Laserfiche WebLink
CITY OF SANTA ANA <br />BUILDING PERMIT APPLICATION WORKSHEET COY» <br />PLEASE PRINT 3/2/05:forms/Bldc <br />PROJECT ADDRESS:140/ N E (OWLY 54 0 SUITE:SAPIN # <br />1 -ww VKO,nSAgg, <br />USE OF BUILDING:RESIDENTIAL COMMERCIAL INDUSTRIAL OTHER <br />MASTERID# <br />NATURE OF WORK:NEW ADD ALTER/T.I.DEMO REROOF REPAIR SIGN MISC <br />NEW/ADDITION/Al TFRATION· <br />1ST FL.. <br />2ND FL.. <br />TOTAL OF OTHER FLS: <br />GARAGE/CARPORT: <br />4 <br />·JOB DESCRIPTION (non-resk <br />13*rkroo,1 fqnt <br />BUILDING OWNER'S NAME: <br />ADDRESS: <br />TENANT'S NAME (Comm/Ind): <br />SF BASEMENT: YES/NO SF NO. OF STORIES: <br />SF PATIO/ENCL PATIO: SF BLDG. HEIGHT: <br />SF RES. REMODEL:SF PROPOSED USE: <br />SF ALTER/T. I.: SF <br />ial projects see reverse side of this application) :5-15-n Alc. 014 a/15€- dot <br />M figno., Hood Fons c»da 22 -6 Ott w J EL j.l ice_ ¥6 hkt-V <br />PHONE NO: <br />CITY:STATE:ZIP: <br />PHONE NO <br />CONTRACTOR'S NAME¢r, mo,t4 8.to729 €t* le- <br />DDRESS: <br />fto, 60*/ 2 5 1 <br />WORKERS COMP. POLICY#:EXP. DATE: 1 <br />AAW (00 32 6700/05 124 3/3 <br />ARCHITECT/ENGINEER: <br />ADDRESS: <br />STATE CONTR. #:3385/3 LIC13%Css:PHONE NO: <br />-7605742975 <br />CITY:STE:-11* 9-1116..0 92271ZIP <br />I1§UR*41CE COMPANY:SANTA ANA BUS. LlC. #: <br />jog Inefn Ingv ¥ GACe <br />STATE LICENSE #PHONE NO <br />CITY: -STATE:ZIP: <br />A <br />CONTACT NAME:fr) I l Ad -M u 1 0-2-PHONE NO:760 07*2973 <br />E-MAIL ADDRESS: /77 / 4 U.Lf (2 Pr, 014.al,-v ey-<i € ) /. C o ,« <br />OFFICE USE ONLY: <br />OCC. GROUP: <br />TYPE OF CONSTR: <br />ACC OR SPC (CIRCLE ONE)HRS PER BLDG. FEE $ ,. <br />RECEIPT#:--1 _RiCFE E PD $ 4 L <br />VALUATION: $SUBMITTAL,DATE{3 <br />FIRE SPKR: YES / NO A/C: YES / NO FLOOD ZONE:PROCES »4/ <br />RES. DEV. FEE: YES / NO PRIOR DWELLING UNIT: YES / NO COMMENTS: <br />rC <br />PLANNING OK TO CHECK & DATE BLDG. DEPT. APPROVAL & DATE <br />PLNG CONDITIONS: