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CITY OF SANTA ANA <br />BUILDING PERMIT APPLICATION WORKSHEET <br />PLEASE PRINT 3/2/05 forms/Bldg.App.Worksheet <br />PROJECT ADDRESS: 253 14 ./. rbe{ 40-SUITE:SAPIN #10179973 <br />USE OF BUILDING: CRESIDENTIA COMMERCIAL INDUSTRIAL OTHER <br />.MASTERID# <br />NATURE OFWORK: NEW ADD q··X[72@ DEMO REROOF REPAIR SIGN MISC <br />NFW/ADDITION/Al TERATION. <br />1ST FL., SF BASEMENT: YES/NO SF NO. OF STORIES: <br />2ND FL.. SF PATIO/ENCE 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 (non-residential projects see reverse side ofthis application)': MOD·f -0044 540,r (payl.dS20 7.11·ek, 4,61 k .. <br />BUILDING OWNER'S NAME:PHONE NOl-ennY Tran 7/4 -623 -3/ q g <br />ADDRESS:CITY:STATE·ZIP. <br />-E-3 / 4 v. -3 r.1 6.P-54&61- A*a CA 1-276)»- <br />TENANT'S NAME (Comm/Ind):PHONE NO: <br />CONTRACTOR'S NAME:STATE CONTR. #:LICENSE CLASS:PHONE NO:5hl 6,1- /1<104 7 17£ Dll <br />ADDRESS CITY:STATE:ZIP <br />2 | GY 4/ Al'r. PL/ A| Jf *9 4/14 *Puff CA.9 2-miI- <br />WORKERS COMP. POLICY# <br />96,7344-704 <br />EXP. DATE: <br />9//1/3 <br />INSURANCE COMPANY <br />7.kri' 6£4 <br />SANTA ANA BUS. LlC. # <br />ARCHITECT/ENGINEER:STATE LICENSE #:PHONE NO <br />ADDRESS:CITY:STATE ZIP: <br />CONTACT NAME: RAN,1-1 Da tj PHONE NO: 714-924- 4764 <br />E-MAIL ADDRESS:44aiti @,Solort; N · Covi <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 OK TO CHECK & DATE BLDG. DEPT. APPROVAL & DATE <br />PLNG CONDITIONS: