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Planning & Building Agency <br />Building Safety Division <br />20 Civic Center Plaza <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-s800 <br />www.santa-ana.org <br />SPECtAL TNSPECTTON/COMPLATNT <br />INVESTIGATION FORM <br />2A3? /d, /zf-grSUBJECT ADDRESS <br />Purpose of lnsp ection <br />/4/ <br />! Residential dCommercial / lndustrial <br />,b? <br />SUITE:- <br />/ <br />U)C <br />@(- <br />m <br />-t <br />aavm <br />U) <br />@ <br />22 <br />Requested by:F Owner D city officiat ! otrer <br />Name: <br />Address <br />Phone: <br />ACTION TAKEN: <br />INSTRUCTIONS: <br />PERMITS REQUIRED <br />PLANS REQUIRED: <br />E None Required ,,(Correction Notice <br />f,OK Subject to Field ! Plan Check Required <br />@ euitoing E Electrical f,Plumbing EMechanical <br />! sit" etrn M-Floor Plan ! Roof Plan ! Elevations <br />! Elect. Plan n Plumbing !Mechanical <br />FEES: fiRegular Fees ! Penalty Fee ! lnvestigation Fee <br />NOTE: Building Permits for unpermitted room additions require a site plan, floor plan, <br />roof plan, framing plan and elevation <br />Remarks : Sira.t 6p ny g77*-t!7rn OD P€ qo I E{tL.'lo'D ar@.*id E F.ras*th} .P <br />\)*gctu26,Et <br />D*+r Ey7*T -71r-T P L/f^/S t,tr// bz steeLtl'. <br />ir-/(4 <br />aC <br />=!I <br />Date:Time ln: 14 Ut Time Out: \lCF't-'lnspector/lD JI,s#@ <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 />Received by Date: <br />Date:Address tagged by: <br />Distribution: White lnspector - Yellow Applicant <br />Nt <br />\n <br />*S <br />\ <br />\\ <br />u <br />N <br />\ <br />OFFICE USE <br />Tracking *: €l1151"L,L Amount Paid: <br />- <br />Receipt #:-