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Planning & Building Agency <br />Building Safety Division <br />20 Civic C€nter Plaza <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-s800 <br />www.sanla-ana.org <br />Cco oo]\- z/\g <br />SPECTAL TNSPECTTON/COM PLATNT <br />INVESTIGATION FORM <br />L <br />SUBJECT ADDRESS <br />Purpose of lnspection <br />QIDB \OO r--r\rntsv*e r surre: 'S?1l <br />E Residential l/ lndustrial <br />c/)C <br />@(- <br />mo--l <br />Ua7m <br />U)I <br />t c <br />Requested by: D Owner I city officiat <br />)LT <br />0{ott",a*iD <br />Ac-,1 7 rName: <br />Address: <br />Phone:5qC-eso.qq-ih <br />ACTION TAKEN: ! None Required ! Correction Notice <br />INSTRUCTIONS: E OK Subject to Field I Plan Check Required <br />PERMITS REQUIRED: E euitOing ! Electrical ! Plumbing ! Mechanical <br />PLANS REQUIRED: E Site Plan ! Floor Plan D Roof Plan ! Elevations <br />! Elect. Plan D Plumbing EMechanical <br />FEES: ! Regular Fees ! Penalty Fee ! lnvestigation Fee <br />NOTE: Building Permits for unpermitted room additions require a site plan, floor plan, <br />roof plan <br />Remarks: <br />, framing plan and elevation <br />6q @C <br />=m <br />fime Out /'l '. f fnn lns pecrorlD: Z Ct*ttzt<- <br />lnspector Office Hours: Monday -- Thursday 4:00pm - 4:30pm and Friday 3:00pm - 3:30pm <br />Permits may be obtained Monday, Tuesday, Thursday and Friday 8:00am - 4:00pm ; Wednesday 10:30am - 4:00pm <br />a) <br />t, <br />Tracking *,W <br />OFFICE USE <br />Amount Paid:Receipt #: <br />Received by Date <br />DateAddress tagged by <br />Distribution: White Inspector - Yellow Applicant <br />9 <br />& <br />7/O <br />t4' <br />3 <br />1Y& <br />>- <br />oate: / /-/a'Z---time tn: