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,,,SANTA <br />A],{A,'[t]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) 6/-7-5804 <br />www.santa-ana.org <br />'t <br />CERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUESTIONNAIRE <br />Please turn in this <br />i:^it fi: f ;K* r' <br />ff i;[ittfpU' <br />o "ff ;' a p p t i c a'l i o n <br />Company Name (Print): <br />)Contact Name <br />Address (mailing address) <br />City:State: <br />-) <br />dl-n ((,1 'l ,8K *^aitAddress ,L.CqPhone No <br />of Occupant E Cnange of Use E Rdditional Occupant <br />1. The following best describes my operation <br />fl office Only Retai! Sales ! Medica!/Denta! <br />ufacturing/Distribution ! RestauranUTake Out Food <br />E 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 busingsp, what-activities occur on-gite, tfre hoflrs of operation, <br />opentothepubric) {^* PtltcxrUJY o,,aX bro,) l}rrassay <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 usg) <br />(,,utrtciYt 9*bL <br />N *"fl4. Has the building or space been vacant or is this a new building? Yes <br />lf vacant, for how long? <br />5. Are you an independent contractor? Yes n <br />6. Location of the business and suite number: <br />N"x <br />1st floor n 2nd floor ! _ floor <br />7 share the floor or business entrance with another Yes E *"f. <br />8. What is the amount of square footage leased? <br />9. How much of the space, which you lease, is office? <br />{ <br />R 1oo% n so% tr 30% <br />lf other than 100%, how is the remaining space used? <br />S: Planning\Clerical-Counter Forms\ <br />CofO Questionnaire 08-27-1 8 <br />Less than 30% <br />I