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CITY OF SANTA ANA <br />BUILDING PERMIT APPLICATION WORKSHEET <br />PLEASE PRINT 3/2/05:forms/Blda.App.Worksheet <br />PROJECTADDRESS 3430 5- 8054-0 L+lol¥ ·sul-rE: l.-4 SAPIN# 011-7940·> rib <br />USE OF BUILDING:RESIDENTIAL COMMERCIAL INDUSTRIAL OTHER <br />< MASTER ID# <br />/ I. <br />NATURE OF WORK: NEW ,ADD ALTER/T.I.DEMO REROOF REPAIR ¢ SIGN ) MISC <br />NFW/ADDITION/Al.TERATION· <br />1 ST FL.SF BASEMENT. YESLNO -- - SF <br />2ND FL.. SF PATIO/ENCL. PA-na SF <br />TOTAL OF OTHER FLS: SF RES. REMODEL: SF <br />GARAGE/CARPORT: SF ALTER/T.I.SF <br />JOB DESCRIPTION (non-residential projects see reverse side of this application) : <br />NO. OF STORIES: <br />BLDG. HEIGHT. <br />PROPOSED USE: <br />ILLuMINATdo CAANNEL LETTERS <br />PHONE NO 949- 160-859\BUILDING OWNER'S NAME: (5) „c?t-k- D.eveloprv,alt-Groop <br />ADDRESS: /4 £ co, t)0.•4 'fe Fl. 24 2 Ma-Floo, CITY· /7, c.,A/f e fack STATE:C 4 ZIP 9 2 66 <br />TENANTS NAME (Comm/Ind): kr. 62 0 E 4-42 Aer PHONE NO: , <br />CONTRACTOR'S NAME 6 ;1 4 64 q *STATE CONTR. #:·¥ 41 -1 7 1 LICENSE CLASS.PHONE NO: <br />6-4 6 7 /4 -4 4 1 -8 4*7 <br />ADDRESS:3,\ 2 5 -Mot A '5' -94 •Dot /4 442 <br />CITY: -STATE: (1 4 ZIP:q z 4-0.-7 <br />WORKERS COMP. POLICY#:EXP. DATE:INSURANCE,COMPANY:SANTAANA BUS. LlC. #: <br />1 6 43 77 4 £01,13'13 5 11 fc F U 6 J <br />ARCHITECT/ENGINEER:STATE LICENSE #:PHONE NO <br />ADDRESS:CITY:STATE ZIP: <br />CONTACT NAME:Kes 6 5 986-QI <br />E-MAIL ADDRESS:9 1% MMo(*<SFC< G)FET· h LT- <br />PHONE NO: ¥l 4-14-7 -243 f <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 OKTO CHECK& DATE BLDG. DEPT. APPROVAL & DATE <br />PLNG CONDITIONS: y 01 -Lt 11.>