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CN*SANIA <br />ANArll,ilfi <br />Planning and Building Agency <br />Building Division <br />20 Civic Center Plaza <br />P.O. Box 1988 (M-20) <br />Santa Ana, Cp.92702 <br />(714) 647-s800 <br />www.santa-ana.org <br />CERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUESTIONNAIRE <br />form with your Certificate of Occupancy application. <br />00rkr\hs 1 Wrulq.fr'Com <br />City: <br />Phone <br />contact Name: 08C{tP ,[ UUVnt6 <br />Address NESS M ailing address):h\q N bPo sr <br />state: W zip q71pl <br />'1ry15 =-,,,* vlindabv+tvtrts Y unitdQ ..,, <br />! Change of Property Owner fr "n"nn" <br />of Occupant ! Cnange of Use E Additional occupant <br />1. The following best describes my operation: <br />! Ofice Only ! Retailsales ! Medical/Dental <br />E Warehouse/Manufacturing/Distribution ff RestauranUTake Out Food <br />E Otfrer (describe) <br />4. Has the building or space been vacant or is this a new building? Yes n No X <br />lf vacant, for how long? <br />wt""tMl <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 busilress,.what activities ogcur on-site, the hours of operation, <br />open to tne puutic; <br />fuSOU,eA,{Y(lft/t0ilA,f frS b)' <br />owner to determine prior business use.) <br />p;il;,a,v( (vtfu ottnt t' \ <br />3. What was the former type of business or use of facility? (Please contact the leasing agent or building <br />5. Are you an independent contractor? Yes fl <br />6.of the business and suite numbert ? <br />1tt floor tr 2nd floor ! _ floor <br />7. Do you share the floor or business entrance with another business? Yes n *" ts <br />8. What is the amount of square footage leased?)50D <br />L How much of the space, which you lease, is office? tltHru,l <br />tr looo/o tr soo/o tr 30% <br />lf other than 100%, how is the remaining space used? <br />cm\cntr-frm\Supp. Quest. <br />N"K <br />O4 t ^l Y { S0.nfu"d+YreQ^qrlDl <br />07t2016 <br />X Less than 30%