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,**SANTA <br />A],[A-'iffiffi <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 />(7141 647-5804 <br />www.santa-ana.org <br />CERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUESTIONNAIRE <br />Please turn in this <br />E Cnange of Property Owner rf Change of Occupant ! <br />State <br />Change of Use <br />lowing best describes my operation: <br />Office Only ! Retail Sales E Medicat/Dental <br />Warehouse/Man ufactu ri n g/Distri <br />of Occupancy application. <br />C <br />Occupant <br />Out Food <br />il NoE <br />your <br />Company Name ( <br />Contact Name: <br />Address <br />€.-r,t <br />maili add rESS <br />0J' <br />):0 <br />City:Zip: <br />E-maitAddress: 4td ha*:c bJ" u)crl.l 6 v*u,"l .Co'y <br />l <br />Additional <br />Phone No. <br />1. The fol <br />tr <br />tr <br />p otn", (descri <br />bution [-l RestauranUTake <br />p-l--Q--p,',- <br />2 <br />3. <br />4. <br />S :Planning\Clerical-Counter Forms\ <br />CofO Questionnate 08-27 -1 I <br />Has the building or space <br />lf vacant, for how long <br />Please provide a brief description of how the business operates at this site (for example, please <br />describe the general natqle of the business, what activilies -occur on-site,lhe hours of operation, <br />open to the pubric). ,,fl-.-y. F- U;+ C g"-,f fp--. <br />What was the former type of business or use gf facility? (Please <br />owner to determine prior business use.) 2Ur U ;-J/fu"*"":':":'!l2Ts asent or buitdins <br />been vacant or is this a new buildino? Yes <br />z Dc^- ar,< V;^ <br />. :# ",#:::,:"J::; .',::.F;fr <br />& l stftoor n 2nd ftoor n <br />7. Do you share the floor or business entrance with an <br />floor <br />other businps <br />l@t <br />zvesffi NoE <br />8. What is the amount of square footage leased? <br />9. How much of the space, which you lease, is office? <br />n rco% tr soo/o n 3oo/o <br />lf other than 100%, how is the remaining space used? <br />fi Less than 30% <br />?(r/ 46rarl t <br />t