HomeMy WebLinkAboutCOO-2020-330-CO - Certificate of OccupancyPlanning & Building Agency
Building Safety Division
20 Civic Center Plaza
P.O. 1988 (M-19)
Santa Ana, CA 92702
(714) 647-s8r5
OCCUPANCY INSPECTION
APPLICATION
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UNIT OR SUITE ZIP CODE
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BUSINESS NAME BUSINESS PHONE NO.
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EMERGENCY PHONE NO.
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EMAIL ADDRESS
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DO YOU SUBLEASE? trYes E No (lF NAME OF
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BUSINESS PHONE
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EMERGENCY PHONE NO.
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MANAGEMENT COMPANY NAME
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OR PROPERTY MANAGEMENT
PROPERTY OWNER'{Lcc 1L'.,t uv'\ c- Sor-ln
J NAME BUSINESS PHONE NOd\qT\ qolu
IEMERGENCY PHONE NO.
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O MANUFACTURING
E OFFICE
E RETAIL SALES
tr WHOLESALE
tr WAREHOUSE
tr GROUP ASSEMBLY
tr AUTO REPAIR (NO WELDING, NO OPEN
FLAMES, NO SPRAY PAINTING
tr AUTO BODY(SEE ATTENTION BELOW)
tr WOODWORKING (SEE ATTENTION BELOW)
(elrrNo ESTABLTsHMENT (sEE PWA)
' E orxen loescRrBE ABovE)
BUSINESS DESCRIPTION ll Yes $,Xo No. 1 Will you be storing and/or utilizing hazardous materials at
this facility?
H Yes ifrt,lo No. 2 Does your production process produce hazardous waste?
lf you have answered Yes to either question you must contact Orange County
Fire Authority's Hazardous Material Disclosure Section at (714) 573-6000.
lf YES, please describe
ATTENTION: ALL GROUP "H" OCCUPANCIES (INCLUDING, BUT NOT LIMITED TO, AUTO BODY, AUTOMOTIVE WORK OR STORAGE
INCIDENTAL TO WELDING WITH OPEN FLAME, WOODWORKING, CUTTING, SHAPING OR SANDING WOOD) SHALL NOT BE CONDUCTED IN
ANY BUILDING OR STRUCTURE UNLESS THERE IS AN APPROVED FIRE SPRINKLER SYSTEM INSTALLED.
SIGNATURE TITLE
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DATE-l - l- |db
DEPARTMENT USE ONLY EXPIRED/OPEN PERMITS?
YES NO Date of report:
PRIOR CONSTRUCTION TYPE
I,, R qPLPRIOR APPROVED USE
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DATE
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PRIOR OCCUPANCY GROUP
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PLANNING--/
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CUP DENIED DATd*7 lt,l.o
CONSTRI.I€TION TYPE
l/n *2 PENIED oo-'7'L7teOCC. LOAD GROUPoccuP*8Y
nspector ' q ', '- /6lV2A
materials at this facility? t I Yes t I No ls hVarclous wastqbeing generated at this site?
fu\tnt^ Vs+aolishWLt+NOTES: (LIMITATIONS OF APPROVED
Note: One of the following must be checked by the C of O lr
I I Yes [ ] No Has the inspector identified any hazardous
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-,.-SANTA
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Planning and Building Agency
Planning Division
20 Civic Center Plaza
P.O. Box 1988 (M-20)
Santa Ana, CA92702
(7141il7-5804
www.santa-ana.org
CERTIFICATE OF OCCUPANCY
SUPPLEMENTAL
QUESTIONNAIRE
Please turn in this completed form with your Certificate of Occupancy application.
Company Name (Print)
Contact Name:
Address (business mailing address):
City:State:_
Phone No.E-mailAddress:
E Cnange of Property Owner E Cnange of Occupant E Cnange of Use n AOOitional Occupant
1. The following best describes my operation:
E Office Only ! Retail Sales E Medicat/Dental
! Warehouse/Manufacturing/Distribution E RestauranUTake Out Food
E Otfrer (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).
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.)
4. Has the building or space been vacant or is this a new building? Yes E No E
lf vacant, for how long?
5. Are you an independent contractor? Yes E No E
6. Location of the business and suite number:
tr lstfloor tr 2nd floor fl _ floor
7. Do you share the floor or business entrance with another business? Yes E No E
8. What is the amount of square footage leased?
9. How much of the space, which you lease, is office?
tr looo/o tr soo/o n 30%
lf other than 100%, how is the remaining space used?
S: Planning\Clerical-Counter Forms\
CorO Questionnaire 08-27-1 8
tr Less than 30%