Laserfiche WebLink
CITY OF SANTA ANA <br />BUILDING PERMIT APPLICATION WORKSHEET <br />PLEASE PRINT 3/2/05:forms/Blda.App.Worksheet <br />PROJECT ADDRESS:3 80 5- y . 82 rc- 4 51 . 50,144« SU\TE SAPIN # <br />USE OF BUILDING. 116*IDEN- COMMERCIAL INDUSTRIAL OTHER <br />MASTERID# <br />NATURE OF WORK ADD ALTER/T.I. DEMO REROOF REPAIR SIGN MISC <br />NEW/ADDITION/ALTF. RATION· <br />1ST EL. <br />2ND FL.. <br />TOTAL OF OTHER FLS: <br />GARAGE/CARPORT: <br />ST BASEMENT: YES/NO <br />SF PATIO/ENCL. PATIO: <br />SF RES. REMODEL: <br />SF ALTER/T.I. <br />SF NO. OF STORIES: - <br />SF BLDG. HEIGHT: <br />SF PROPOSED USE: <br />SF <br />JOB DESCRIPTION (non-residential projects see reverse side of this application) :50/2, FV Fyr./6'a¥£126 , 3·92 £50/ DE-. Exs b MA 100 A - <br />BUILDING OWNER'S NAME:PHONE NO:, i 376 -53 3 - <FT// <br />ADDRESS. gy/y S . 6 ird st.CITY r /STATE:CA z:p 9707.5-Ak/*,4 JA,41·-ah <br />Ana <br />TENANT'S NAME (Comm/Ind): U PHONE NO·/vt CV M L & n 96 0 - S-03-%3 / j <br />CONTIV\CTOR'S NA E STATE CONTR. #-LICENSE CLASS: PHONE NO: <br />93 5-2*3 6 ,C>ID 3/0 - y65-9053 <br />4 - <br />ADDRESS:CITY,-STAT,4 ZIP'2-OUS- s - tueskrn Ave.16 rrtn ce-905-6/ <br />WORKERS COMP. POLICY#·EXP. DATE:INSURANCE COMPANY:SANTA ANA BUS. LlC. # <br />tvo 5 733 2-1600 ·7--3/-/r .2-040 c 11 Am#ricon <br />ARCHITECT/ENGINEER:STATE LICENSE #.PHONE NO: <br />K) .L 73 5-2-G 3 <br />ADDRESS:STATE 72 9,50 f-2-ble U S . »&54-M Av€.CITY - <br />-1 0-« 61/10€- <br />3*NIACT NAME:f #Ky/-14£U <604 y---PHONE NOT 2-3 719'97/- 6795-2 <br />UE-MAIL-ADDRESSED 9.6 441 ©_Oe,-6,196 g.,/.r,Q. ·(DOM <br />OFFICE USE ONLY:ACC OR SPC (CIRCLE ONE)HRS PER BLDG. FEE $Al/k <br />OCC. GROUP:RECEIPT#·_ ------P/C FEE PD $ ' <br />TYPE OF CONSTR:VALUATION: $i l_O i Ob SUBMITIAL DATE: - <br />FIRE SPKR: YES / NO A/C: YES / NO FLOOD ZONE:PROCE*Q-,l ,(1-' <br />RES. DEV. FEE: YES / NO PRIOR DWELLING UNIT: YES / NO COMMENTS: <br />PLANNING OKTO CHECK& DATE BLDG. DEPT. APPROVAL & DATE <br />PLNG CONDITIONS: <br />e £ A /1