HomeMy WebLinkAboutCOO-2021-209-CO - Certificate of Occupancycoo-2021_209_CO
Planning & Building Agency
Building Safety Division
20 Civic Center Plaza
P.O. 1988 (M-le)
Santa Ana, CL 92702
(714) 647-s8ts
OCCUPANCY INSPECTION
APPLICATION
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NAME DRIVERS LICENSE NO. & STATEBI.IS
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DO YOU O Yes (IF YES, NAME OF q lt ,r lltLo
PANY NAME BUSINESS PHONE NO
b w EMERGENCY PHONE NO.
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BUSINESS PHONE NO.aNJh qryb EMERGENCY PHONE NO.
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BUSINESS DESCRIPTION
O MANUFACTURING
D OFFICE
E RETAIL SALES
E WHOLESALE
tr WAREHOUSE
tr GROUP ASSEMBLY
FLAMES, NO SPRAY PAINTING
O AUTO BODY (SEE ATTENTION BELOW)
tr WOODWORKING (SEE ATTENTION BELOW)
tr EyrG ESTABLTSHMENT (SEE PwA)
turrHER (DESCRTBE ABOVE)
WaA* Sahn
*.rrldr*otr AUTO WELDING, NO OPEN
Or* Ky. 1 Will you be storing and/or utilizing hazardous materials at
lhis facilily? 1/
El yes E/(o No. 2 Does your production process produce hazardous waste?
lf you have answered Yes to either question you must contact Orange County
Fire Authority's Hazardous Material Disclosure Section at (714) 573-6000.
lf YES, please describe
ATTENTION: ALL GROUP "H" OCCUPANCIES (INCLUDING, BUT NOT LIMITED TO, AUTO BODY, AUTOMOTIVE WORK OR STORAGE
tNctDENTAL TO WELDTNG W|TH OPEN FLAME, WOODWORKTNG, CUTT|NG, SHAPTNG OR SANDTNG WOOD) SHALL NOT BE CONDUCTED tN
ANY BUILDING OR STRUCTURE UNLESS THERE IS AN APPROVED FIRE SPRINKLER SYSTEM INSTALLED.
SIGNA
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TITLE DATE
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DEPARTMENT USE ONLY EXPIRED/OPEN PERMITS?
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PRIOR APPROVED USE
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PRIOR,APPROVAL DATEu I tlt, llilt1
PRIOR OCCUPANCY GROUP
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PRIOR CONSTRUCTION TYPE
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PLANNING
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ZONE
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CUP APPROVED
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DENIED j/ 25 / auDATE
OCC. LOAD OCCUPANCY GROUPE CONSTRUCTION TYPE
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DENIED 'ff'tg -z/
Note: One of the following must be checked by the C of O-lnspector.
[ ] Yes I I No Has the inspector identified any hazardous materials at this facility?[ ] Yes [ ] No ls hazardous waste being generated at this site?
l-/
NOTES: (LIMITATIONS OF APPROVED OCCUPANCY)
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,--SAI,{TA
ANA-"Hffi
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Planning and Building Agency
Planning Division
20 Givic Genter Plaza
P.O. Box 1988 (M-20)
Santa Ana, CA-92702
(714) 647-s804
www.santa-ana.org
CERTIFICATE OF OCCUPANCY
SUPPLEMENTAL
QUESTIONNAIRE
Please turn in this form with of Occu pa ncy appl ication.
Company Name (Print):
Contact Name:
Address (business mailing address)w
City:State Zip 4a+Dl
Phone No.:rl Itw
fl Change of Property Owner 6"*e of Occupant E Cnange of Use E ROditional Occupant
1 The following best describes my operation:
E Offce Only ! Retailsales f] Medical/Dental
E Warehouse/Manufacturing/Distribution E RestauranUTake Out Food
6rn* (desc ri be) g%.*t\ $[p1^,
\.J
Please provide a brief description of how the business operates at this site (for example, please
describe the general nature of the business, what activities occur on-site, the hours of operation,
open to the pubric). ?ZALqCSalon - bilt?Ni\e- lpdnn_-.{7ro yln-Sun
What was the former type of business or use of facility? (Please contact the leasing agent or building
owner to determine prior business use.) -ri I
E(w^bwfic{'(,/YruSONrWrYfsu'o'jbolNYv'rgilyl'
Has the building or space been vacant or is this a new building? Yes E *od
2
3
4
lf vacant, for how long?
5
6
Are you an independent contractor? Yes fl *" {
Location of the business and sgite number:
n 1st floor ( 2^o floor
9nAqn"<
! _ floor
,/7. Do you share the floor or business entrance with another business? Yes D/ No E
8. What is the amount of square footage leased?\?D'
9. How much of the space, which you lease, is office?
tr 1oo% tr so% tr 3oo/o
lf other than 100%, how is the remaining space used?
S:Planning\Clerical-Counter Forms\
CofO Questionnaire 08-27-1 I
1.""than 30%
E-mailAddress:
10. ls the building sprinklered? Yes K
"11. Do you plan on making any improvements to thg,tfuilding such as: exterior painting, signage,
interior tenant improvements? Yes E No EK
lf yes, please describe:
12. Will your business include a lobby or waiting area? Yes E *" {
lf yes, what will be the dimensions?
13. Do you store equipment, materials, or products within the building? ,""/*o a
a. Will there be outdoor storage of equipment, materials, or products? Yes E *o {
lf yes, please describe:
b. Witl there ne sfo/ge racks, pallets and/or shelving exceeding 5 feet 9 inches in
height? Yes fi No | @ermit required for racks/shetving over 6', inquire with permit counterl
14. Doyou manufacture a product at the site? Yes E N" {
lf yes, please describe (including process and end product):
a. Wilt operations produce dusUwood shavings or similar materiat? Yes E *" {b. Does the operation involve the use of welding or open flame? Yes E No E|/
15. Does the proposed use involve a patient care profess:ry( sucn as doctor, dentist, chiropractor,
acupuncturist, or physical therapist? Yes E No El'
a.
)Ane
proposed use within the mental health profession, such as:
Mt{olNotApplicable !Psychologist EPsychiatrist
E Socialworker E Other
16. ls counseling proposed as a part of your business operation? Yes fl No
a. Does your counseling business contract work with a public agency? Yes E No E
lf yes, please describe:
17. Will your business be offering the following services:
E Alcoholsales ! Smoking Lounge
E goOy piercing/ Ear piercing
18. Will your business be offering massages as part of your business
massage as ancillary to pedicures, manicures, and other services. Yes
Z /attoost Perm anent make-u p
E[None of the above
operation? TIK includestl NoV
19. ls cannabis or cannabis related product stored,, distributed, tested, manufactured or
dispensed at your business? Yes E No
20. Do you prepare or sell food for consumption on or off the property? Yes E No
lf yes, do you provide sit down service !, drivethrough !, or orders to go/pick-up !?
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CofO Questionnaire 08-27 -1 I
Please explain:
21. Does your business sell automobiles or motorcycles? Yes E No
lf yes, please explain:
22. Does
Yes
your businesgz6ervice or repair vehicles or install equipment and accessories into vehicles?tr trto E/
lf yes, please explain
23. I acknowledge that I have requested and received all zoning and Santa Ana Municipal Code
requirementJ pertaining to my business and occupancy applicaiion. A 6 (initialj
I DECLARE UNDER PENALW OF PERJURY, THATTHE FOREGOING STATEMENTS ARE TRUE AND
CORRECT TO
L\
Signature
Print Name
r1->tr: fra(
Title
lnformation
The Planning Division's Public Counter is open for walk-up customers from 8:00 a.m. to 4:00 p.m., Monday
through Friday, except Wednesday 10:30 a.m. to 4:00 p.m. The Planning Division is located within City
Hall - Ross Annex, 20 Civic Center Plaza, First Floor. Additionally, you may call us al (714) 647-5804
should you require any general information.
The Planning Division reviews Certificate of Occupancy requests for change of address, new businesses,
or expansions to ensure that the proposed use is consistent with the established zoning regulations of
Santa Ana. Please check with the Planning Division's Public Counter prior to signing a lease or committing
your business to a certain location to determine the feasibility.
lf a nonconforming use is discontinued, or if a nonconforming building is vacant, unused or unoccupied for
a period of 12 consecutive months, any subsequent use must conform in every respect to the provisions of
the Municipal Zoning Code, and a nonconforming building may not thereafter be used or occupied until it
conforms in every respect to the provisions of the Code.
Generally, the following uses will require further documentation or an extended review and may or
may not be permitted: office uses within an industrialzone; medical, restaurant, laundromat, trade
or technical schools, and automotive repair and service uses within spaces that were not previously
used for such purposes; a building that does not meet the parking demand for the proposed use;
or a use which generates a higher parking demand or adherence to development standards than
the previous uses.
You may need to provide floor plans, site plans, or document the prior use before obtaining a
Certificate of Occupancy to determine the grandparented rights of a nonconforming use, or a use
which has additional Gode requirements.
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CofO Ouestionnate 08-27 -18
B.-,
BEST OF MY KNOWLEDGE AND BELIEF.
MEMORANDUM
TO:
FROM:
SUBJECT
MCT # 54283
Thursday, March 25, 2021Finance & Management Services Agency
Planning and Building Agency
Miscellaneous Cash Transaction
I
All fees are subject to change at any time and may also be affected by scheduled adjustments on July 1 of each year. The Payee must
pay the prevailing rate at the time payment is made.
PROJECT NAME:
PROJECT ADDRESS:
COO for Revolution Beauty Salon
116 W Fourth St Unit# 7, Santa Ana, CA92701-4643
MASTER tD #2021-165115
AP #398-264-02
Application # COO-2021-209-CO Permit #
ISSUED TO
ADDRESS:
Revolution Beauty Salon
116W 4th St Unit
Santa Ana, CA 92701
ITEM DESCRIPTION QTY UNIT RATE AMOUNT FUND NO.
1 Certificate of Occupancy (Planning and lnspection)1 0000 $499.36 $499 36 01 1 16002 51605
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Acct*:
R(pt+: r-t3224849
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Comments:
lssued By: Enriquez, Gissel (Planning and Building Agency)
TOTAL MCT AMOUNT $ 499.36
GL Account #
01 1 16002 51605
Total
$499.36
NOTES For payment to be considered complete, a
Miscellaneous Cash Transaction (MCT) must be paid
in full. Applicant must return to Planning with
stamped cashier validation of the paid MCT for
closure in the Planning system.
Page 3 of 3
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$499 .56
(:OO FOR RECOLUTiIJI{ BEAUTY SALIJ
C:ertif icote ol Occupqncc
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