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1 CITY OF SANTA ANA <br />BUILDING PERMIT APPLICATION WORKSHEET <br />PLEASE PRINT <br />PROJECT ADDRESS: 31 01 S. BA Kek 5+ <br />USE OF BUILDING: /FliEiE@3AL COMMERCIAL <br />SUITE: <br />INDUSTRIAL OTHER <br />3/2/05:forms/Bldg.App.Worksheet <br />SAPIN #b / /7 9 ge/B <br />MASTERID# <br />NATURE OF WORK: NEW ALTER/T. I.DEMO REROOF REPAIR SIGN MISC <br />NFW/ADDITION/Al TFRATION· <br />1 ST rL. <br />2ND FL.. <br />TOTAL OF OTHER FLS: <br />GARAGE/CARPORT: <br />sr BASEMENT. YES/NO <br />SF PATIO/ENCL. PATIO: <br />SF RES. REMODEL: <br />SF ALTER/T.I. <br />SF NO. OF STORIES' <br />SF BLDG. HEIGHT: <br />SF PROPOSED USE: <br />SF <br />JOB DESCRIPTION (non-residential projects see reverse side of this application) :/5, 317 4/ BoOF Mou'Mt€O <br />Phu¥-0 VOLI'lic- r®ouusi . val.1/AT\D 10 -#23 , DOO <br />BUILDING OWNER'S NAME: -PHONE NO:05€. A. 6-(:36,4 tor-601 7 {4 - 194 - 413 1 <br />ADDRESS:CITY STATE:ZIP: <br />* 3 1 0 2 5 . 8 4 key 51 lan-tot 4¥Mt CA 9276-7 <br />TENANT'S NAME (Comm/Ind):PHONE NO: <br />CONTRACTOR'S NAME:PBA :STATE CONTR. #:LICENSE CLASS:PHONE NO:Sok ; Beys (FROU¥% ILK /Tvvt ¢394,VS#(mu Cl-1059, 1 8, oqc 7/Lt -67 6-32»W1 <br />ADDRESS:CITY:grew STATE:ZIP:45 I W LAM/7 tfit 'Of , 9:t 2-1 L FEN 6(6 14%*0/6 92,9>2/ <br />WORKERS COMP. POLICY#:EXP. DATE:INSURANCE COMPANY:SANTA ANA BUS. LlC. #: <br />9005154 -/4 0% /1014 trA-4, roupevp,ahon 10$Vahle/A/Fl€X <br />ARCHITECT/ENGIN#ER:STATE LICENSE #PHONE NO <br />Davo\. t/09;V)€61/541*)/949 - 185-Ut 09 <br />0 <br />ADDRESS:CITY:STATE:ZIP: <br />/02 91'/,eF) -lvy.6 Zn 60 1 +A /+f e YA CA 914 177 <br />CONTACT NAME:93orMAA n Cle PHONE NO: ,6 -39£)-6 206 <br />E-MAIL ADDRESS:jtchw#hellefow ev€Obi . Canl <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 <br />PLNG CONDITIONS: