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,^-SAJ,[TA <br />ANAJ{ilffi <br />Planning and Building Agency <br />Planning Division <br />20 Civic Center Plaza <br />P.O. Box 1988 (M-20) <br />Santa Ana, CA92702 <br />(714) il7-5804 <br />www.santa-ana.org <br />CERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUESTIONNAIRE <br />P/ease turn in this form with <br />Company Name (Print)c,b" <br />Contact Name: Da^^-t bpn'- <br />of Occupancy appl ication. <br />Address (business rr;;.n "oor".(;, <br />/6 lo /t/u) <br />City:..-1 state: CA' zip t'Z 7o3 <br />Change of occupant E Cnange of Use fl Additional occupant <br />Phone N"., 'l /4 t'/ 6 t' 65 7 I E-mail Address: r,-l''ptb-/1 *nl4o @ n'-'ilrcrp=- <br />E Cnange of Property owner ( <br />1. The following best describes my operation: <br />! Ofice Only ! Retail Sales n Medical/Dental <br />E Warehouse/Manufacturing/Distribution E RestauranUTake Out Food <br />Q other (describe) bo\ f,l'y <br />I <br />2. Please provide a brief description of how the business operates at this site (for example, please <br />describe the general natqre of the bpliness, w-hat acttyities occur on-site, the hours of operation, <br />open to the [ubtic). l"rl, Jl"p 8n*, / f""-,l( <br />3. What was the former type of business or use of f4ility? (Please contact the leasing agent or building <br />owner to determine prior business use.) b_J7J lV <br />4. Has the building or space been vacant or is this a new building? Yes fr NoE <br />lf vacant, for how long?OPr O,*c. I r. <br />5. Are you an independent contractor? Ves ft No E <br />6. Location of the business and suite numbe ,, d. C <br />N lstftoor tr 2ndftoor ! <br />-floor7. Do you share the floor or business entrance with another busi ness? Yes <br />+F NoE <br />8. What is the amount of square footage leased? <br />9. How much of the space, which you lease, is office? <br />tr 1oo% tr so% tr 3oYo <br />lf other than 100%, how is the remaining space used? <br />S:Planning\Clerical-Counter Forms\ <br />CofO Questionnate 08-27 -18 <br />x Less than 30% <br />I <br />or