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;-$ANTA <br />NA.ffi <br />\-tr.r'' s.Jr'1 <br />l,llllt <br />Pla'rrjrr!r & Euildirrg AgencY <br />Buil(ling SufctY Divisiorl <br />2O Crvic Cclltcr PI'rr'i <br />P.O. Bo\ 1983 (Nl l9) <br />Sit|t.r Arr.r, CA 9;l i0'l <br />(7lJl 6{7 sll5-l <br />SPECIAL IN S P ECTIO N/C OMP LAINT <br />INVESTIGATION FORM <br />SL,6.lbt'I \L)plit:SS <br />.,'\\. \ - <br />Re;u-sted b',' <br />N3f ]e I <br />Owner \ContractoI <br />!t, - l4"i ,, <br />Real Estate Agent Other <br />tx' I a 4-A tZ |L2ild.ess <br />Phone <br />iEES <br />I <br />,ACTlON TAKEN <br />INSTRUCTIONS <br />None Required <br />OK Sub,ect to Field <br />Correction Notice <br />X Plan Check Required <br />PERl,l!TS REQUIRED. Xauitoing f |i,ectricat <br />PLAi\is REQUIREO i4site ptan x Floor Plan <br />Elect. Plan Plumbing <br />/-Regular Fees Penalty Fee <br />f elumuing fMechanical <br />Roof Plan )4lElevations '; <br />Mechanical <br />lnvestigation Fee <br />NOTE: Building Permits for unpermitted room additions require a site plan' floor t- <br />plan. ro-oi plan, framing plan, and elevations <br />, <br />Ranrarks 1$U"y:lt\aE-.). <br />L / /11 DDa <br />01 <br />rLl <br />D^D-t-du)u-=ryo/'1( : fir,tiULt!d4. <br />pt tut \ ) tle<( Q"ub A''1 7N <br />l;r"_tas'y,11 oy.t pa@-*r) <br />?L <br />-Ltx-P <br />p"/al4 <br />€"!{-t/Er=-?q-Jgrt,1;(pl"e1u < pa rL P(*N Lt(rrtc- <br />ON FtFlTJ.tllAU< (tt'xt1t <br />E2tvt,TEQ Wb LL- .- <br />Time <br />pd(lo I1 1w/a" ,11-)4fiADeoarted: l'0.'fu!'H' <br />thursday 4 00 - 4.30 Plvl and Ftt,l-r <br />,t.ry, Ihursday and Friday 8 00 n 00 !V, 1 <br />:r 15 E o']5' /l lourlt Paid <br />off ice Use <br />Dale , ' .,. <br />Dal. <br />I'rlh r', eirf! <br />) <br />\,/Vhrte & Yellow - lrspector <br />l'l) <br />ac <br />Emo <br />-1 <br />oOp <br />maa <br />Ilrljl,L <br />l: <br />I <br />,'t- ;-r.. -- <br />-li.'sl(lcrltl.ll \l('orrrlllrrclJl/lrlLlLlstll;ll <br />f,t Lrr\Sr: il I rsf .'atloll ------ !-:- "' '' ,' I ' - <br />dl'l <br />ti)-,,,t