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.,*SNTA <br />NA <br />tl$lNC <br />I Bt[.Dt\c <br />rc[\0 <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 />(7'r4) 647-s800 <br />SPECIAL INSPECTION/COMPLAINT <br />INVESTIGATION FORM <br />SUBJECT ADDRESS <br />Purpose of lnspection <br />SUITE (D <br />C <br />@L <br />mo <br />--l <br />oonma <br />CNRequested by: <br />Name: <br />EI Owner E Contractor O Real Estate Agent B Other <br />Address <br />Phone:Fax: <br />ACTION TAKEN: <br />INSTRUCTIONS: <br />PERMITS REQUIRED: <br />PLANS REQUIRED: <br />FEES: <br />aC <br />=m <br />lnspector/lD <br />lnspector Office Hours: 8:00 - 8:30 A.M and 3:30 - 4:00 P.M. <br />Permits may be obtained Monday, Tuesday, Thursday and Friday 8:00 - 4:00; Wednesday 10:00 - 4:00 <br />Time: n <br />Tracking H'. <br />Office Use <br />Amount Paid,_ Receipt # <br />Date <br />DateAddress tagged by <br />Distribution: Whitc - Inspcctor Pink Ou,ncr/Contractor Yellow Filc Copy <br />fl Commercial/lndu strial tr Residential <br />E None Required E Correction Notice <br />O OK Subject to Field tr Plan Check Required <br />I Building O Electrical O Plumbing tr Mechanical <br />O Site Plan D Floor Plan B Roof Plan tr Elevations <br />-0 Regular Fees tr Penalty Fee E lnvestigation Fee <br />NOTE: Building permits for unpermitted room additions require a site plan, <br />floor plan, roof plan, framing plan and elevations <br />Remarks: <br />t:. I <br />At"Date: <br />Received by,