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K <br />1Planning & Bullding Agency <br />Bullding Safety Division <br />20 Civic Center Plaza <br />P,O, Box 1988 (M-l9) <br />Santa Ana, CA 92702 <br />(7{4) 647-585s <br />SPECIAL INSPECTION/COMPLAINT <br />INVESTIGATION FORM <br />SUBJECT ADDRESS SUITE <br />tl Residential <br />Purpose of lnspection: <br />I Commercial/lndustrial <br />Requested by: (o*n"t <br />Name: /- ),.. . , i <br />tr Contractor tr Real Eslate Agent ! Other <br />Address: <br />251 <br />ACTION TAKEN: tr None Required O Correction Notice <br />INSTRUCTIONS: )@f SuUj""t to fi"ta tr Plan Check Required <br />PERMITS REQUIREIi: {Building ,ft-Electrical EPlumbing _$<Mechanical <br />PLANS REQUIRED: Xsite Plan tr Floor Plan 0 Roof Plan ! Elevations <br />! Elect. Plan tr Plumbing D Mechanical <br />FEES: lRegular Fees ! Penalty Fee tr lnvestigation Fee <br />NOTE: Building Pemits for unpermitted room additions require a site plan, floor <br />plan, roof plan, framing plan, and elevations <br />Remarks <br />Date: y,/l // \ Time ln <br />Time <br />Departed: /l: I i) y' ,i I lnspector/lD <br />lnspector Office Hours: lronday - Thursday 4:00 - 4:30 PM and Friday 3:00 - 3:30 PM <br />be oblained l\,4onday , Thursday and Friday 8:00 - 4:00;Wednesday 10:00-4:00 <br />Received by: <br />u <br />Tracking #: <br />Office Use <br />Amount Paid: I r1L - Recei pt# <br />DateAddress tagged by <br />Distribution: White & Yellow - lnspector Pink - File Copy <br />\ <br />-,-SANTA <br />NA-',}r,$ffi <br />,R/ '-r <br />r-{-( <br />+ <br />aC <br />@ <br />mo-t <br />oo7maI <br />ac <br />=ITI <br />Phone:') <br />) <br />t-r \f <br />Date: