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t <br />,,-SANTA <br />NA-"'iil)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 />(71416/.7-s804 <br />www.santa-ana.org <br />CERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUESTIONNAIRE <br />Please turn in this completed form with your Ceftificate of Occupancy application. <br />Company Name (Print): <br />Contact Name AI /+t lif ol**... <br />Address (business mailing address):lrtl e. tf + 9t,, J..,i{.- [,-ot <br />City:5'^+ 1\-State:Ct[ zip, q L+z,i <br />Phone ruo.' ?l'( - 8)Q - tl4o E-maitAddress <br />! Cnange of Property Owner ts, Cnung" of Occupant I Cnange of Use ! Additional Occupant <br />{rfl4yl-irUe.o .( E+,lsT6ir S fftE-1. The following best describes my operation: <br />fi[ Onice Only ! Retail Sales ! Meaical/Dental <br />E Warehouse/Manufacturing/Distribution f] Restaurant/Take Out Food <br />E Otner (describe) <br />owner to determine prior business use.,)6(q'.-, . /r"L*t4,.(r*t\*-.-^s= <br />4. Has the building or space been vacant or is this a new building? Yes ( <br />lf vacant, for how long? <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 activitie5 occur on-site, the hours of operation, <br />open to the public). ADf - - AttaZ*A:,..- /Csre.k- p.*-t -fi", <br />' <br />&..2\t.-$Lrn 1 A#/lrtnly^ Sfu^ - *r--, 14- F <br />3. What was the former type of bdsiness or use of facility2 (Please contact the leasing agent or building <br />5. Are you an independent contractor? Yes E <br />6. Location of the business and suite number: <br />NoE <br />/,t <br />,+(,^,..-. -g^.+^. 4". <br />No &. <br />n lstftoor tr 2nd ftoor fl 1[ rroo. <br />7. Do you share the floor or business entrance with another business? Yes A[ No E <br />8. What is the amount of square footage leased?z <br />9. How much of the space, which you lease, is office? <br />fu toou tr soYo tr 3oYo <br />lf other than 100%, how is the remaining space used? <br />ct qz-T{ <br />S:Planning\Clerical-Counter Forms\ <br />CofO Questionnaire 08-27 -1 I <br />tr Less than 30% <br />J)