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Home My WebLink AboutCOO-2020-283-CO - Certificate of OccupancyPlanning & Building Agency Bulldlng Safety Divlslon 20 Civic Center Plaza P.O.l98E (M-r9) Santa Ana, CA 92702 (714) 647-581s coo-2020-283-co OCCUPANCY INSPECTION APPLICATION ) BTN 5-7a t q, C U)zm @ @ o07ma @ I E. F,, Dbrr r. A".i t c-a-tr lJ r/'r, r,<.,,9 S^.dho..n EUSINESS NAME BUSINESS PHONE NO t lAtitln.Qo45'o 'iY BUSINESS ADORESS DO YOU SUBLEASE? O Yes f,No (rF YES. NAME OF SUBLEASOR)SOUARE FEET 3Ll Dg FLOORAREA J LEASING AGENT OR PROPERTY MANAGEME].IT COMPANY NAME Xr-rrrna r"\ t-A n.n, BUSINESS PHONE NO 61$71j -1ss4 ().lzn tLF, ln) ./ rrJ IAna1( (.l7 BUSTNESS DEScRrproN Comfl\ur-n rt.r Cl i.r i r.ffioor." FLAi/ES, NO SPRAY PAINTING O AUTO EOOY (SEE ATTENTION BELO'I/) O WOODVVORK,ING {SEE ATTENTION BELOW ) O EANI{G ESTABLISHMENT (SEE PWA) (orxen t oescnrBE ABovE) II MANUFACTURING O OFFICE E RETAIL SALES OWHOLESALE OWAREHOUSE O GROUP ASSEMBLY E Vcr I No No. 1 Will you b. !6ng .nd/or r.(fltdng hazrrdous rnstdals at his lscillty4 5 Vas { No ilo. 2 Ooes }olJr prodLEdon Plocals prodr.Ea hazaldou3 westc? lf you havc ilrewErcd Yes to e{hs question you must Dontact Ormga County FirB AuttDnty s Hau rdous Matenar orsclosurE Scctton at ( 7t4) 57$6000 lf YES, d.asa dcacrlb ATTEf{TION: ALL GROUP 'H'OCCUPANCIES 0NCLUOING, BUT NOr LIMITEO rO, AUIO BOOY, AUTOMOflVE WORK OR STORAGE INCIOENTAL TO WELDING WITH OPEN FLAME, WOODTA/ORKING, CUTTING, S}IAPING OR SANDING WOOD) SHALL NOT BE CONOUCTED IN ANY BUILOING OR STRUCTURE UNLESS TI-IERE IS AN APPROVED FIRE SPRINKLER SYSTEM INSTALLED. SIGNATURE I .r.-u-15,.e-c-fo. of Opr TITLE ,o 2b)-o DATE 5 I I DEPARTMENT USE ONLY ryS'o'lfi% "TLT:I-*" ln ltn l, &.1 PRroRAPPRovEousE N l+ PRToRAPPRoVAL** N$ CYGROUP + PLANNING ZONEct 'Nr+*'NI{')W)'i'oltq lzozo' CONSTRUCTION TYPEv9occ LoAO DATE t>-11-z,a at this I lYas INo bâ‚¬ing generatsd at thls slte? eOF Note: One cf rha following must bo chcckrd by lhc C ot O Inspactor [ | Yes [ | No Ha3 thâ‚¬ inspcctor ldcnUllcd any hazardous .\ D vq,Sv APJROVE Y&l Plannlng and Bulldlng Agency Plannlng Dlvlelon 20 Clvlc Center Plaza P.O. Box 1988 (M-20) Santa Ana, CAg2702 (71 4) 647-5E04 www.Santa-ana.org CERTIFICATE OF OCCUPANCY SUPPLEMENTAL QUESTIONNAIRE Please turn ln this completed form with your Ceftificate of OccuqncY Company Name (Print):nl4- Contact Name Address (business mailing address):JAI. City:I r-r State:-Q\- zp: 9f, l?A Phone No.:1r.l 4t l^E+nail Address: ! Cfrange of Property Owner I Change of Occupant E Change of Use I Additional Occupant 1. The followlng best describer my opcratlon: ! offlce only fl Retailsales fi Medlcal/Dental il WarehouselManufacturlng/Dlatrlbutlon D RestauranUTake Out Food fl ottrer (dercrlbe) 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, Ao/,c+L Cl '^, t- artt) Fi. t-l ?" e-t' the hours of operatlon, open to the Publlc).c 'Drut), d,n q &\-a, 5p.rv$,-a;?rc ,51 i'\c !c cl- 4. Has the building or space been vacant or is this a new building? Yes E[ ruo D lf vacant, for how long? 5. Are you an independent contractor? Yes D No E 6. Location of the business and suite number:eoo r L l7,r<'t' -1>{.P AD q ! 