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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: 6 (F ff) A V-1-1-6 43 -SUITE:SAP\N# to | 90/2? <br />USE OF BUILDING:RESIDENTIAL COMMERCIAL INDUSTRIAL OTHER <br />59) 0 MASTERID# <br />NATURE OF WORK: NEW ALTER/T. I. DEMO· REROOF REPAIR SIGN MISC <br />NFW/ADDITION/ALTERATION <br />1ST FL.. <br />2ND FL.. <br />TOTAL OF OTHER Fla <br />GARAGE/CARPORT: <br />108 DESCRIPT <br />SF BASEMENT: YES/NO <br />SF PATIO/ENCL. PATIO: <br />SF RES. REMODEL: <br />SF ALTER/T I. <br />SF <br />SF <br />SF <br />SF <br />*2REUk-4 c i 7 -:rk.7 0-«ug·,2dental pfojects see reverse side oftbis applicati <br />NO. OF STORIES: <br />BLDG. HEIGHT: <br />PROPOSED USE: <br />21··41431,57-M <br />000 ,/DU <br />BUILDING OWNER'S NAME93 2 - r6 932145 71 4*6Ll ,-1 (3-3PHONE NOAd <br />ADDRESS:6 9% #*tollf dRUW+te A em 52?01 <br />TENANT'S NAME (Comm/Ind):PHONE NO: <br />CONTRACTOR'S NAME: - , <--3 STATE CONIR #1 - /LICENSE CLASS:2339%3rltfUb r 3©6621 3 [.5999 er 0.-lib <br />ADDRES 949- 62*:asou Clgil,f i-Z¥·-2©-7-72_ STATE*71-ZIP.01.9((9.-- <br />g3100011 031 8 jEg3§32-f 6(2£9.-8 /4·1« . <br />S COMP. POLICY 'INSURANCE COMRADIY,1 SANTA ANA BUS. LlC. # <br />ARCHITECT/ENGINEER:STATE LICENSE #-PHONE NO: <br />ADDRESS:CITY:STATE:ZIP: <br />CONTACT'NAMGge? 4%0 6(3412 4(2«PHONE No:9967-2« f·23 * 60 20 <br />E-MAIL ADDRESS:-i/a*14 0 +\50 €00)4£ codo <br />OFFICE USE ONLY:ACC OR SPC (CIRCLE ONF)HRS PER BLDG. FEE $ <br />OCC. GROUP RECEIPT #:P/C FEE PD $ <br />TYPE OF CONSTR:VALUATION: $20'.aed>SUBMITTAL DATE:0/'2443 <br />1 , <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 <br />PLNG CONDITIONS <br />f