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.**SANTA <br />NAJliil* <br />Plaru ng & Bulldi <br />Building Safety D <br />ngAflency- . : <br />lvlsrdn <br />20 Civic Center Plaza <br />P.O. Box 1988 (M-rg) <br />Santa Ana, CA 92702 <br />(714) 647-s8s3 <br />SPECIAL INSPECTION/COMPLAINT <br />INVESTIGATION FORM <br />n <br />SUBJECT ADDRESS: <br />n Residential <br />Purpose of lnspection: -: <br />U Commercial/lndustrial <br />SUITE: <br />Requestedby: D Owner ! Contractor ! Real EstateAgent U Other <br />Name: <br />Address: <br />Phone: <br />ACTION TAKEN: ! None Required O Correction Notice <br />INSTRUCTIONS: o OK Subject to Field tt Plan Check Required <br />PERMITS REQUIRED: B Building E Electrical ! Plumbing t) Mechanical <br />PLANS REQUIRED: Q Site Plan E Floor Plan O Roof Plan ts Elevations <br />Ll Elect. Plan E Plumbing a Mechanical <br />FEES: 'E Regular Fees I] Penalty Fee tr lnvestigalion Fee <br />NOTE: Building Permits for unpermitted room additions reguire a site plan, floor <br />plan, roof plan, framing plan, and elevations <br />Remarks: . ' <br />Date:Time ln: <br />Time <br />Departed:lnspector/lD: l- <br />lnspector Office Hours: Monday - Thursday 4:00 - 4:30 PM and Friday 3:00 - 3:30 PM <br />Permils may be obtained Monda y, Tuesday, Thursday and F riday 8;00 - 4:0O; Wednesday 1O:00 - 4:00 <br />Tracking # <br />Office Use <br />Amount Paid:Receipt # <br />Date: <br />Date: <br />Distribution: White & Yellow r- lnspector Pink - File Copy <br />Received by: <br />Address tagged by: <br />U)C <br />@(- <br />mo-{ <br />oov <br />m <br />@I <br />I <br />I <br />I <br />U,C <br />=lTt