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CITY OF SANTA ANA <br />BUILDING PERMIT APPLICATION WORKSHEET <br />PLEASE PRINT 3/2/05:forms/Bldg.App.Worksheet <br />PROJECT ADDRESS:3ff», 441.SUITE:SAPIN #)O / 90942 j <br />USE OF BUILDING: RESIDENTIAL COM INDUSTRIAL OTHER14IRCIAL <br />MASTER ID# <br />NATURE OF WORK:NEW ADD ALTEFUT. I.DEMO REROOF REPAIR SIGN MISC <br />NFW/ADDITION/Al TFRATION: <br />1ST FL.. <br />2ND FL. <br />TOTAL OF OTHER FLS: <br />GARAGBCARPORT <br />JOB DESCRIPLIS*l jnon-resj! <br />SF BASEMENT: YES/NO SF NO. OF STORIES: <br />SF PATIO/ENCL. PATIO: SF BLDG. HEIGHT: <br />SF RES. REMODEL:SF PROPOSED USE: <br />SF ALTERIT.I.SF <br />tial Drojects see reverse side of thjE-applic7£p )thjP nt Howl 11> tte=o., <br />v. 1 MUE-W IN v/(4_[ -N w Mee ACA A <br />1 <br />BUILDING OWNER'S NAME:l_uy va.. Fwe„12 <97EVI 60 PHONE NO: . gidY-f;g- <br />ADDRESS:C\-rf·. (}Al* ,0/A- STATE *-np·.25767Or-- <br />TENANT'S NAME (Comm/Ind): PHONE NO: <br />CONTRACTOR'S NAME: ,r , /*pr 2410T·tw 4/7 8 <42 64£6LICENSE CLASS:PHONE NO: <br />OV <br />ADDRESS:94-5 (414 yr-,CITY,(%·joe<-A- STATE:g-- ZIP:g-Eff <br />WORKERS COMP POLICY#EXP. DATE:4/1 4-INSURANCE COMPANX:SANTA ANA BUS. LIC. #:7 99 >(et:5%- <br />ARCHITECT/ENGINEER:STATE LICENSE #:PHONE NO: <br />ADDRESS:CITY:STATE:ZIP: <br />CONTACT NAME:PHONE NO:G 41 *rb . 49*8 <br />E-MAIL ADDRESS:EfYIN &@-) 34¢'u, »ktok . ep- <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: $\6 SOO 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 OK TO CHECK & DATE BLDG. DEPT. APPROVAL & DATE <br />PLNG CONDITIONS: <br />- <br />- 0