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Com <br />of Occupancy application. <br />(iA\ Vi(-oJ <br />,--SANTA <br />NA-',lt[,]ffi <br />Planning and Building Agency <br />Planning Division <br />20 Civic Center Plaza <br />P.O. Box 1988 (M-20) <br />Santa Ana, C492702 <br />(714) 647-5804 <br />www.santa-ana.org <br />CERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUESTIONNAIRE <br />Contact Name: <br />Address (business mailing address)q <br />city: \2(!P {Cicd4/ state: t-ft zip, QL9DI <br />Phone No., ff<tl 8L4 zbL+E-mair Address: tntug g\rVttt n.R}OrnC o CU, <br />E Change of Property Owner fl Cnange of Occupant ! Change of Use E ROOitional Occupant <br />1. The following best describes my operation: <br />{onr..only E Retail Sales E Medical/Dental <br />n Warehouse/Manufacturing/Distribution n Restaurantffake Out Food <br />E Otner (describe) <br />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 />opentothepublic). \n5\Jfa\\Ce_ \CvUV-Ofg ta\UN,Yloyrnr<_t Gfrnq.re.(Cra\) <br />t.ton- Sq+'. lo qrn--lp^., , o p€v"\ tD +\1e pJvc\ iC . <br />What was the former type of business or use of facility? (Please contact the leasing agent or building <br />owner to determine prior business use.) <br />4 Has the building or space been vacant or is this a new building? yes E *o VZ <br />lf vacant, for how long? <br />5. Are you an independent contractor? Yes E ruo M/ <br />o. Locationof thebusinessandsuitenumber, 143= W \St (t Uftit 2O5 <br />tr lstftoor glznoftoor ! <br />-ftoorDo you share the floor or business entrance with another business? y". N/ruo E <br />8. What is the amount of square footage leased? <br />9. How much of the space, which you lease, is office? <br />S looo/o tr soYo { ro*tr Less than 30% <br />lf other than '100%, how is the remaining space used? <br />Loa\l o+fir€- <br />S:Planning\Clerical-Counter Forms\ <br />CofO Questionnaire 08-27-18 <br />2 <br />3 <br />7 <br />Please turn in this completed form with <br />€hi na .R\anco <br />. t fi. r,l.e O