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.,,*SANTA <br />ANA/[}$ <br />lctlcv1p <br />Planning & Building Agency <br />Buildlng Safety Division <br />20 Civlc Cente, Plaza <br />P.O. Box 1988 (M-19) <br />Santa Ana, cA 92702 <br />(7{4) 647-58s3 <br />SPECIAL INSPECTION/COMPLAINT <br />INVESTIGATION FORM <br />SUITE aC <br />@ <br />mo-t <br />oon <br />maa <br />Commercial/lndustrial <br />Requested by: tr Owner tr Contractor tr Real Estate Agent p ouerk44 <br />\NName: <br />Address <br />Phone: <br />ACTION TAKEN: o None Required trC on Notice <br />INSTRUCTIONS:, <br />PERMITS REoUIRED <br />PLANS REQUIRED: <br />|l OK Subject to Field lan Check Required <br />tl,/tumoing <br />gl,-Roof Plan <br />tl Mechanical <br />/Buitding <br />- a/sir. Prrn <br />D Elect. Plan <br />#lectrical <br />/f loor Plan <br />D Plumbing <br />l] Penalty Fee <br />ffiechanical <br />tr Elevations <br />>st-.\- <br />FEES o/Regulai Fees tr lnvestigation Fee <br />NOTE: Building Pemits for unpermitted room additions require a sile plan, floor <br />plan, roof plan, framing plan, and elevations <br />Remarks >.u1,/,.) )tU o L4) <br />aa- <br />} .t Lc,v?e,*,,-t< 4n1 p <br />/ o., a- a', -))?u, <br />Date lime ln: /('a'-,"orllTol 12 a S-tnspectorrn dz.pt**/ <br />Date <br />Date <br />Diskibutioni White & Yellow - lnspeclor Pink - File Copy <br />SUBJECT ADDRESS: <br />Purpose of lnspection: <br />tl Residential <br />U\ <br />t-)<nc <br />; <br />lTr <br />Received by: <br />ly'r,'t <br />lnspector Offlce Hours: Monday - Thursday 4:00 - 4:30 Plvl and Friday 3:00 - 3:30 PM <br />P€rmits may be obtained Monday, Tuesday, Thursday and Friday 8:00 - 4i00;Wednesday 10r00 -4:00 <br />-t ^ Office use <br />Trackins #; -'lCl bTfrhAmount Paid: e- Receipt #: <br />Address tagged by: