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thuwday,Vlarth tTtu Xolp <br />Planning & Building Atency <br />Building Safety Division <br />20 Civic Center Plaza <br />P.o. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-s800 <br />www.santa-ana.org <br />SPECTAL TNSPECTION/COMPLAI NT <br />!NVESTIGAT!ON FORM <br />SUBJECT ADDRESS:(xt S SUITE:- <br />CNC <br />@(- <br />mo--l <br />oonma)I <br />[Residential I Commercial / lndustrial <br />Purpose of lnspection { <br />Requested by : El owner <br />tTr.o,^ Vu <br />! city official <br />Name: <br />Address: <br />Phone: <br />CA 1 <br />o <br />ACTION TAKEN: E None Required E Correction Notice <br />INSTRUCTIONS: E OK Subject to Field ! Plan Check Required <br />PERMITS REQUTRED: E auihing El Electrical E Plumbing D Mechanical <br />PLANS REQUIRED: E Site Plan E} Floor Plan ! Roof Plan ! Elevations <br />! Elect. Plan ! Plumbing EMechanical <br />FEES: E[ Regular Fees E Penalty Fee ! lnvestigation Fee <br />NOTE: Building Permits for unpermitted room additions require a site plan, floor plan, <br />roof plan, framing plan and elevation <br />Remarks:P*etxz. A^-I, l-r r\ i\aT2 lJk/, AYZ Ll LO t^,J TJDqJJ t -tfl U)C <br />=!-r.re{?- <br />Date:Time ln: gtqs frl^ Time Out:A, 15 a^lnspector/lD:rEsn P l1,3 <br />lnspector Office Hours: Monday -- Thursday 4:00pm - 4:30pm and Friday 3:00pm - 3:30pm <br />Permits may be obtained Monday, Tuesday, Thursday and Friday 8:00am - 4:00pm ; Wednesday 10:30am - 4:00pm <br />Tracking #sl1lr <br />OFFICE USE <br />Amount Paid: <br />Received by:Date: <br />Date:Address tagged by: <br />5lt) <br />Distribution: White lnspector - Yellow Applicant <br />Receipt #: <br />! other <br />3A2-iE_