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S AJ\iTA <br />lIr <br />Planning and Building Agency <br />Planning Dlvlsbn <br />20 Civic Cent€r Plrr <br />P.O. Eox 19E8 (m-20) <br />9anta Ana, CA 92702 <br />(71/3)647.58114 <br />www.santa-rna.org <br />CERTIFICATE OF UPANCY <br />S ENTAL <br />NAIRE <br />Please tum in this compled torrn wlth of <br />Cornpany Name (Print) <br />ts lyf r v <br />Contacl Name:€K 5 <br />Address (business mailing address):A a. /v s7leer <br />City:ffrN 7n 4/,14 stao: y'* <br />phone rn.,/ty',\ 6 3/ -Afrb-E-maitAddress: <br />I Cnange of Property Owner D Change of Occupant D Changp of Use E Additbnal <br />1. The following best describm my operatlon: <br />! Office Only ! Retail Saler fl HedicaUDental <br />I Warehouse/tanufac{uring/Distrlbutlon ! RestruranUTake Out <br />F-*'(descrlbef 4rro &*tY &lOrrl- <br />2. Please provide a brief description of how the busines" op"r"t", at this site r please <br />describe the general nature of the business, u/trat activities occur on-site. the <br />/:dz/zn <br />of operaUon, <br />op€n to the public).trAS oF <br />,X a-./to*t <br />oPz:{ :uvlt*t -b4ry* <br />4 o$, tLz /r..*,2"'e /^ <br />3. What was the former type of business or use of facilityZ (Plaase contact ttlo <br />ownat to detemine priu business use.) <br />&z,L <br />4. Has the building or spaoe been vacant or is this a new building? Yes n <br />agont or building <br />lf vacant, for how long? <br />5. Are you an independent contractor? Yes ! *o X <br />6. Location of the business and suite number:A2b u, /Er <br />(.r"* n 2dfloor [-noor <br />7. Do you share the floor or business ontranc€ wilh another business? Yes N D <br />8. What is the amount of square fmtage leased? <br />9. How much of the space, s'ttich you lease, is office? <br />n tooo/o tr soo/6 n 30% <br />lf other than 100%, how is the remaining spaco used? <br />S ; Ptrnfp\Ocrtc*Countr Fcm3\ <br />CoE Qrarorrrarro 0&27- I 6 <br />X than 3O% <br />ru$\\r <br />,i 8t ltttl\t <br />rn0