HomeMy WebLinkAbout2800 N Main St #304 - Misc. CertificateBuilding Safety Division
20 Civic Center Plaza
P.O. Box 1988 (M-19)
Santa Ana, CA 92702(714) 7-54L5
tltww.santa-ana.org
Request for Temporary
Ceftificate of Occupancy
Project Add ress V*4 a 3,=-
Business Name , "+r^ 4*'-)B u ild ing Use
Business Owner's Name -!I("Ppnon"Qsr rtq-+obt
Applican
Address
t's Name/?co\o \-\rrh,ry\tu\ ilk. AqD {.rCI"^i[ao , cA q}s1r\
lf occupancy is partial, specify location. lnclude SiteiFloor Plan
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lf approved, the Temporary Certificate of Occupancy (TCO) will become void after 30 calendar days of date
of issuance; at which time a permanent Ce(ificate of Occupancy will be granted or occupancy terminated.
There is no renewal process for this request. The applicant is aware that Section 109.1 of the California
Building Code indicates, in part, that no building or structure shall be used or occupied until the Building Official,
or authorized representative, has issued a Certificate of Occupancy. Failure to obtain a Certificate of
Occupancy, or terminate occupancy at time of expiration of TCO, may result in criminal prosecution.
lnitials \- f
The applicant understands that the fee is not refundable, even if the request is denied. The request for
Temporary Certificate of Occupancy does not grant any utility service release. lnitials UJ yyl
The applicant hereby agrees to hold the City of Santa Ana, its officers, and employees free and harmless from
any incidence or occurrence, which may occur as a result of this TCO. lnitials W$\
Applicant's Sig nature Date \! \Cl?op*
Bldg Permit No lofl7lz4
Total Area of Building_sf
Releases Okay Date
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P lu m b ing/Mech a n ical J
1,o
7
Electrical
Fire
Police
Planning
Public Works
Occupancy
Received Date
Expiration Date
tl-\6 - t2-Approve 6g21s ll --lrc - r-l Denied Date t-r./*-
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12-t1-,,2-Notified
Offici4_s Signature lssue Date: ll '11 - t 2--,
Certificate of Occupancy Reference No.
G G,.,
TCO No.: DOL\2b
.--SANTA
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Reason for Request:
FOR OFFICE USE ONLY
$404.13 Fee
occupancy Group M
Approved Use_
Tvoe of Construction it b. z.rPl-'' ------------
Area to be occupied_sf