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CITY OF SANTA ANA <br />.U N j/- <br />BUILDING PERMIT APPLICATION WORKSHEET <br />PLEASE PRINT <br />PROJECT ADDRESS. 2*33 4 U ks- ;26//2.«@aL,/ 5/-SUITE: <br />USE OF BUILDING:@81152XL COMMERCIAL INDUSTRIAL OTHER <br />3/2/05:fonins/Bldq,App.Worksheet <br />SAPIN # <br />MASTERID# <br />NATURE OF WORK: NEW ADD ALTER/T. I.DEMO REROOF REPAIR SIGN <922.3 <br />NFW/ADDITION/Al TFRATION <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 ALTERIT. 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) :4 32169,6- /47»*WI <br />I N S 77*0 0 fLOOF- 170 9-- - '. · - 1 ·= 6 Kjd < A C <br />BUILDING OWNER'S NAME: -72605*dJ-A P J'>nat) - <br />ADDRESS:292-37 /Fr.3*/2-&6013 (1190,7 f*022 <br />PHONE NO: <br />999 3 7/ r g-yo <br />STATE:ZIP- <br />£* 4 6766 <br />TENANT'S NAME (Comm/Ind):PHONE NO: <br />CONTRACTOR'S NAME·STATE CONTR. #:LICENSE CLASS: <br />2 6547 g£>62.0 Y 93-3 Vt ? rk <br />ADDRESS:CITY:STATE:5/420 -,3>%67»944/92. 5- ..3»97 /«1 -51 ES'097 <br />WORKERS COMP. POLICY#:EXP. DATE:INSURANCE COMPANY:SANTA ANA BUS. LlC. #: <br />ARCHITECT/ENGINEER:STATE LICENSE #:PHONE NO: <br />ADDRESS:CITY:STATE-ZIP: <br />--C -156**6 NANE: .ift:#45;601//¢9 /42-se; 712=-- ---PHONE-Ne:-9 27 9- 970 -32- di-3 <br />4 E.*&*S™ESST- /070[/lo /2840£5 7'ME> 4>*9/2-- <br />OFFICE USE ONLY:ACC OR SPC (CIRCLE ONE)HRS PER BLDG. FEE $ <br />..OCC. GROUP:RECEIPT # P/C FEETYPE OF CONSTR:VALUATION: $DOD SUBMITTAL DATE <br />FIRE SPKR: YES / NO A/C: YES / NO FLOOD ZONE:PROCEC <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 />A tn \ 1 \143%