HomeMy WebLinkAbout80428238 - Certificate of Occupancy^-'{>
Planning & Building Agency
Building Safety Divlsion
20 Civic Center Plaza
P.O. 1988 (M-r9)
Santa Ana, CA 92702
(714) 647-581s
No. 804-28238
OCCUPANCY INSPECTION
APPLICATION
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BUSINESS ADDRESS UNIT OR SUITE3r CODE
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BUSINESS NAME BUSINESS PHONE NO.
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EMERGENCY PHONE NO.
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BUSINESS OWNER'S MAILING ADDRESS EMAIL AI]DRESS
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DO YOU SUBLEASE? r Yestillo (lF YES, NAME OF SUBLEASOR)SOUARE FEETSsz 9aPr'
FLOOR AREAShPAo*-
LEASING AGENT OR PROPERTY MANAGEMENT COMPANY NAMEPA* ?4- 5nn* /w* 6?u'ce LLe-
BUSINESS PHONE NO.
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NAME PHONE NO.
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EMERGENCY PHONE NO.
PROPERTY OWNER'S ADDRESStq?+ n/t<-Hra+/Lr/w fl f. szr',ie, ,tx ?rA-
BUSTNESS DES.RTPT.N WPg/.
I J RETAIL SALES
TWHOLESALE
LT WAREHOUSE
r I GROUP ASSEMBLY
D AUTO REPAIH (NO WELDING, NO OPEN
FLAMES, NO SPRAY PAINTING
I] AUTO BODY(SEE ATTENTION BELOW)
L wooDwoRKlNG(sEE ATTENTON BELOW)
D EATING ESTABLISHME}.IT (SEE PWA)
L OTHER (DESCRIBE ABOVE)
I ] MANUFACTURING
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t t Ves Mdo No. 1 Will you bs storing andor utilizing hazardous materials at
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No.2 ooos llour prcducrion procsss produc€ heTanrous wasts?
lf you have answered Yes lo eilher question you must contact Orange County
Fire Authori!y's Hazardous Material Disclosure Seclion at (714) 57&6000.
lf YES, please
ATTENTION: ALL GBOUP "H" OCCUPANCIES (INCLUDING, BUT NOT LIMITED TO, AUTO BODY, AUTOMOTIVE WORK OR STORAGE
TNCTDENTAL rO WELDTNG WlrH OPEN FLAME, WOODWORKTNG, CUTTTNG, SHAPTNG OR SANDTNG WOOD) SHALL NOT BE CONDUCTED tN
ANY BUILDING OR STRUCIURE UNLESS THERE IS AN APPROVED FIRE SPRINKLER SYSTEM INSTALLED.
tAr.LA cSSIGNATURETITLE p/az,/tqDATE
DEPARTTVGNT USE ONLY YES t I NO Dato of report:4 l
PRIOR APPROVED USEP/n PRIOR APPROVAL DATEtv/<PRIOR OCCUPANCY GROUPA PRIOR CONSTRUCTION TYPE// A, ePK
PLANNINGDc ctZONE VA CUP APPROVED
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DENIED tzy'>1rtDATE
occ. LoAD OCCUPANCY GROUP
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CONSTHUCTION TYPEE* *c Z.&9^-?,
APPROVED DENIED
'o->lo-4-ZrDDATE
Not€: One of the ,ollowing mfst be checked by the C ot O lnsp€ctor.
[ ] Yes I I No Has th€ inspoctor identified any hazardous mat€rials at this [ ] Yes [ ] No ls hazardous waste being generated at this site?
NOTES: (LIMITATIONS OF APPROVED OCCUPANCY)
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Please turn in this completed form with your Certificate of Occupancy application.
Company Name (Print)UL ffi67a,zz/c .
Contact Name: h"
,,-SAI,[TA
ANA-"'i,[]ffi
Planning and Building Agency
Planning Division
20 Civic Center Plaza
P.O. Box 1988 (M-20)
Santa Ana, C492702
(7141il7-5804
www.santa-ana.org
CERTIFICATE OF OCCUPANCY
SUPPLEMENTAL
QUESTIONNAIRE
Address (business mailing address):ttz- e . ts 5r ta;rfl sn
c,tv,OhtA W* state: U zip lzh(
Phone No *V- L9" -2<va E-maitAddress: A*q-,frRa P ryl6r'A+. ArTD6
E Cnange of Property Ownerrfr Change of Occupant ! Change of Use E Rdditional Occupant
1. The following best describes my operation:
,toor..only ! Retail Sales n ueaicat/Dental
E Warehouse/Manufacturing/Distribution fl Restaurant/Take Out Food
E Other (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,
open to the public). Dle t41z"4*z- h*-**f _ M _p - g _ { .*tfant-e DAYEZ{/ruflT Socur-a .
3. What was the former type of business or use of facility? (Please contact the leasing agent or building
owner to determine prior business use.)9tn/ue .
