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CITY OF SANTA ANA <br />BUILDING PERMIT APPLICATION WORKSHEET <br />PLEASE PRINT 3/2/05.forms/.Bldg.ADD.Worksheet <br />PROJECT ,ADDRESS: 2610 0 Grful boller St SUITE:SAPIN fte #5665 03 1 <br />USE OFBUILDING:NllAL COMMERCIAL INDUSTRIAL OTHER <br />MASTERID# <br />NATURE OF WORK ALTER/El.DEMO REROOF REPAIR SIGN MISC <br />NFW/ADDITION/ALTERATION: <br />1ST FL.. <br />2ND FL.. <br />TOTAL OF OTHER FLS: <br />GARAGE/CARPORT <br />SF 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) : S,2-X 2.501,u 02,>o .#LUSLAr.*eu , Bals. + t.,)662 0-6 A ,·14.kn- SlhA/\ u./ 90,1€ f3 capgotoo <br />BUILDING OWNER'S NAME·K/la,u\ U el 4 Ch avc,-2, <br />ADDRESS:CIA( <br />4 1-610 1\J (Dpre<*levit.r 9%:34,07-601 4,2 <br />PHONE NO· <br />7/4 - <br />STATE: <br />044 <br />asT- 614 2 <br />ZIP: <br />92706 <br />TENANT'S NAME (Comm/Ind.1.PHONENO: <br />CONTRACTOR'S NAME:STATE CONTR. #:LICENSE CLASS:PHONE NO:€ v w K 72·0 y Group 1 110 97059 /8, 0.2 6 <br />ADDRESS·CITY STATE:ZIPR .2/ F 2/1413 { lu L/(krvt-e/t ¥201 grE..1-{ 1, 1%,204. <br />WORKERS COMP. POLICY#:EXP. DATE.INSURANCE COMPANY:SANTA ANA BUS. LlC. #: <br />*Ut)5364 -23 O-2-/ / o //9 1**11¢/tiNgwaL LOAfevag;t,U9' Pt/viA <br />ARCHITECT/ENGINEER:STATE LICENSE #:PHONE NO·<bb i e 721 1 nee-Ana 067 G st 7k*636 - G t/6/ <br />ADDRESS:STATE:ZIP:Ila, i U -1175-biA Auu ' CA 9,2-©(57 <br />CONTACT NAME: TE*U·Wuxvx C/IAA.4 PHONE NO:0-6 -390- 6% 26 <br />E-MAIL ADDRESS:' okv (90 -41/(/.6 #PL>Le·€«Sa la c..0 »0'1 <br />UU <br />CITY: <br />65% ta FVT€ 9 <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: $ e·2 00-0 SUBMIT-[AL DATE: 14 9 <br />FIRE SPKR: YES / NO A/C: YES/NO FLOOD ZONE:X PROCESSED DC_.- <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: