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Planning & Building Agency <br />Building Safety Dlvision <br />20 Civlc Center Plaza <br />P.O. Box 1988 (M-i9) <br />Santa Ana, CA 92702 <br />(714) 647-5853 <br />SPECIAL INSPECTION/COMPLAINT <br />INVESTIGATION FORM <br />SUBJECT ADDRESS SUITE:aC <br />@ <br />mo <br />--{ <br />0ovm(,a <br />Requested by , ilo*nl, <br />I>-'..n <br />t=l Contractor tr Real Estate Agent tr Other <br />Name: <br />Address <br />Phone: <br />I+K <br />5 L <br />ACTION TAKEN: ! None Required tr Correction Notice <br />INSTRUCTIONS: D OK Subject to Field D Plan Check Required <br />PERMITS REQUIRED: tl Building D Electrical E Plumbing tl Mechanjcal <br />PLANS REQUIRED: 3. Site Plan n Floor Plan tr Roof Plan u Elevations <br />tl Elect. Plan n Plumbing ll Mechanical <br />FEES: E Regular Fees ,l Penalty Fee L.l lnvestigalion Fee <br />NOTE: Building Permits for unpermitted room additions require a site plan, floor <br />plan, roof plan, framing plan, and elevations <br />Remarks: <br />lnspector Office Hours: Monday - Thursday 4:00 - 4:30 PM and Friday 3:00 - 3:30 Pl, <br />Pemits may be oblained L4onday , ThuGday and Friday 8:00 - 4:0O; Wednesday 10100 - 4:00 <br />Tracking #: ir-, <br />Office Use <br />Amount Paid: \ 5[-\Receipt # <br />Received by Date <br />Date <br />-,-SANTA <br />NA,rl[ffi <br />Address tagged by <br />Distribution: White & Yellow - lnspector Pink - File Copy <br />We1ne14,,.\ A\.,1 Itj IOIB <br />a N .I <br />! Residentiat D Commercial/lnduslrial <br />. ,...,\_Purpose of lnspection: <br />TT-<\,.\\\-..r D(a-Y-*\.\ I t c ilrf.r <br />h <br />L <br />.' <br />g)c- <br />!'r <br />rl <br />Date: -r__Time tn: /l/) <br />Time <br />Departed: , lnspector/lD: <br />eb <br />AqUAA :at)e