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,,,*SANTA <br />ANAqH* <br />! <br />\Planning and Building Agency <br />Planning Division <br />20 Givic Center Plaza <br />P.O. Box 1988 (M-20) <br />Santa Ana, C492702 <br />(7141il7-5804 <br />www.santa-ana.org <br />CERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUESTIONNAIRE <br />Please turn in this completed form with your Certificate of Occupancy application. <br />Company Name (Print):Glenn Lukos Associates, lnc. <br />conract Name: Dominique Brunel <br />Address (business mailing address):1940 E. Deere Ave, Suite 250 <br />Santa Ana state, cA 2ir,92705City: <br />phoneNo.. (949) 340-2537 E_maitAddre... dbrunel@wetlandpermitting.com <br />E Change of Property Owner E Change of Occupant ! Change of Use E Additional Occupant <br />1. The following best describes my operation: <br />E Ottlce Only E Retailsales E Medicat/Dental <br />! Warehouse/Manufacturing/Distribution E 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 business, what activities occur on-site, the hours of operation, <br />Open tO the pUbliC)' cLAisabiologacalconsultingfirmthatutitizetheofficespaceforstandard@mmerciatotficeaclivities.cLAk@psstandardhou6of <br />3$Iil'3lJi":rT,i??"'#f$?.il:ffffi1":ff;ffi1fi'liffi,*i;i:i"?;"Jfi1ffi[TS'.1,',:1[1'LT:,il'#P;o.'I;"n" <br />and vendoG/seruice technicians as needed. <br />3. What was the former type of business or use of facility? (Please contact the leasing agent or building <br />owner to determine priorbusrness use.) <br />Commercial office use <br />4. Has the building or space been vacant or is this a new building? Yes E No E <br />lf vacant, for how long? <br />5. Are you an independent contractor? Yes n No E <br />6. Location of the business and suite numbe r' 250 <br />tr lstfloor E 2ndfloor ! _ftoor <br />7. Do you share the floor or business entrance with another business? Yes E No E <br />8. What is the amount of square footage teased? 9,038 sqft <br />9. How much of the space, which you lease, is office? <br />E looo/o tr soo/o n 3oo/o <br />lf other than 100%, how is the remaining space used? <br />Less than 30% <br />S:Planning\Clencal-Counter Forms\ <br />CofO Questionnaire 08-27-1 8