HomeMy WebLinkAboutCOO-2020-162-CO - Certificate of OccupancyPlanning & Building Agency
Buildin g Safety Division
20 Civic Center Plaza
P.O. 1e88 (M-le)
Santa Ana, CA 92702
(7r.r) 647-s8rs
( coo-2020-162-CO
OCCUPANCY INSPECTION
APPLICATION
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zusrNEssNAME SvpER XJDs bE-ru.r*L LDOft\P?tu^trrc nr SuAr{6Al N-Tfln", DE^ITA/ T_Nla.
BUSINESS PHONE NO.
,8W,,fl1"76X
EMERGENCY PHOT.IE NO.
,trt?, 4q{ _q 6 q3
T,NE I H D
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BUSINESS C}I,V}IER'S DRIVERS LICENSE NO. & STATE _/t
/116 El Rrto csleols,aat'l-co^tu€' GL€rvD*t cfi lrzo{
DO YOU SUBLEASE? OVesf,rrb 0F YES, NAME OF SUBLEASOR)SQUARE FEET
3,ooo 5F
FLOOR AREA
3 oOO 5:F
LEASING AGENT OR PROPERTY MANAGEMENT CO{i'PANY NAMERot-c BUSINESS PHONE NO.
,8sg2t - qlot EMERGENCY PHONE NO.
,fsfit'r4+ o?s1
LEASIT{G AGENT OR PROPERTY MAI{AGEi'ENT COMPANY ADDBESS/lL:;o El cftn{No REfr4?r'7rt^l DT€@r c-,4 ?8t3o
R oTC Sfr l0fr NNfr , LI C_
PROPERTY O/VNER'S NAI\IE
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AUSINESS PHONE NO.EMERGENCY PHOI'IE NO.
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t t Tso Et dnfiTyo KeA L *7tu flA,tr, DJECJI, ct+ ? Zuo
PROPERTY o\/\NER'S ADDRESS
BUSINESS DESCRIPTION
UMANUFACTURING
O OFFICE
E RETAIL SALES
EVWOLESALE
OWAREHOUSE
OGRqJP ASSEi/ELY
trAUTO REPAIR (NOWELDING, NO OPEN
FLAT'ES, NO SPRAY PAINI'IT.IG
E AUTO BODY (SEE ATTENNON BELOT/V)
Dr,\,ooDWoRKING (SEE ATTENTIOT{ BELOVV)
O EAnNG ESTABLISI-Iil,ENT (SEE PWA)
o orHER (DESC-R|BE ABO/E)
U t* (* i.lo. 1 tMl yor be stodng and/or rnilzing hazadous matorhb at
thb fadily?.
31 Vc fio No.2 Does your poductbn process prcduce hazardous uesie?
lf you have anwrpred Y€6 lo either queslbn you musl contac.l Orange County
Fke Authority's Hazadous Material Disclooure Sedion al (714) 57&dXD.
lf YES, please
ATTENTIoN: ALL GROUP "H" OCCUPANCIES (INCLUDING, BUT NOT LIMITED TO, AUTO BOOY, AUTOMOTIVE WORK OR STORAGE
INCIDENTAL TO WELDING WTH OPEN FLAME, WOOO ,ORKING, CUTTING, SHAPING OR SANDING \ /OOD) SHALL NOT BE CONDUCTEO lN
ANY BUILDING OR STRUCTURE UNLESS THERE IS AN APPROVED FIRE SPRINKLER SYSTEM INSTALLED.
T-DEffi/0wrteNTLE DATE
:K dr2S1 Z-oD
DEPARTMENT USE ONLY PERMITS?
Date of report:W VJuNo
PRIOR APPROVED USE M PRIOR APPROVAL DATE
Nfl
rlRroR occuPANcYGRot P
NA
PRIOR CdNSTRUCTION TYPE
Nft
PLANNING
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ZolrlE VA
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APPROVED
w( ilru DENIED DATE
2 l, t f zozo
OCC. LOAD b I
DENIED DATElc-lz-uq
l.lote: One of lhe follovdng mus{ be checked by the C of O lnspe<tor.
I I Yes [ | ],lo l-las the inspec{or identifiod any hazardous naledals at this ls hazardous waste being generaled at thb site?
iIOTES: (LIMITATIONS OF APPROVED OCCUPANCY)
I IYes I
[5e:
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Planning and Building Agency
Planning Division
20 Civic Center Plaza
P.O. Box 1988 (M-20)
Santa Ana, CA927O2
(714) 6475804
www.santa-ana.org
CERTIFICATE OF OCCUPANCY
SUPPLEMENTAL
QUESTIONNAIRE
Please tum in this complefcd form with your Ceftificate of Occupncy application.
company Name (print): t, , pe < Vt>5 Dt-nTftt - PRAcTTC? oF 1t1frtfffi Df,ftfl
TNC
Contact Name hr?- 4HrcsTilE- (ttan DTfr/1/
Address (business mailing address)4nz E, FrRSi- 9TREtr-* Zft
City:S,fttvT+ ^^r
1. The following best describes my operation:
tr
tr
Ofiice Only E Retai! Sales MedicaUDental
on E RestauranUTakeOut Food
! Otner (describe)
2. 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,
opentothepublic). Deff+ otrFICeJ RL=tft7eD uSA-€ . ^.mr.T (lr ftt.t fu.Frr,n 1;o0an-/"oo/: t:h fr'tf"Te^3. What was the former type of business or use of facitily? (Please contact the leasing agent or building
ownerto determine pior business usa.)
P*y lEss 1iloe
X4. Has the building or spare been vacant or is this a new building? Yes NoE
lf vacant, for how long?nf
5. Are you an independent contractorZ Ves f,No fI
6. Location of the business and suite number:\/p\ lstfloor tr 2dfloor !
-floor-\
7. Do you share the floor or business entrance with another business? Yes n No X'
8. What is the amount of square footage leased?
9. How much of the space, which you lease, is office?
(100o/o tr so%tr 3oYo
lf other than 100o/o, how is the remaining space used?
S :Phnning\Clerixl'Counler Forms\
CofO Quedionnaire 0&27-1 8
Less than 30%
,,-SANTA
NA,'iffii
swe lft zip: ?)7A I
Phone No., (Kt?) <23-76)( E-maitAddress: C<JerL{s. €t7 ,.na' l' Lc,.\U
E Change of Property Oruner EI Cnange of Occupant fl Cnange of Use E ROoitional Occupant
10. ts the building sprinklered? Yes tr frf. fi
11. Do you plan on making any improyg;nents to the building such as: exterior painting, signage,
interiortenant improvements? Yes A Xo E
ff yes, please describe: Zlfeffo e TTtrtnTAPt@VErreNT frR
12. Wllyour business include a tobby orwaiting area? Yes E No
lf yes, what will be the dimensions?
13. Do you store equipment, materials, or produds within the building? Yes D *" (
a. \Mll there be outdoor storage of equipment, materials, or products? Yes E
lf yes, please describe:
a. Will operations produce dust/wood shavings or similar materiat? Yes Db. Does the operation involve the use of welding or open flame? Yes E No
DETJTrtLr-T$cP
'"F
b. Will there be storage qcks, pallets and/or shetving exceeding 5 feet 9 inches in
height? Yes n No
Xerzrftrcqulrcdfornds/shdingovu6',tnqulrcwtthpemltoounterf
14. Do you manufacture a product at the site? Yes E N" (
lf yes, please describe (including procrass and enO proaua\1:
R5
15. Does the proposed use involve a patientpqye profegsion, such as doctor, dentist, chiropractor,
acupuncturist, or physicaltherapist? VesA No fl
a. ls the proposed use wilhin the mental health profession, such as:
E6o/Not Applicable fl Psychologist ! Psychiatrist
E Socialworker ! Otner_
16. ls counseling proposed as a partofyourbusiness operation? Yes E No A
(
cuftivated, d istributed, tested, manufactured or
tr
a. Does your counseling business contract work with a public agency? Yes n ruo)/',/\
lf yes, please describe:
17. Willyour business be offering the following seMces:
E Alcoholsales E Smoking Lounge E Jattoos/ Permanent makeup
fJ eooy piercing/ Ear piercing -,EKruon" of the above
18. Wll your business be offering massages as part of your business operation?, fhis includes
massage as ancillaryto pedicures, manicures, and otherseMces. Yes E *",(
19. ls cannabis or cannabis related product stopg,
dispensed at your business? Yes fl No Xa
20. Do you prepare or sell food for consumption on or off the property? Yes E No
lf yes, do you provide sit down seMce E, drive-through E, or orders to go/pick-up f]?
S:Phnning\Cbrical-Counler Forms\
CofO Quegionnaire 0&27-18
Please explain:
21. Does your business sell automobiles or motorcycles? Yes fl No
lf yes, please explain:
x,
22. Doesgtrt i:tq service or repair vehicles or install equipment and accessories into rehicles?
lf yes, please explain
23. I acknourledge that I have requested and received all zoning and Santa Ana Municipal Code
requirements pertaining to my business and occupancy application (initial)
I DECI.ARE UNDER PENALTY OF PERJURY, THAT THE FOREGOING STATEMENTS ARE TRUE AND
CORRECT TO THE BEST OF KNOWLEDGE AND BELIEF.
rl Date
Print
lnformation
The Planning Division's Public Counter is open forwalk-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 wilhin 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 priorto 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 requirc further documentation or an extended review and may or
may not be permitted: office uses within an industrial zone; medical, restaurant, laundromat, trade
or technical schools, and automotive rcpair and service uses within spaces that werc 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 phns, 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:Pbnning\Clerixl-Counler Forrns\
CofO Quedbnnahe 0&27-18
I
MEMORANDUM
TO:
FROM:
SUBJECT:
MCT #49077
Thursday, February 27, 2020Finance & Management Services Agency
Planning and Building Agency
Miscellaneous Cash Transaction
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.
PROJECT NAME:
PROJECT ADDRESS:
Super Kids Dental-Certificate of Occupancy
407 E First St Unit# 2-A, Santa Ana, CA 92701-5334
MASTER tD #2020-158114
AP # 398-516-12
Application # COO-202O-1 62-CO Permit #
ISSUED TO
ADDRESS:
Christine Shangaldian
Super Kids Dental
1526 El Rito Ave.
Glendale, CA 91208
ITEM DESCRIPTION QTY UNIT RATE AMOUNT FUND NO.
1 Certificate of Occupancy (Fee Purposes Only)1.0000 $481.68 $481.68 01116002 51605
llosLer
(:(:+ ! I
Comments:
lssued By: Khang, Kathy (Planning and Building Agency)
TOTAL MCT AMOUNT $ 481.68
GL Account #
01 1 16002 51605
Total
$481.68
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
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