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-,-SANTA <br />NA <br />ILI\\NC <br />{ But0r\c <br />lcn$ <br />Planning & Building Agency <br />Building Safety Division <br />20 Civic Center Plaza <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647 -58s3 <br />SPECIAL INSPECTION/COMPLAINT <br />INVESTIGATION FORM <br />SUBJECT ADDRESS: <br />tr <br />Purpose of lnspection: <br />SUITE: <br />Residential Fofr< <br />4 7t,-r eM- <br />o//o <br />Requested by <br />Name: <br />o Owner o Contractor o Real Estate Agent fotu. <br />0c,u --) <br />Address <br />Phone: <br />ACTION TAKEN: <br />INSTRUCTIONS: <br />PERMITS REQUIRED: <br />PLANS REQUIRED: <br />tr None Reouired' 4-, <br />OK Subject to Field\ <br />a Correction Notice <br />tr Plan Check RequiredF <br />Yr Bu ilding a Electrical o Plumbing tr Mechanical <br />lNl <br />x" <br />Site Plan tr Floor Plan n Roof Plan XElevations <br />n Electrical Plan o Plumbing tr Mechanical <br />egular Fees n Penalty Fee n lnvestigation Fee <br />NOTE: Building permits for unpermitted room additions require a site plan, floor <br />plan, roof plan, framing plan, and elevations <br />Remarks:/W/LL\(./)c <br />i,Lt -tTdfN1-lrt /z eir' <br />UNI O 7-1) <br />oate: 1fl4/t/) Timetn:/ / D 0 ( rlT ime o eparrca: / t 4 {f/L') I nspecto r/t D : <br />T*f,Io---*"" ro,rs: Monday-Thursday 4:00-4:30 PM and Friday 3:00-3:30 P. <br />Permits may be obtained Monday, Tuesday, Thursday, and Friday 8:00-4:OO and Wednesday .10:00-4:00 <br />Office Use <br />Tracking #:1 Amount Paid:Receipt #: <br />Received by Date: <br />Date:Address tagged <br />FORM 84 02-2009 <br />Distribution: White and Yellow - Inspector Pink - File Copy <br />Commercial/l ndustrial <br />(t <br />C <br />@c-mo-t <br />Iovm <br />U)I <br />FEES: <br />n <br />\