Laserfiche WebLink
CITY OF SANTA ANA <br />BUILDING PERMIT APPLICATION WORKSHEET <br />PLEASE PRINT 3/2/05:forms/Bida.ADD.Worksheet\ <br />PROJECT ADDRESS: 4800 /114/# St SA CA-SUITE: 905-0 SAPIN #10)609 99 \ <br />USE OF BUILDING:RESIDENTIAL CCOMMERCIAL 3 <br />1 <br />INDUSTRIAL OTHER <br />MASTERID# <br />NATURE OF WORK: NEW ADD /-ALTER/-r.1. j DEMO REROOF REPAIR SIGN MISC <br />NEW/ADDITION/Al TFRATION· <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.:1 50 SF <br />JOB DESCRIPTION (non-residential projects see reverse side of this application): /97,1-4.-C /470-skf <br />BUILDING OWNER'S NAME:PHONE NO: <br />w est El E Lb <br />ADDRESS.00 /978/ M SP CITY 5-ANF AN A ;STATE: ZIP: <br />CA 92703- <br />TENANT'S NAME (Comm/Ind)PHONE NO:SU¥-AA 5€64 u fr <br />CONTRACTOR'S NAME:STATE CONTR. #:LICENSE CLASS:PHONE NO: <br />NAKA M UAA -llec mA w )/UQ 6&5-30 1 15 -S€ 2.-696 -/900 <br />ADDRESS:CITY:STATE:ZIP: <br />&520 ll) e U 5 Fokb rc SAA;+A Fe EfR / ME C.A 90670 <br />WORKERS COMP. POLICY#EXP. DATE:INSURANCE COMPANY:SANTA ANA BUS. LlC. # <br />CA /0000 49 1-3-/9 EveR- eff <br />ARCHITECT/ENGINEER:STATE LICENSE #PHONE NO. <br />ADDRESS:CITY:STATE:ZIP: <br />CONTACT NAME: /11 /Ke Ece MA AJ PHONE Not SEE- 674- /900 <br />E-MAIL ADDRESS: MI k€ € A/2 j K l /3KS · C 0 Fl,1 <br />OFFICE USE ONLY: <br />OCC. GROUP: <br />TYPE OF CONSTR: <br />FIRE SPKR: YES /NO <br />ACC ORNSPC (¢;IRCLE ONE)HRS PER <br />RECEIPT#-20\ € 9,0 <br />VALUATION: $1 12' (730 <br />A/C: YES/NO FLOOD ZONE:V <br />KA BLDG. FEE $ <br />P/C FEE PD $)9 1-6, <br />SUBMITTAL DATE:8-8 \4-1 <br />PROCESSED »--1._i . <br />RES. DEV. FEE: YES / NO PRIOR DWILLING UNIT : YES / NO COMMENTS: <br />PLANNING OKTO CHECK& DATE BLDG. DEPT. APPROVAL & DATE <br />PLNG CONDITIONS: