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.,,, ,SAITA <br />A\A",,.:,i', <br />PLnnhgrd EuldryAeencYPlrmff Dffibn <br />2OClubGrnbrPb <br />P.O. EorrCllO{0,&nbAn , cAgllti2 <br />[rra] 6a7ato. <br />rru.aatilaana.or! <br />CERTIFICATE OF OCGUPAilGY <br />SUPPLEUENTAL <br />QUESTIONNAIRE <br />plGr,'E frtm tn d',ls anlry,le,trd fq/m wldil your c,,d/'rc,tre d oc,;uprcy cpllattur. <br />Company Narne (Print):6YLT . LLC <br />Contact Name:Fr t c, rnear <br />Addres" (busaness mailirlg addras):6S0 E. Dyec Rd <br />Citr 5antf^ Ana $ate: CA.210 t <br />Phorp itlo.: <br />'71tt' 3oto' 325t E<ndrAddres r 6ic,5.Cofn\ <br />[J Cnangeof propertyOmer E Chamoof Occupant E Changeof Use E AddiUoml Occupant <br />1. The followlng bct dccrlbes my operaton: <br />tr ffi- o,tv {R.,,illSaloe E Icdlc.lrD.nt t <br />flWrntrourrtUmtlctrrlngDhtrlbutoo El ncateurenUfake Out Food <br />E Ofior(Oe*rttcl <br />2. Please provide a brief descriptibn of how the business operates at this sito (for exantple, pbase <br />describi the general nature of tre business, wtrat activities oco.rr on-slte, the hourr of operaffon' <br />open totfre publlc). Iini*ot payro\\ eLo ^\n^rr C* ct ggace\ Com?r.nY . <br />Barn - U Pn, <br />3. Wtrat was the former t)rye of business or use of facili[y? Fleaso oltad the baerp agor( or btffitg <br />wnqto deloflt ineprbrD{rsfressus-, <br />U*, UU i klf nJ <br />4. Has lhe bu1ding or spaoe been vacant or b this a new buiHingZ ves fl Xo EI N OUJ brui lOti nqd <br />lf nacant for how long? <br />5. Anyouanirdepen<lentcontracror? Yes E No EI <br />6. l-ocation of the busirpss and suite numbel:(,50 E <br />fl rrrxrr d ztrcr, O <br />-floor7. Do 1lou strarcthefloororbusiness entrance with anotrrerbusiness? Yes E Nod <br />8. What b the amount d square fmtage l6asod?21,-1as <br />9. Fbrr muctr of the space, wttictt you baso, ls office? <br />tr 1oo% tr fi% tr 30% <br />lf ofiorftan 100%, trow b frre remahing spao u!€d? <br />Nar(Jrroo0t <br />d Leegthan3o% <br />S,Flmklrclorrcd4onrfr Fcmd <br />OdOr..lbamf.lJ,,-.n-15 <br />E I I <br />I