1nfloor ! 2"afloor tr -floTT. Do you share the floor or business entrance with another business? Yes E t'to El 8. What is the amount of square footage leased?3 L{Dq 9. How much of the space, which you lease, is office? n 100o/o E 50o/o D goo/o n Less than 30% tf other than 100%, how is the remaining space used? i\e.l .ca-( Exarr fioorrr9 ANA ?IIN\C IBlltDlu Il]t\(I *,,SANTA SrPlanning\Clodcrl4ountcr FormE\ CoiC Ouo3tronnalrc 0&27-18 \-t I ?l -Tr,',.,t) 'P',1t,l omertodet*mlrc Prior What 10. lsthe bulldlng sprlnklered? Yes E X" E 11' Do you plan on maklng any- improygnents to the building srch as: exterlor palnting, slgnage, lnterlor tenant lmprovements? Yes fl No n lf yes, please descrtbe: ?ar.di- arr.rj FIoo .,r.,) 12. Wlll yurr buslness lndude a lobby or waiflng area? y"u & lf yes, what will be tre dlmenslons? No 13. Do you store equipment, materlals, or proclucts within the buildlng? yes fi ruo E a. will there be outdoor storage of equipment, materlals, or products? yes f] ruo H, lf yes, please descrlbe: b. Wlll there be storagelacks, pallets and/or shelvlng exceedlng 5 feet 9 Inches ln helght? Yes I No E @amltrequbecttorlrrckslahetutng-owlrl,,tnqrdrewtthpannttcountq) 14. Do you manufacture a product at the site? Yes E No E lf yes, ploase doscrlbe (includlng process and end prcduct): a. Wlll operatlons produce dusUwood shavlngs or slmllar matertal? Yes ! no Eb. Does the operaHon lnvolve the use of weldlng or open flame? yes E No B - 15. Doos the proposed use lnvolve a patientcare professlon, such as doctor, denflst, chlropractor, acupuncturlst, or physical theraplst? Yes E No E a. ls tho proposed use Wthin the mental health professlon, such as: E[ Nonot Applicable E Psychologtst D psychtatrtst E Soctatworker tr Otner_ 16, ls counseling proposed as a part of your business operation? yes E No 4 a. Doos your counseling businees contract work wlth a public agency? yes E *o R lf yes, ptease describe: 17. Wlll your buslness be offerlng the following servloes: E Atcohol sales E smoking Lounge E- Tattoos/ permanent make-upE eoOy pierclng/ Ear pterclng B None of the above 18. Will lour business be offering ma{isageg as part of your business operation?. Thls lncludes massage as anclllary to pedlcures, manlcures, and other servlces. yes i No EJ 19. ls cannabls orcannabis related prqduct stor-q(, cultlvated, dlsributed, tested, manufactured or dlspensedatyourbusiness? Yes E No m 20. Doyou propare orsellfood forconsumption on or offthe property? yes fl No E lf yes, do pu provlde sit down service E, drjve-thror.rgh E, or orders to grc/pick-up E? S :Planrdn g\Clâ‚¬rlcCâ‚¬ou ntaf Forms\ CoO Ou6stlomdro 0a-27-1 8 Please exPlaln: 21. Does your buslness sell automoblles or motorcytles? Yos E No ffi lf yes, Please exPlaln: 22. Does your buslness eervice or repalr vehlctes or lnstall equlpment and accessoriee into vehlcles? yesE NoX lf 1os, Please exPlaln: 23. I acknowledge that I have reguested and reoeived all zonlng and SaSrta Ana Munlclpal Code-- i.qurr"*"nti'perterningi;;;tsr;ilil. and occupancy appllcatlon' H e (inltial) I DECLARE UNDER PENALTY OF PERJURY, THAT