4. Has the building or space been vacant or is this a new building? y", d No"E
lf vacant, for how long?b - ovh\.
5. Are you an independent contractor? Yes n Noud
9?-o6. Location of the business and suite number:
tr l stfloor tr 2nd floor ,ff,16rtoo,
7. Do you share the floor or business entrance with another business? yesd No E
8. What is the amount of square footage leased?*soo. 9a Pi
9. How much of the space, which you lease, is office?
tr looo/o ilv"r" tr 3oo/o
lf other than 100%, how is the remaining space used?
n Less than 30%
fuValA- dfut+ttt- tht'l'nt q5-E
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CofO Questionnare 08-27 -1 8
10. ts the building sprinklered z vesll/No z
11. Do you plan on making any improverg,ents to the building such as: exterior painting, signage,
interior tenant improvements? Yes EI No !
lf yes, please describe: AuLlarL' zd/'ra*'"' 2aaT On*n* 9V'z-7c'
12. Will your business include a lobby or waiting area? Yes E No d
lf yes, what will be the dimensions?
13" Do you store equipment, materials, or products within the building? Yes n No {
a. Will there be outdoor storage of equipment, materials, or products? Yes f] Noril
lf yes, please describe:
b. Will there be storage racks, pallets and/or shelving exceeding 5 feet 9 inches in
height? Yes E NM @ermit required for rackdshelving over 6', inquire with permit counterl
14. Doyou manufacture a product at the site? Yes E Nord
lf yes, please describe (including process and end product):
a. Will operations produce dusUwood shavings or similar material? Yes E N" {b. Does the operation involve the use of welding or open ftame? Yes n No E!-
15. Does the proposed use involve a patient care profess,len, such as doctor, dentist, chiropractor,
acupuncturist, or physical therapist? Yes ! No EI
a. ls the proposed use within the mental health profession, such as:
druolruot Applicable ! Psychologist E Psychiatrist
n Socialworker f] Ot'er_
16. ls counseling proposed as a part of your business operation? Yes E *rd
a. Does your counseling business contract work with a public agency? Yes E *" d
lf yes, please describe:
17. Will your business be offering the following services
fl Alcoholsales fl Smoking Lounge
E goOy piercing/ Ear piercing
Tattoos/ Permanent make-up
None of the above
18. Will your business be offering massages as part of your business
massage as ancillary to pedicures, manicures, and other services. Yes
S: Planning\Clerical-Counter Forms\
CofO Questaonnate 08-27 -1 I
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operation? Tlis includestr ruOZI
19. ls cannabis or cannabis related product sloreQ/ cultivated, distributed, tested, manufactured or
dispensed at your business? Yes E No.Z
20. Do you prepare or sell food for consumption on or off the property? Yes E *od
lf yes, do you provide sit down service E, drive-through E, or orders to go/pick-up !?
Please explain:
21. Does your business sell automobiles or motorcycles? Yes E
lf yes, please explain:
N",r/
22. Does your busineyserviceYesE NoE
lf yes, please explain:
or repair vehicles or install equipment and accessories into vehicles?
23. I acknowledge that I have requested and received all zoning and Sa4ta Ana Municipal Code
requirements pertaining to my business and occupancy application. W (initial)
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Print Name i. -Ozzae+te fLtz-4;o1*rt fi*VAa
I DECLARE NDER PENALTY OF PERJURY, THAT THE FOREGOING STATEMENTS ARE TRUE AND
THE BEST OF MY KNOWLEDGE AND BELIEF
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Signature Date
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 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 Questionnane 08-27 -18
MEMORANDUM
TO: Finance & Management Services Agency
FROM: Planning and Building Agency
SUBJECT: Miscellaneous Cash Transaction
MCT # 47777
Monday, December 2, 2019
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:
coo 80428238
1820 E First St Unit# 520, Santa Ana, CA 92705-4009
MASTER tD#2019-156224
AP #402-211-08
Application # MISC-201 9-952-CO Permit #
Santa Ana, CA 92705
ITEM DESCRIPTION QTY UNIT RATE AMOUNT FUND NO.
'l Certificate of Occupancy (Fee Purposes Only)1 0000 $481.68 $481.68 01 1 16002 51605
Botchi:53231 - 1?/2/20190tfice: {:TYH Trone*: 4[tAcr:ti; Refi:
Frcpti:tt?S27?11 - l?/?/?lttq
Transnct i on TotctlAI,IEER JAFRI
ID: (:CllEl.l..At
4777'/
1 I?? PH
r4s1 .68
(:ertif icqte of 0ccupnncg
L'l I 1601r?- 51605fltr11-
llnster'(:ard
CC+: *****x*xr*tt4437
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$481 .
Auth+ :585?:?C
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Comments:
coo 80428238
lssued By: Pezeshkpour, Ali (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 1 of 3
ISSUED TO: Ameer Jafri
MLogica, lnc.
ADDRESS: 1820 E. First Street Suite 520