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Planning & Building Agen€y <br />Building safety Division <br />20 Civic Center Plaza <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />17 L4l 647 -5,AOO <br />www.santa-ana.org <br />SPECTAL TNSPECTTON/COMPLAINT <br />INVESTIGATION FORM <br />SUBJECT ADDRESS 7 <br />L 1 E SUITE:-a)C <br />@(- <br />mo-l <br />IU7 <br />maa <br />fl(esidential <br />D" <br />I Commercial / lndustrial <br />*,n s + S\ah u<, *oPuof lns ection:0}^uu[rt\:U <br />Reque <br />Name: <br />sted by: d o*n", <br />s csf v1n vuEL 0 ! city officiat <br />SrS$r$ <br />a <br />>\(-S <br />(rruOf <br />Address:51 6.DTZ <br />Phone 2a L saSB <br />ACTION TAKEN: I None Required #orrection Notice <br />, <br />INSTRUCTIONS: EOf SuUject to Field ! Plan Check Required <br />PERMITS REQUIRED: ftmilaing D Electrical ! Plumbing ! Mechanical <br />PLANS REQUIRED: ! Site Plan ! Floor Plan ! Roof Plan ! Elevations <br />! Elect. Plan ! Plumbing ! Mechanical <br />FEES: S8egular Fees I Penalty Fee ! lnvestigation Fee <br />NOTE: Building Permits for unpermitted room additions require a site plan, floor plan, <br />4 <br />roof plan <br />Remarks: <br />, framing plan and elevation <br />o Arl aC <br />=rn <br />-T-2 6 9., qr o <br />/-<-4-7H z b-.t- <br />LrAl <br />oate: l-9'Ll Time ln: A€l0 tf lnspectortn:J) -'t?Time Out <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 />Received by <br />S!.Kt1}Lh <br />OFFICE USE <br />Amount Paid:Receipt #: <br />Date: <br />Date: <br />Distribution: White lnspector - Yellow Applicant <br />1,,D <br />E other <br />Address tagged by: