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CITY OF SANTA ANA <br />BUILDING PERMIT APPLICATION WORKSHEET <br />PLEASE PRINT <br />PROJECT ADDRESS:)'7/6 1*85 4- rive/ 14,12 -SUITE <br />USE OF BUILDING: -29-SIDENTIXCI> COMMERCIAL INDUSTRIAL OTHER <br />3/2/05:forms/Bldgi:App.Worksheet <br />SAPIN # 10 1 2 09 2 3 <br />620 14 - /13301 <br />MASTERID# <br />NATURE OF WORK: NEW ADD ALTER/T. I.DEMO REROOF REPAIR SIGN MISC <br />NEW/ADDITION/Al-TFRATION <br />1,ST FL. <br />2ND FL.. <br />TOTAL OF OTHER FLS <br />GARAGE/CARPORI <br />JOB DESCRIPTION (non-residentia <br />(31 3 Kno £402>- i <br />\ 0 0 4 10 1-0 04 <br />SF BASEMENT: YES/NO SF NO. OF STORIES: <br />SF PATIO/ENCL. PATIO:SF 'BLDG. HEIGHT: <br />SF RES. REMODEL: SF PROP.OSED USE: <br />SF ALTEFUT.I.SF <br />i projects see reverse side of this application)6 .151< U.> Poof, PMOUV)-1-t. 2) 44 .66/91 Offrlde,fo,v ila 6)4149 1 44··· <br />BUILDING OWNER'S NAME::6n,A- 010[50»0 <br />ADDRESS CITY\ 4 /0 wes* A.« king .5• Ada 4,4 l <br />mr¢503- 2,(41% <br />STATE: <br />GA 357 on <br />TENANT'S NAME (Comm/Ind):PHONE NO: <br />23%01241 so)Ar Air«,1-00-646 L#4 -219 06;0TOR S NAME STATE CONTR.#+1100 4 LICENSE CLASS·HONE NO <br />ADDRESS·CITY:STATE-ZIP>:7\ 14(ju R ihinlpe b\vd ;1-0-4 Ar\@eler C IA-£700 29 <br />t <br />WORKERS COMP. POLICY#:EXP. DATE:INSURANCE COMPANY:SANTA ANA BUS. LlC. # <br />49006200 6.12 1 1 Zc eg\-1%09©rr, f 1 hi{,¥K vt,le, <br />ARCHITECT/ENGINEER:STATE LICENSE # <br />O «Ay -CI;UiulA I 44 109 4 PH#m: -7 I q- 9100 <br />Al 'PT> e Gy, 6 Ned 01 vol CL *lof 7* Lmo-2 3ZIP <br />CONTACT NAME:Chric ck<An PHONE NO:310-(02,9 -66(rld <br />E-MAIL ADDRESS: CE 4 54 9 g Arygric•£ 4 30)«r OJre-4 * Govvi <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:\IALUPT\ON'.%l-#) / 000 SUBMITTAL DATE:3// 4, <br />/ <br />FIRE SPKR YES /NO A/C YES / NO FLOOD ZONE: A E PROCESSED .D c. <br />RES. DEV. FEE: YES / NO PRIOR DWELLING UNIT : YES / NO COMMENTS: <br />PLANNING OK TO dAECK & DATE-BLDG. DEPT. APPROVAL& DATE <br />PLNG CONDITIONS. <br />. 3=. <br />'t .:4