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CITY OF SANTA ANA <br />BUILDING PERMIT APPLICATION WORKSHEET <br />PLEASE PRINT <br />PROJECT ADDRESS: 0'609 w - ST. A-qflf a..SUITE: <br />USE OF BUILDING: C-REIDENTJACD COMMERCIAL INDUSTRIAL OTHER <br />3/2/05:forms/Bldg.App.Worksheet <br />SAPIN #/0/90994 <br />MASTER ID# <br />NATURE OF WORK:NEW ADD ALTERIT.1.DEMO REROOF REPAIR SIGN IMI-SOL#.-F <br />NFW/ADDITION/Al TFRATION· <br />1ST FL.. <br />2ND FL.. <br />TOTAL OF OTHER FLS: <br />GARAGE/CARPORT: <br />SF BASEMENT: YES/NO <br />SF PATIO/ENCL. PATIO: <br />SF RES. REMODEL: <br />SF ALTERIT.I. <br />SF NO. OF STORIES: | <br />SF BLDG. HEIGHT: <br />SF PROPOSED USE: <br />SF <br />JOB DESCRIPTION (non-residential projects see reverse side of this application): 14ST-#•-t-L-1 44 10 F·OOF MOLSWT-€0 <br />p.-,6 MODUL€9 -4 1 1,-M/€8-1-GR . <br />BUILDING OWNER'S NAME: - PHONE NO: <br />MABISELA F€y€s <br />ADDRESS:CITY:STATE:ZIP <br />0-3001 - . ST. MJ,JE PL.Sh,J -r-8- #AIA Ch 49-1-04 <br />TENANT'S NAME (Comm/Ind):PHONE NO: <br />CONTRACTOR'S NAME: · STATE@10£1 53,1 1 CENSE CLASS: PHONE NOLE#/ i E>Lf, LIDE FS 40 (Jibm) 5*9 z'lequADDRESS:CITY: * STATE:ZIP: <br />Mel S- 0014€,-ry Ofz. .6€4€lg/ }A-/ AU-S C k 102'I <br />WORKERS COMP. POLICY#: <br />900 1 11-0 <br />EXP. DATE, <br />Pl qi 14 <br />INSURANCE COMPANY: <br />ST>T€ cokle <br />SANTA ANA BUS. LlC. #: <br />ARCHITECT/ENGINEER:STATE LICENSE #:PHONE NO: <br />pwah-IC, 1--BU O h.je (903-QDq (341 ) 9-5 4 -9-7451 <br />ADDRESS: 4 CITY: .STATE:ZIP: <br />CM'60(23 eMP Pl 40€ 8 F©.9,9 0 D\Awl 040 e»a C#> <br />CONTACT NAME: 0**91 ST-1 1-41 4000..PHONE NO: t& ID) 9(09.- 9,51-coe <br />E-MAIL ADDRESS:CAOW DA- 4 4 4 2 4 &1# cu <br />OFFICE USE ONLY:ACC OR SPC (CIRCLE ONE)HRS PER BLDG. FEE $ <br />OCC. GROUP:RECEIPT #P/C FEE PD $ <br /><30 <br />TYPE OF CONSTR:VALUATION: $,«),EKE)-+-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: