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Home My WebLink About80428216 - Certificate of Occupancy,Planning & Building Agency Building Safety Division 20 Civic Center Plaza P.O. 1988 (M-19) Santa Ana, CA 92702 (714) 647-s8ts No. 804-282LG OCCUPANCY INSPECTION APPLICATION BTN 3qqqt s u,C @4=,m (n @ N u\ \$ h# \t 1. L7 BUSINESS \J qqq a1. tt BUSINESS OWNER'S NAME & TITIIE BUSINESS OWNER'S DRIVERS LICENSE NO. & STATE t nja-r(onr zbaT at\i<o BUSINESS OWNER'S MAILING ADDRESS C0fhnrtjv'ttI sY>Tbrk C11 (IF YES, NAME OF SUBLEASOR)DO YOU SUBLEASE? Yes SQUARE FEET LEASING AGENT OR PROPERTY MANAGEMENT COMPANY NAME A LEASING AGENT OR'PROPERTY MANAGEMENT COMPANY ADDRESS f I nJY -f ( rv\ L,? PI]OPERTY OWNER'S NAME BUSINESS PHONE NO. fiq-U b1, t7yLl EMERGENCY PHONE NO. ,7V?,1 b1 t 3 ,i '/ Tfla UrA o?o rW .U)t Nuhrz qcrt cn qLuG3PROPERTY OWNER'S ADDRESS I BETAIL SALES r I WHOLESALE WAREHOUSE I GHOUP ASSEMBLY iT AUTO REPAIR (NO WELDING, NO OPEN FLAMES, NO SPRAY PAINTING tr AUTO BODY(SEE ATTENTION BELOW) D wooDwoRKlNG(sEE ATTENTTON BELOW) n EATTNG ESTABLTSHMENT (SEE PWA) D oTHER (DESCRTBE ABOVE) (1-orrrce BUSINESS DESCRIPTION i- MANUFACTURING I I Yes D{ No No. 1 Will you be storing and/or utilizing haradous matarials al thisfacilffi t I Yes }{,No No.2 Does your production procsss producâ‚¬ haTanlous waste? ll you have answered Yes to eilher question you must conlact Orange County Fire Authority's Hazardous Material Disclosure Section at (714) 573-6000. ff YES, please ATTENTION: ALL GBOUP "H" OCCUPANCIES (INCLUDING, BUT NOT LIMITED TO, AUTO BODY, AUTOMOTIVE WORK OR STORAGE TNCTDEALTAL TO WELDINGIVITH OPEN FLAME, WOODWORKTNG, CUTT|NG, SHAPTNG OR SANDTNG WOOD) SHALL NOT BE CONDUCTED tN ANY6UA\I,G OT6fFUCTIBE UI!,#STHERE IS AN APPRoVED FIRE SPRINKLER SYSTEM INSTALLED.mrc f(Al@-{nG<' DATE . tr/ ezlutq DEPAHTMENT IISE ONLY YES r I NO Date of roport: t L PRIOB APPROVED USEa/a PRIOR APPBOVALDATE+/n -PRIOR OCCUPANCY GROUP.u/<PRIOR CONSTqt,CTION TYPE ^/< UAl PLANNING $-?LZONE CUP DENIED DATE ,tt,/z-2,/t t OCC. LOAD OCCUPANCY GROUPb CONSTBUCTION TYPE lF. t/8. rPK APPROVEDT\\ b"tMd\ DENIED 6*zz'?>lDA'TE Note: One of the following must bâ‚¬ chscked by the C of O lndpector. ' [ ] Yes [ ] No Has the inspector identified any hazardous matedals at this [ ]Yes il ls hazardous waste being - site? NOTES: (LIMITATIONS OF APPROVED OCCUPANCY) _ I { (I t I Planning and Building Agency Planning Division 20 Givic Center Plaza P.O. Box 1988 (M-20) Santa Ana, C492702 (7',t41647-5804 www.santa-ana.org CERTIFICATE OF OCCUPANCY SUPPLEMENTAL QUESTIONNAIRE *-SAI'{TA ANA,'lt'ilffi Please turn in this completed form with your Certificate of Occu pa ncy appl ication. Company Name (Print)AJ T CNT T-l.) Contact Name:NJ \) Address (business mailing address):2? 31 \r.t , F['flrt sr . tvtu tf A City:6ANTA A$A State: CA Zip: phoneNo.: 4..lq'qQ1-tj qV E-maitAddress: G.\\i f\t den E Cnange of Property Owner E Cnange of Occupant E Cnange of Use E Additional Occupant 1. The following best describes my operation: Bf Orice Only n Retail Sales n Medical/Dental E Warehouse/Manufacturing/Distribution ! RestauranUTake Out Food E Ottrer (describe) Please provide a brief description of how the business operates at this site (for example, please describe the general nature of the business, whaf.activities occur on-site,, the hgurs of operation, open to the public). y4-(ll51rh v(,,(.t U 4tt 16 ,&,.hal bU,( J t ,t r$"'{N - - rcsri on ho I attruni ly < 1a ce s r What was the former type of business or use of facility? (Please contact the leasing agent or building owner to determine prior business use.) 4. Has the building or space been vacant or is this a new building? Ves ( No E lf vacant, for how long?Nt1d 4!Jr9- 5 Are you an independent contractor? Yes E No B. Location of the business and suite number: (AN l.f A tr lstfloor tr 2ndfloor ! -floor7. Do you share the floor or business entrance with another business? Yes E No 6 8. What is the amount of square footage leased?r,.J on/ â‚¬ 9. How much of the space, which you lease, is office? ,J ) N A e etg. (a) tr looo/o tr 50% tr 30% tr Lessthan3o% lf other than 100%, how is the remaining space used? S: Planning\Clerical-Counter Forms\ r-il\96 corn 2 3 6 CofO Questionnate 08-27 -18 I 10. ts the building sprinktered? Yes EJ ruo n 11. Do you plan on making any improvements to the building such as: exterior painting, signage, interiortenantimprovements? Yes n No Eil- grVC. JA, nCâ‚¬- (.ONs1-yZUcn Ofr) lf yes, please describe: 12. Will your business include a lobby or waiting area? Yes E No E lf yes, what will be the dimensions? 13. Do you store equipment, materials, or products within the building? Yes n No E a. Will there be outdoor storage of equipment, materials, or products? Yes E No E lf yes, please describe: b. Will there be storage racks, pallets and/or shelving exceeding 5 feet 9 inches in height? Yes f] No E (permit required for racks/shelving over 6', inquire with permit counterl 14. Do you manufacture a product at the site? Yes E No EI lf yes, please describe (including process and end product): a. Witl operations produce dust/wood shavings or similar material? Yes n No Eb. Does the operation involve the use of welding or open flame? Yes E Noâ‚¬ 15. Does the proposed use involve a patient care profepsion, such as doctor, dentist, chiropractor, acupuncturist, or physical therapist? Yes n No KL a. ls the proposed use within the mental health profession, such as: f EtrttolNot Applicable ! Psychologist ! Psychiatrist E Socialworker E Ot'er_ 16. ls counseling proposed as a part of your business operation? Yes E ruoN a. Does your counseling business contract work with a public agency? Yes E No EL lf yes, please describe: 17. Will your business be offering the following services: E Alcoholsales E Smoking Lounge E goOy piercing/ Ear piercing ! Tattoos/ Permanent make-up fi None ofthe above 18. Will your business be offering massages as part of your business operation? This includes massage as ancillary to pedicures, manicures, and otheiservices. Yes E No E 19. ls cannabis or cannabis related product stored, cultivated, distributed, tested, manufactured or dispensed at your business? Yes n No El 20. Do you prepare or sell food for consumption on or off the property? Yes E No ,EI lf yes, do you provide sit down service E, drive+hrough E, or orders to go/pick-up !? S: Planning\Clerical-Counter Forms\ CofO Questionnaire 08-27-1 I I Please explain: 21. Does your business sell automobiles or motorcycles? Yes E No B lf yes, please explain: 22. Does you Yes E r busi No NESSg service or repair vehicles or install equipment and accessories into vehicles? lf yes, please explain 23. I acknowledge that I have requested and received all zoning and Saqtg Ana Municipal Code requirementspertainingtomybusinessandoccupancyapplication. ID E UNDE TY OF PERJURY, THAT THE FOREGOING STATEMENTS ARE TRUE AND co OF MY KNOWLEDGE AND BELIEF. x Print 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, exceptWednesday 10:30a.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 at(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 Code requirements. S: Planning\Clerical-Counter Forms\ CofO Ouestionnairc 08-27 -18 tl ztl ?-Dt1 Date t MEMORANDUM TO: Finance & Management Services Agency FROM: Planning and Building Agency SUBJECT: Miscellaneous Cash Transaction MCT #47704 Friday, November 22, 2019 I st 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. ISSUED TO: Allison Levy Community Development Partners ADDRESS: 3416 Via Oporto #301 Newport Beach, CA 92663 or] TOTAL MCT AMOUNT $ 481.68 Comments: coo 80+28216 lssued By: Pezeshkpour, Ali (Planning and Building Agency) GL Account # 01'116002 51605 Total $481.68 PROJECT NAME: PROJECT ADDRESS: Tiny Tim Community Room lmprovements 2239W Fifth St Unit# A, Santa Ana, CA 92703-2808 MASTER tD #2019-153662 AP # 007-313-15 Application # MISC-2019-941-CO Permit # ITEM DESCRIPTION QTY UNIT RATE AMOUNT FUND NO. 1 Certificate of Occupancy (Fee Purposes Only)1 0000 $481.68 $481.68 01116002 51605 Eotch*:53132 - ll/22/2frt9 I0: LR0SALES0ffice: CTYH Tronsi: 70 1 of 1Accti: Ref *: 4771:t4 Rcpti:02811869 - tl/22/2(t19 3:34 FH Tronsoct ion Totol i481.68ALLISOH LEVY COHIIUHITY DEUELOPNENT PART}IERS $4S1. 01 I 16tr02- 51605trr10- V isa CC+: ***r********5614 s491. Authi:r-r321r"'tI 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 2 of 3