THE FOREGOING STATEIUENTS ARE TRUE AND Lonnrcr ro rHE BEsr oF MY KNowLEDGE AND BELIEF' olroro Slgnature Datâ‚¬ Name S:Pl{lnlnglclodcel4ounter Folm3\ CoO Ouoe{onnelre 0&27-1 I lnformatlon The Plannlng Divislon's Publlc counter ls open for walk-up cuetomeLs from 8:00 a'm, to 4:00 p'm', Monday itri"ugh FiiO""y, except Wednesday 10:30 a.m, to 4:00 p'm..rhe Plannlng Dlvlslon le located wihln City Hall - Ross Annox, 20 Clvlc Center plaza, Flrst Floor, Additlonally, you may call us at (714) 647-58M should you requlre any general informatlon, Tho P'lannlng Dlvislon revlews Certiflcate of Occupancy r99u9sb.J91$ange of address' new businesses' or expanstons to ensure'iiait[" i,i.p"r"o_r1s.e.[s consistbnt wlth the establlshed zoning regulations of Sanla Ana. please ohock;iii, th" Fir[nrng oirr.bn's Publlc counter prlor to slgnlng a lease or committing your buslness to a certaln location to determlno the feasiblllty' lf a nonconformlng use is dlscontlnued, or ff a nonconformlng bulldlng ls vacant, unused or unoccupled for I prir"a "i'ri *n-ee*ttu" ;ontns, any subsequont use musi conform ln every retp,-"^"1g-tlifrovislons of fhe Munlclpal Zoning eoOe, "nJ a'noicontormtng bulldlng may not thereafter be ueed or occupled untll it conforms lh every respect to tre provislons of the Code' Generally, the followlng uses will requlre further documentatlon or an extended revlew and may or ;;fi;t ir;p"rmnt"a' ittrc" u"." wtihln an lndustrlal zone; medlcat, restaurant, laundromat, trade or technlcal schoole, "nJ .rtorotlve repalr and seMce usc whhln apacee that were not proviously used for auch purpose; a Oufldlng th* does not meet the parklng demand for the propoeed uae; or a u8e whlch genorat& a frGfieiparklng demand or adherence to development atandardo than the prevlous usee. You may need to provlde floor plans, slte plans, or document the prlor ug-e beJore obtalnlng a Certlflcate of OccU-pancy to aeteimlne the grandparented rlghts of a nonconformlng uce' or a uso whlch hae addltlonal Code requlrements, glt MEMORANDUM TO: FROM: SUBJECT MCT #49921 Friday, June 5, 2020Finance & 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. ISSUED TO: Kathleen EatorrBravo Obria Medical Clinics of Southern California ADDRESS: 1773lrvine Blvd. Ste 2018 Tustin, cA 92780 TOTAL MCT AMOUNT $ 481.68 Comments: Phone: lssued By: Khang, Kathy (Planning and Building Agency) GL Account # 01 1 16002 51605 Total $481.68 Obria Medical Clinics of Socal C of O 2001 E First St Unit# 209, Sanra Ana, CA 92705-4020 MASTER tD #2020-159290 AP # 400-081 -06 Application# COO-2020-283-CO Permit # AMOUNT FUNO NO.RATEITEM OESCRIPTION QTY UNIT Bot':h+:55662 - 6/19/2t72fi I0: LROSALES Uff icet (:TYH Trttnsil 1 I of I Accti: Reft: 41921 Rcpti:02984474 - 6/19/2t12(r 4:00 Frl Trsnsqct ion Tottrl $4Sl.69 KAl HLEEN EATON BRAUT) OBRIA fIEDI(:AL (:LINICS OF SOUTH $481.68 01116002 51605r 0000 $481 681 Certificate of Occupancy (Planning and lnspeciion) $4S1.(:ert if icate ot' 0ccuPctncY oil l60112- 516rJ50110- V isn CC+ : *rrt*r**irr*r l?77 $481 "Authi rr.r19823 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 PROJECT NAME: PROJECT ADDRESS: