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CITY OF SANTA ANA <br />BUILDING PERMIT APPLICATION WORKSHEET <br />PLEASE PRINT .. 3/01/02 forms/Bldo.ADD.Worksheet <br />PRCUECT ADDRESS:O t)-1 On t hElt SUITE: | SAPIN #10 I flo 6(0 <br />USE OF BUILDING:RESIDENTIAL COMMERCIAL INDUSTRIAL OTHER <br />NATURE OF WORK: NEW ADD ALTEFVT.1.DEMO REROOF REPAIR ISIGN) - MISC <br />NFW/ADDITION/Al TFRATION <br />1ST FL SF <br />2ND FL SF <br />TOTAL OF OTHER FLS:SF <br />GARAGE/CARPORT:SF <br />BASEMENT: YES/NO SF NO. OF STORIES: <br />PATIO/ENCL PATIO:SF BLDG. HEIGHT: <br />RES. REMODEU SF PROPOSED USE: <br />ALTER/T.1..SF <br />JOB DESCRIPTION (non <br />*. -- 1 <br />I€ <br />me reverseside of this application) : <br />101 FqI fl.ifi <br />BUILDING OWNER'SNAME: JDAt,000 ,ARD,6 MI1,4 40<W PHIN 574 ' 7jaADDRESS:670 W 17# 9 04 c'-ry: 208 k 111244,STATE: 2,4 ZIP:?46 4 7 <br />TENANTS NAME (Comm/Ind):4 J g rn ohqy e PHONE NO: <br />CONTRACIAR'S NAME: <br />11 404 1 GAXI <br />ADDRESS:12 65 *A4NA4840 <br />1WfildOUCY#: <br />057 e<p- MEI:14 <br />ARCHITECT/ENGINEER: N /01 <br />STATE 7#'1'63 UCENSE CLASS:PHONE NO: ' <br />(45 7/4 693.61989 <br />CITY: QhA ¢'1 STATIA A ZIP:94 74 7 <br />IA PANY:SANTA ANA BUS. LlC. #: <br />STATE'LICENSE #:PHONE NO: <br />MmAVK¢01CE COA <br />ADDRESS:CITY:STATE:ZIP: <br />CONTACT NAME:PHONE NO: <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: PRIOR DWELLING UNIT: YES / NO ADJUSTMENTS: <br />PLANNING OK TO CHECK & DATE BLDG. DEPT. APPROVAL & DATE <br />PLNG CONDITIONS:rls«LA <br />ya L-1 L--l -»-1 <br />ential F