Laserfiche WebLink
CITY OF SANTA ANA <br />BUILDING PERMIT APPLICATION WORKSHEET <br />PLEASE PRINT 3/2/05:forms/Blda.ADD.Worksheet <br />PROJECT ADDRESS:2- 931--54 8-ene, Dr.SUITE:SAPIN #h / 90 99/ <br />USE OF BUILDING:FlESIDENTIAL' COMMERCIAL INDUSTRIAL OTHER <br />MASTERID# <br />NATURE OF WORK: NEW ALTER/T. I.DEMO REROOF REPAIR SIGN MISC <br />NFW/ADDIIION/ALTERATION· <br />1ST FL.. SF BASEMENT: YES/NO SF NO. OF STORIES: <br />2ND FL.. SF PATIO/ENCL. PATIO:SF BLDG. HEIGHT: <br />TOTAL OF OTHER FLS: SF RES. REMODEL: SF PROPOSED USE. <br />GARAGE/CARPORT:SF ALTER/T.1.- SF <br />JOB DESCRIPTION (non-residential projects see reverse side of this application): 4 -C,U) Vi#*WAA roof -rACAAnk d S\a \(- 99\Yip/\6 . <br />BUILDING OWNER'S NAME: <br />1-(·en An Lo <br />ADDRESS: <br />TENANT'S NAME (Comm/Ind): , <br />CONTRACTOR'S NAME: <br />50\ar el¥·y <br />ADDRESS: <br />al 09 5 · (branci Au e . <br />PHONE NO: <br />1 14 - 3Ipl 1 012 2. <br />CITY:STATE:ZIP: <br />PHONE NO: <br />STATE CONTR. #.LICENSE CLASS:PHONE NO·%99\04 CAU 1)4·9!4.98311 <br />cin':STATE: .zIP <br />Sa n M A·n a 4270£3 <br />WORKERS COMP. POLICY#:EXP. DATE: <br />liolel 0 <Flol-(94052> (A- I-\ t.4 <br />INSURANCE COMPANY: <br />L\ be.r--41/ <br />SANTA.ANA BUS. LlC. # <br />ARCHITECT/ENGINEER:STATE LICENSE #.PHONE NO: <br />ADDRESS:CITY:STATE:ZIP. <br />CONTACT NAME: \'Si n « 83f-S a\)(1 .PHONE NO: 1)4.-[5)4- 51:t?60 <br />E-MAIL ADDRESS:6 *pers noA P Kn\Or c jh/, C,Orn . <br />, <br />OFFICE USE ONLY:ACC OR SPC (CIRCLE ONE)HRS PER <br />OCC. GROUP.RECEIPT #14* <br />TYPE OF CONSTR:VALUATION: $le)808 <br />FIRE SPKR: YES / NO A/C: YES / NO FLOOD ZONE: <br />BLDG. FEE $ <br />P/C FEE PD $d <br />SUBM\UALDATE·. <br />PROCESSED /4/ <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: