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*-SNTA <br />NA,ffi <br />tr-r">d..Y I.na 2o+h <br />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) 647.5800 <br />SPECIAL INSPECTION/COMPLAINT <br />INVESTIGATION FORM <br />E Com mercia l/lnd u stria I i6.Sesidential <br />C <br />@(- <br />m <br />C) <br />--1 <br />OoA <br />m <br />@a <br />\^ <br />\I, <br />\i.j <br />t^ <br />E <br />11 <br />= <br />(- <br />Purpose of lnspection ofl [\ <br />Requested by: 6.Owner D Contractor O Real Estate Agent tr Other <br />Name {<L4 <br />Address: 5,Lr.J p>t:(+ <br />Phone CoA 7o&_ Fax <br />Fftpstr <br />Y <br />D None Required <br />tr OK Subject to Field <br />uild ing <br />ite Plan <br />egular Fees <br />fl Correction Notice <br />frel^n Check Required <br />Electrical plumOing Nf.i.echanicat <br />Floor Plan bGoof Plan I Elevations/ <br />Penalty Fee 0 lnvestigation Fee <br />tr <br />f <br />NOTE: Building permits for unpermitted room additions require a site plan, <br />floor plan, roof plan, framing plan and elevations <br />L12 ! <br />!,/: <br />C <br />=m <br />o^t". 6f zrsl lJ rime <br />rd, <br />a C)lnspector/lDt7 <br />ector Office Hours: B:00 - B:30 A M and 3:30 - 4:00 P.M <br />Permits may be obtained Monday. Tuesday. Thursday and Frida y 8.00 - 4:00, Wed nesday 1 000-400 <br />Office Use <br />TrackingH: SI.6qqbq{, AmountPaid: <br />Rcceivcd by <br />Receipt # <br />Adtlress tagged by,_ <br />_ Date <br />DatL- <br />Distnbution: \\'hitc Inspector Pink Ou ncr 'C'ontractor Yellou Filc Copy <br />i <br />SUBJECTADDRESS: 5>,{ (^)SUITE: <br />ACTION TAKEN: <br />INSTRUCTIONS: <br />PERMITS REQUIRED: <br />PLANS REQUIRED: <br />FEES: <br />Re ma rks: