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OCCUPANCY INSPECTION
APPLICATION
BTN 375s1\
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Planning & Building Agency
Building Safety Division
20 Civic Center Plaza
P.O. 1988 Or-le)
Santa Ana, CA 92702
(7r4) 647-s8rs
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UNIT OR SUITE ZIP CODEq2707BUSINESS ADDRESS
NO,
6
NAME &
EMAIL ADDRESS
o
MAILING
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E NO.
3,1 -v 3)t1 Y3',l -yl3)
BUSIN
SO.nf+w e <T Ca,-tA €{Lc t
OR PROPERTY MANAGEMENT
J oco wt . 4* ffir^Lvo # bBr c+ 9z1o1PROPERTY
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EMERGENCY E
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[|" ruo. I Will you be storing and/or utilizing hazardous malerials at
t I ves XNo No. 2 Does your production process produce hazardous waste?
Jt )rou havo answered Yas to either question lrou must contact Orang€ County
Fire Authoriv6 H'ardous Malerial Disdosurs S€ction al (714) 573-6000.
lf YES, pl€ase d€scribe
this facility?
[ ]YesBUSINESS DESCRIPTION
|laeuurncruntue
-]OFFICE
.T RETAIL SALES
, I WHOLESALE
.- WAREHOUSE
I GROUP ASSEMBLY
] iAUTO REPAIR (NO WELDING, NO OPEN
FLAMES, NO SPRAY PAINTING
. AUTO BODY(SEE ATTENTION BELOW)
WOODWOHKING (SEE ATTEI.TTION BELOW)
., EATING ESTABLISHMENT (SEE PWA)
OTHER (DESCRIBE ABOVE)
UWrIgyt-l:fr^"t ,
ATTENTIoN: ALL GBOUP "H" OCCUPANCIES (INCLUDING, BUT NOT LIMITED TO, AUTO BODY, AUTOMOTIVEWORK OR STORAGE
INCIDENTAL TO WELDING WITH OPEN FLAME, WOOOWORKING, CUTTING, SHAPING OR SANDING WOOD) SHALL NOT BE CONOUCTED IN
ANY BUILDING OR STRUCTURE UNLESS THERE IS AN APPROVED FIRE SPRINKLER SYSTEM INSTALLED.
'"'L o o '^*&,e
PERMITS?
Date of report:YESDETARfIUETT USE ONLY
V-A/, SPr
PRIoR ooNSTRUCtION TYPE gPRIOR APPROVED USE
l4i.Jufitruprdq
PRIOH APPROVAL DATEItln )fitu
PBIOR OCCUPANCY GROUPp.-17 OENIED Ir
DATE5 I 1oIthrD
PLANNING
n\
ZONE CUP
OCC. LOAD OCCUPANCY GFOUPB r-l CONSTRUCTION TYPE/A trf-tor'r,tgnt:
APPROVED DENIED
3 7-ty-zo
DATE
Nolo: On€ of tho ,ollowhg musl b€ checked by the C o, O lnsp€c{or.
[ ] Y6s [ ] No Has the lnsp€ctor ldentified any hazardous materials at this raclllty?
NOTES: (LIMITATIONS OF APPROVED OCCUPANCY)Alolv (roru? t rt6
[ ] Yes I I No ls hazardous waste being generaled at lhis sito?
SQUABE FEET
t An r-)
?TCPRAREA 7DoTdUSUBLEASEz -'vesXtto (tF YES, NAME oF SIIBLEASoH)
Slt^trh- tr,./t
PROPERTY OWNEH'S NAMEP.;dli),)' F1.,*,n^
PROPERTY OWNEB'S AODRESS
,-,,SAJ.ITA
ANAJqilffi
Plannlng and Building AgencY
Planning Division
20 Civic Center Plaza
P.O. Box 1988 (M-20)
Santa Ana, CA92702
(714) 6/.7-s804
www.santa-ana.org
CERTIFICATE OF OCCUPANCY
SUPPLEMENTAL
, OUESTIONNAIRE
Please turn in this compteted form with your Certificate of Occupancy application.
Company Name (Print):P, l-.. Pra4r's j6 ,-r LLL
Contact Name: n
Address (business mailing address)
City:5^lu ?-u-n state:C A zip: 4Z 70 7
phone\o.: (ztd 53^ -zq, q E-mailAddress:
-
! Change of Property Owner f, Change of Occupant n Change of Use n Additional Occupant
1. The following best describes my operation:
E Otfce Only ! Retailsales E Medical/Dental
BI Warehouse/Manufacturing/Distribution E RestauranUTake Out Food
n Otner (describe)
Please provide a brief description of how the business operates at this site (for example, please
describe the general nature of the business., what activitiq,s ogcur on-site, the hours of operation,
open to the iublic). I4aOL : ^g ShoPt mt4.a l mao\;,a i,r-l1
ho0/)i8t3o-3loo n-f )
What was the former type of business or use of facility? (Please contact the leasing agent or building
owner to determine pnbr buslness use.) € OO 4 i ,.. q
-)
Has the building or space been vacant or is this a new building? Yes I f,fo,E
tf vacant, for how long?
5. Are you an independent contractor? Yes ! ruo ,x ?:vo € . Df ep. Rp
6. Location of the business and suite number'*5*g, , G
f t"Roor ! 2ndfloor !
-floor7. Do you share the floor or business entrance with another business? Yes E Uo E(
8. What is the amount of square footage leased?.€+
9. How much of the space, which you lease, is office?
tr 1oo% tr so% ! 30%
S:Planning\Clerical-Counter Forms\
CofO Questionnane 08-27 -1 I
I , Lo.u:
2.
