[ ] Yes [ ] No Has the inspector identified any hazardous materials at this facility? <br />NOTES: (LIMITATIONS OF APPROVED OCCUPANCY) <br />[ ] Yes [ ] No ls hazardous wasle being generated at this site? <br />BUSTNESS oescnrpror,r Behavioral Theraov Services <br />J^^^;L^