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P/ease turn in this completed form with your Certificate of Occupancy application. <br />Company Name (Print): <br />Contact Name:cro .L <br />Address (business mailing address):( n . (. A' L+hee ei <br />City:a.a+lht nru<;d <br />Phone No.:E-mailAddress: <br />E Cnange of Property Owner W{^nn"of Occupant E Cnange of Use E ROOitional Occupant <br />The following best desclbes my operation: <br />E Orice Only {eetail Sales E Medical/Dental <br />n Warehouse/Manufacturing/Distribution n Restaurant/Take Out Food <br />E Otner (describe) <br />Please provide a brief description of how the business operates at this site <br />describe the general nature of the business, what activities occur on-site, the <br />open to the public). o Fd f*, (yoo ftrzl Ty I(ro:.ilfir2 -(o 7 <br />o <br />-bt,l <br />1 <br />2. <br />S: Planning\Clerical-Counter Forms\ <br />CofO Questionnaire 08-27-1 8 <br />(for example, please <br />, hours of ope <br />:oa trttA . <br />ration,lvl To <br />tro P A4 <br />t^kt <br />or3. What was the former type of business or use of facilityZ (Please contact the leasing <br />owner to determine prior business use.,) <br />Le*tVantiq\/Ce ff-o<e <br />4. Has the building or space been vacant or is this a new building? Yes E No <br />lf vacant, for how long? <br />{*"o <br />a;, <br />9. How much of the space, which you lease, is office? <br />tr 1oo% tr soYo n 3oo/o <br />lf other than 100%, how is the remaining space used? <br />5. Are you an independent contractor? Yes l <br />6. Location of the business and suite number <br />tr lstfloor tr 2ndfloor <br />7. Do you share the floor or business entrance with another business? Yes E *o { <br />8. What is the amount of square footage leased? <br />Less than 30% <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-s804 <br />www.santa-ana.org <br />CERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUESTIONNAIRE <br />{ <br />2-4.oC <br />,--SANTA <br />A}IAJIII}ffi