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Purpose of lnspection UIL U] <br />SUITE <br />fCommercialilndustrial I Residential <br />*NSNTA <br />NA.ffi <br />Planning & Building Agency <br />Building Safety Division <br />20 Civic Center Plaza <br />P.O. Box 1984 M-19 <br />Sa nta Ana, CA92702 <br />(714) 647-s800 <br />SPECIAL INSPECTION/COMPLAINT <br />INVESTIGATION FORM <br />aCcl(_ <br />mo-l <br />oox <br />maaRequested by: f Owner I Contractor -i Real Estate Agent <br />Nane F Wa/Ni N1 Errtr) <br />/otner <br />T <br />Address <br />Phon e Fax <br />.dNon" Reouired I Correction Notice./ <br />X OK Subject to Field tr Plan Check Required <br />tr Buildlng tr Electrical tr Plumbing 0 lvlechanical <br />I Site Plan E Floor Plan tr Roof PIan tr Ele'rations <br />E Regular Fees tr Penalty Fee O lnvestigation Fee <br />NOTE: Building permits for unpermitted room additions require a site plan, <br />floor plan, roof plan, framing plan and elevations <br />Remarks: Ul)ilft" rddZE /xc*Z Eil fuiz\roazn-4 f3J>rttDl-Zz--T <br />UMDgo-Ac,oLzpo M)re> P^JIV-X//9. <br />-r 7/ <br />aC <br />=m <br />Da re ttne /t:Tb {Wt lnspector/lD <br />lnspector Office Hours: B:00 - B:30 A.tVl and 3:30 - 4 00 tu1 <br />Permits may be obtained tulonday. Tuesday, Thursday and Friday 8 00 - 4:00: U/ednesday 10:00 - ,l 00 <br />Office Llse <br />Tracking =AmoLrnt P;rid Receipt 1 <br />Receir ed by 0 Drte <br />DateAddress trgged by <br />Distribution \!'hiu - [nspector Pink O\!ner Contractor \-elloir File Copy <br />SUBJECT ADDRESS: 6,/ I g. II4 KIN 4, <br />I <br />ACTION TAKEN, <br />INSTRUCTIONS, <br />PERIVIITS REQUIRED: <br />PLANS REOUIRED <br />FEES: <br />I <br />uUnglc4n4uND (;tiT, t'' U"-:=7' <br />^tb;-/ajf-.Dft <br />'*N/'. <br />I <br />I <br />'-'P n) <br />,&-a