3.
4
X Less than 30%
lf otherthan 100%, howis the remaining space used? SLof f,-l*r, T*f s;)r;o ^1
l,Oola kooSL
10. ls the building sprinklered? Yes p Uo tr
1'1. Do you plan on making any improvements to the building such as: exterior painting, signage,
interior tenant improvements? Yes E No E[
lf yes, please describe:
12. Will your business include a lobby or waiting area? Yes f] f.fo ,E
lf yes, what will be the dimensions?
13. Do you store equipment, materials, or products within the building? Yes [[ ruo D
a. Will there be outdoor storage of equipment, materials, or products? Yes n NoE
lf yes, please describe:
b. Will there be storage racks, pallets and/or shelving exceeding 5 feet 9 inches in
height? YeS D No F (permit reguired for racks/shetving over 6', lnquire with permit counterl
14. Do you manufacture a product at the site? Yes p No f]
lf yes, pleasp describe (including process and end product):"'-d';I;l-- ;;;-tZ;;"- , var; oo s tplo,Luc*sa. i,viitoperitionS"pioau"-"dtrs?w5odsrravingsoisi#larmaterial? Ygs tr ryq tr
b. Does the operation invotve the use of welding or open flame? Yes fl No EI
15. Does the proposed use involve a patient care profession,'such as doctor, dentist, chiropractor,
acupuncturist, or physical therapist? Yes E ruo ^E[
a. ls the proposed use within the mental health profession, such as:
Etr No/Not Applicable fl Psychologist E Psychiatrist
Socialworker fl Other
16. ls counseling proposed as a part of your business operation? Yes D No E[
a. Does your counseling business contract work with a public agency? Yes E No E
lf yes, please describe:
17. Will your business be offering the following services:
E Acoholsales n Smoking Lounge ! Tattoos/ Permanent make-up
E AoOy piercing/ Ear piercing fi ttone of the above
18. Will your business be otfeqing massages as part of your business gperation?-This includes
massage as ancillary to pedicures, manicures, and other services. Yes ll No ,tSi
19. ls cannabis or cannabis related product storeg, cultivated, distributed, tested, manufactured 0r
dispensed at your business? Yes E No E
20. Do you prepare or sell food for consumption on or off the property? Yes n ruo ff[
lf yes, do you provide sit down service n, drive-through E, or orders to go/pick-up E?
S: Planning\Clerical-Counter Forms\
CofO Ouestionnate 08-27 -18
a
Please explain:
21. Does your business sell automobiles or motorcycles? yes E ruo ,E
lf yes, please explain:
22. Does
Yes
your business service or repair vehicles or install equipment and accessories into vehicles?n NoEl
lf yes, please explain:
23. I acknowledge that I have requested and received all zon ing and Santa Ana Mun icipal Code
requirem ents pertaining to my business and occupancy application hfn nitial)
I DECLARE UNDER PENALTY OF PERJURY, THAT THE FOREGOING STATEMENTS ARE TRUE AND
CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF.
Title
lnformation
S:Planning\Clerical-Counter Forms\
CofO Questlonna'Ie 08-27-1 I
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 CityHall- Ross Annex, 20 Civic Center Plaza, First Floor. Additionally, you may call us at(114) 647-SgOa
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 leasL or committingyour 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 lrlunicipal Zoning Code, and a nonconforming building may not thereaftei 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 ormay not be permltted: offlce uses wlthin an industrial zong; medlcal, restaurant, laundromat, trideor technica! schools, and automotive repair and service uses wlthin 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 adherencelo development standards thanthe previous uses.
You may need to provide floor plans, site plans, or document the prior use before obtaining aCertificate of Occupancy to determine the grandparented rlghts of a nonconforming use, or a usewhich has additional Code requirements.
MEMORANDUM
TO: Finance & Management Services Agency
FROM: Planning and Building Agency
SUBJECT: Miscellaneous Cash Transaction
MCT #49644
Tuesday, May 12,2020
All fees are subject to change at any time and may also be affected by scheduled adjustments on Julyl of each year. The Payee must
pay the prevailing rate at the time payment is made.
ISSUED TO: Fierro Miguel
ADDRESS: 260 E Dyer Rd
Tustin, CA 927807
TOTAL MCT AMOUNT: $ 481.68
Comments:
lssued By: Soto, Ricardo (Planning and Building Agency)
GL Account #
011't6002 5160s
Total
$481.68
PROJECT NAME:
PROJECT ADDRESS:
Pulse Precision COO
260 E Dyer Rd, Santa Ana, CA 92707-3752
MASTER tD # 2020-1 58879
AP #411-021-03
Application # COO-2020-250-CO Permit #
ITEM DESCRIPTION QTY UNIT RATE AMOUNT FUND NO.
1 Certificale of Occupancy (Planning and lnspection)1.0000 s481.68 s481.68 01116002 51605
$s[,6f1i:Il;331 - 5/12/2tt2lt I0: LROSAI
Ulf ire: (:TYll Trqnei: 14 1 nl
AccLl: Refi: 49644
Rcr,t*:0295779tt - 1/12/2tt2lt 2t31 Fn
TrnnsccL i on Totctl i4Bl .68
F ITFIRO IlI SUEL
Certilicnte ol 0ccuponcv
Lr11 16tr0?- 516u5rr[ttit-
V iEo
(:Ci: *xrrrxxr *rxx 1 335
t48
$48
Authi: it?I l1
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.
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