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CITY OF SANTAANA <br />BUILDING PERMIT APPLICATION WORKSHEET <br />PLEASE PRINI 3/2/05:forms/Bldg.App.Worksheet <br />PROJECT ADDRESS: 20 2 2 E / 7 9-4 g f-SUITE:SAPIN #joi/7991,3 1 <br />USEOFBUILDING:RESIDENTIAL COMMER*L-PINDUSTRIAL OTHER <br />MASTERID# <br />NATURE OF WORK: NEW ADD ALTEFUT. I.DEMO REROOF iREPAIR (*) MISC <br />NFW/ADDITION/Al-TERATION· <br />1ST FL..SF BASEMENT· YES/NO SF NO. OF STORIES: <br />2ND FL.. SF PATIO/ENCL. PATIO:SF BLDG. HEIGHT: <br />TOTAL OF OTHER FLS.- SF RES. REMODEL SF PROPOSED USE: <br />GARAGE/CARPORT:SF ALTER/T. I.: .SF <br />JOB DESCRIPTION mon-residential projects see reverse side of this application) :Brfs#a4 i er, 4 / raft <br />ef -(c«- U+ C(,Aimptu( U44*w. sILL€ , /5' T /.U 1 <br />BUILDING OWNER'S NAME:J CI ©*47 *1 4 PHQNE NO: <br />9/4 -54/-/2 00 <br />ADDRESS·CITY STATE ZIP:2 612 & . m.wlek -A€LU.4 5+Sh,q fc, 446 42?03- <br />TENANTS NAME (Comm/Ind):PHONE NO:14+twivo (/4 +1 46 144 e 'eM <br />U <br />CONIRACIOR'S.NAME:SIATE CONTR. #L LICENSE CLASS:eMONE NO: <br />C.6/c_ 99 U $59/ 39%2 95 7,4 -937 7199- <br />ADDRESS CIT*STATE:Z\P. 72-2 Lf 31 L 4 32_ /&-n«(gu,( 4vu 0*£66924 6,14 2*- <br />WORKERS COMP. POLICY#:EXP. DATE·INSURANC EY #,SANTA ANA BUS. LlC. #: <br />Swerof i °793 0 /6 C //9 KW(61 <br />ARCHITECT/ENGINE E t 6,* STATE LICENSE #:PHONE NO: <br />94#,e <br />ADDRESS:CITY:STATE:ZIP: <br />CONTACT NAME:Ohlls &00 2 ata PHONE NO:9/4-93£ + 05-0 9 <br />E-MAIL ADDRESS:6*nis © € -CriC.4 1 . Lawn <br />l <br />OFFICE USE ONLY:ACC OR SPC (CIRCLE ONE)HRS PER BLDG. FEE $ <br />OCC. GROUP:RECEIPT #P/C FEE PD $ <br />TYPE OF CONSTR:VALUATION: $SUBMITTAL DATE: <br />FIRE SPKR: YES /NO A/C: YES / NO FLOOD ZONE:PROCESSED <br />RES. DEV. FEE: YES/NO PRIOR DWELLING UNIT: YES / NO COMMENTS: <br />PLANNING OKTO CHECK& DATE BLDG. DEPT. APPROVAL & DATE (10712&»'23PLNGDONDITIONS <br />LLED--410 ¥y