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,"-SANTA <br />NA <br />tLt\t\c <br />$iltoNt <br />16t\fi <br />I <br />Planning & Bullding Agsncy <br />Eullding Safoty Divlsion <br />20 Civlc Center Plaza <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-5853 <br />SPECIAL INSPECTION/COMPLAINT <br />INVESTIGATION FORM <br />SUITE: <br />l l Commercial/lndustrial <br />SUBJECT ADDRESS: <br />il Residential <br />Purpose of Inspection: r I ri E <br />CNC <br />@(- <br />mo <br />-.{ <br />g <br />0vm(r) <br />cn <br />c <br />Requested by: fl Owner O Contractor <br />Name: <br />tr Real EstateAgent H other <br />Address n4 i.tA 4e Z t'I K <br />Phone:771 lt GI <br />ACTION TAKEN: D None Required tr Correclion Notice <br />INSTRUCTIONS: O OK Subject to Field S Plan Check Required <br />PERMITS REQUIRED: ts Building t'} Electrical E Plumbing O Mechanical <br />PLANS REQUIRED: E Site Plan ts Floor Plan ll Roof Plan b Elevations <br />D Elect. Plan D Plumbing D Mechanical <br />FEES: E'ilegular Fees U Penalty Fee D lnvestigation Fee <br />NOTE: Building Permits for unpermitted room additions require a site plan, floor <br />plan, roof plan, framing plan, and elevations <br />Remarks:, )' ; <br />C <br />=m <br />Date:Time ln: <br />Time <br />Departed: !t t, 't', ,-, lnspector/lD: <br />lnspector Office Hours: Monday - Thursday 4:00 - 4:30 PM and Friday 3:00 - 3:30 PM <br />Permits may be obtained Monday. Tuesday, Thursd ay and Friday 8:00 - 4:0O; Wednesday 10:0O - 4:0O <br />Tracking #I' <br />Office Use <br />Amount Paid: <br />Date: <br />Date: <br />Oistributionr White & Yellow - lnspector Pink - File Copy <br />Received by: <br />FA <br />t 9zl \l <br />ILF-)( <br />Ut <br />) <br />U <br />Address tagged by: <br />Receipt #: