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CITY OF SANTA ANA <br />BUILDING PERMIT APPLICATION WORKSHEET <br />PLEASE PRINT <br />PROJECT ADDRESS:j»L- 5. <br />USE OF BUILDING:RESIDENTIA <br />Sprite U -SUITE: <br />COMMERCIAL INDUSTRIAL OTHER <br />3/2/05:forms/Bldg.ADD.Worksheet <br />SAP\N# 0/7 96,/2- <br />MASTERID# <br />NATURE OF WORK: NEW ALTEFUT.1.DEMO REROOF REPAIR SIGN MISC <br />NFW/ADDITION/Al TFRATION- <br />1 ST FL..1667.64 sp BASEMENT: YES/NO SF NO. OF STORIES: t <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 ALTEFUT. I.:SF <br />JOB DESCRIPTION tnon-residentialprojects see reverse side of this application) :S.opAJ, pl) Ref-60 95-AL -1 11 MInct UNK t\J..uu \-</ <br />Ute /66 + L I <br />BUILDING OWNER'S NAME:PHONE NO:7(11/397-29(6U I tv\ Mt,3Apho a <br />ADDRESS:16 31 5. 59rle A.CITY:Soni An«STATE: ZIP:(4 ?0767 <br />TENANT'S NAME (Comm/Ind):PHONE NO35 3,¥Ul 548044 6 <br />CONTRACTOR'S NAME:STATE CONTR. #:LICENSE CLASS:PHONE NO:6</ Aoro Sor 830 45 /OLD ?51 -6-73 7733 <br />, <br />ADDRESS:39% 51 F>ed Gzk- 64· svi,4,,CITY: <br />1,Jilde #40 0- <br />STATE- ZIP: <br />6-A 735:15- <br />WORKERS COMP. POLICY#: <br />997 - 058 3301 <br />ARCHITECT/ENGINEER: <br />EXP. [)4TE:/ <br />t f <br />INSURANCE COMPANY: <br />Acte VU t-dr . <br />STATE LICENSE # <br />SANTA ANA BUS. LIC. #: <br />PHONE NO: <br />ADDRESS:CITY:STATE:ZIP: <br />CONTACT NAME:606 0-0 cA no A PHONE NO:15--7 -8/3-&¥65 <br />E-MAIL ADDRESS:b kor d m· A n /9 5 -19/-6 - 254Ac /00'71 <br />OFFICE USE ONLY:ACC OR SPC (CIRCLE ONE)HRS PER BLDG. FEE $ <br />OCC. GROUP:RECEIPT # ' C P/C FEE PD $ , <br />TYPE OF CONSTR:VALUATION: $15000 SUBMITTAL DATE:q ld' 9 <br />FIRE SPKR: YES / NO A/C: YES / NO FLOODZONE: . 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: