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Planning & Building Agency <br />Building Safety Division <br />20 Civic Center Plaza <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-s800 <br />www.santa-ana,org <br />SPECTAL TNSPECTTON/COMPLAI NT <br />INVESTIGATION FORM <br />SUBJECT ADDRESS: <br />Purpose of lnspection <br />! Commercial / lndustrial <br />Requested by: D Owner ! city otticiat <br />Name: <br />Address: <br />Phone: <br />ACTION TAKEN: ! None Required ! Correction Notice <br />TNSTRUCTTONS: f] OK Subject to Field fl Plan Check Required <br />PERMITS REQUIRED: E euihing E Electrical <br />PLANS REQUIRED: E Site PIan E F|oor PIan <br />n other <br />Plumbing E Mechanical <br />Roof Plan ! Elevations <br />! Elect. Plan ! Plumbing ! Mechanical <br />FEES: fl Regular Fees ! Penalty Fee ! lnvestigation Fee <br />NOTE: Building Permits for unpermitted room additions require a site plan, floor plan, <br />roof plan, framing plan and elevation <br />Remarks: <br />Date lnspector/lD:- <br />lnspector Office Hours: Monday - Thursday 4:00pm - 4:30pm and Friday 3:00pm - 3:30pm <br />Permits may be obtained Monday, Tuesday, Thursday and Friday 8:00am - 4:00pm ; Wednesday 10:30am - 4:00pm <br />Tracking # <br />OFFICE USE <br />Amount Paid:Receipt #: <br />Received by Date: <br />Date:Address tagged by <br />Distribution: White lnspector - Yellow Applicant <br />SUITE:- <br />! Residential <br />\^i <br />a)C <br />@C- <br />m <br />--l <br />Iop <br />m <br />U)I <br />@C <br />=lTl <br />Time ln: Time Out: