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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: 20,28 60 € Ct..u-64 0/r SUITE: <br />USE OF BUILDING:r-*aDENT'69 COMMERCIAL INDUSTRIAL OTHER <br />SAPIN # <br />MASTER ID# <br />NATURE OF WORK: ADD ALTER/T. I.DEMO REROOF REPAIR SIGN MISC <br />NFW/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.SF <br />JOB DESCRIPTION (non-residential projects see reverse side of this application) : <br />BUILDING OWNER'S NAME:Ohill(*vt< P .k-0.-w-7 / c-, 67 / r 44 0 .7PHONE NO: <br />ADDRESS*4-029 00 c CUUU€e Auc CITY.· 0 /9 A STATE: - - ZIP:07%.46/N Gti"<Cy[ \9 9109 <br />TENANT'S NAME (Comm/Ind):PHONE NO: <br />CONTRACTOR'S NAME:STATE CONTR. #:LICENSE CLASS:PHONE NO: <br />ADDRESS:CITY:STATE:ZIP: <br />WORKERS COMP. POLICY#:EXP. DATE:INSURANCE COMPANY:SANTA ANA BUS. LIC. #: <br />ARCHITECT/ENGINEER:STATE LICENSE #:PHONE NO: <br />ADDRESS:CITY:STATE:ZIP: <br />CONTACT NAME:/th Ill *1«- 21*!AA PHONE NO: 7 /4/ - r/ - 4/4/f-</ <br />E-MAIL ADDRESS:D W @lfwvt 3-06 ( (D Vo,6.00 e,rrn - <br />V <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: YES / NO PRIOR DWELLING UNIT: YES / NO COMMENTS: <br />PLANNING OK TO CHECK & DATE BLDG. DEPT. APPROVAL & DATE <br />PLNG CONDITIONS: <br />.