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CITY OF SANTA ANA <br />BUILDING PERMIT APPLICATION WORKSHEET <br />PLEASE PRINT 3/2/05:forms/Blda.App.Worksheet <br />PROJECT ADDRESS:2980 N. WAA *,SUITE: Eb SAP\14# ) 1 ,-13 lo ) <br />USE OF BUILDING:RESIDENTIAL COMMERCIAL INDUSTRIAL OTHER <br />MASTER ID# <br />NATURE OF WOI}K NEW J ADD ALTER/T. I.DEMO REROOF REPAIR SIGN MISC <br />NEW/ADDITION/Al TFRATION· <br />1ST FL.. SF BASEMENT: YES/NO SF NO, OF STORIES: <br />2ND FL..SF PATIO/ENCL. PATIO: SF BLDG. HEIGHT: <br />TOTAL OF OTHER FLS:SF RES. REMODEL: SF PROPOSED USE: <br />GARAGE/CARPORT SF ALTERIT.I.SF <br />JOB DESCRIPTION (non-residential projects see reverse side of this application) : <br />BUILDING OWNER'S NAME: /, <br />\U <br />-PHONE NO: <br />7 /4. S V 7 -773 00 <br />ADDRESS CITY:,/1 n STA:ZIP:-2-200 U ·MAin St.b. 14 927Dr <br />TE,NANT'S NAME (Comm/Ind):PHONE NO: <br />CONTRACTOR'S NAM€17 · STATE CONTR. #:LICENSE CLASS:PHONE NO: <br />TA-u,;3+19 yvv./(/r C- U U- 9" -691 -788 9 <br />ADDRESS'19&-U 042 34-Ar ULL <br />WORKERS COMP. POLICY#:EXP DATE: <br />Pldc 004 046- /2 9- 1 0-15 <br />STATE:ZIP'ppfR uers, 73.1 Ag 52 r or <br />INSURANCE COMPANY:SANTA ANA BUS. LlC. #: <br />ABSoc. Int). ·Co. <br />ARCHITECT/ENGINEER:STATE LICENSE #:PHONE NO: <br />ADDRESS:CITY:STATE:ZIP: <br />CONTACT NAME:L/1. Ctr 6 A-KIR' 4324-PHONE NO: 14N - 6 9 7, yrd'l <br />E-MAIL ADDRESS7-Tbian /Z) f/emQerS;ahs.ora i-,>V 1 <br />OFFICE USE ONLY:ACC OR SPC (CIRCLE ONE)HRS PER BLDG. FEE $ <br />OCC. GROUP:RECEIPT #P/C FEE PD $ <br />TYPE OF CONSTR:VALUATION: $SUBMITTAL DATE: <br />FIRE SPKR: YES / NO A/C: YES/NO FLOOD ZONE:PROCESSED <br />RES. DEV. FEE: YES/NO PRIOR DWELLING UNIT: YES / NO COMMENTS: <br />PLANNING OK TO CHECK & DATE BLDG. DEPT. APPROVAL & DATE (--ja i - a89=2) <br />PLAG CON-MIONS: <br />. , t=*:*3frlRD