Laserfiche WebLink
CITY OF SANTA ANA <br />BUILDING PERMIT APPLICATION WORKSHEET <br />PLEASE PRINT <br />PROJECT ADDRESS:moo 6- f-1+4 sk 12< A SUITE: 4 <br />USE OF BUILDING:RESIDENTIAL MERCIA INDUSTRIAL OTHER <br />3/2/05:forms/Bldg.App.Worksheet <br />SAPIN # <br />MASTER ID# <br />NATURE OF WORK:NEW ADD ALTEFUT. 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 ALTENT. I.:SF <br />JOB DESCRIPTION (non-residential projects see reverse side of this application) : <br />BUILDING OWNER'S NAME: 2 PHONE NO: <br />1»CAL /2 L (6,4,+Lic, 2&206* v.,4 9-*f 2SD- 3313 <br />ADDRESS:CITY: <br />TENANT'S NAME (Comm/Ind): - , j27•0-2 4via 32,3 u,00,0.,ce <br />CONTRACTOR'S NAME: r.STATE CONTR. #:Ell:S Sts.) 5 -7 22-7 GE <br />ADDRESS:CITY:-SY 20 •3 . &02 8-4 Ec Mou te <br />WORKERS COMP. POLICY#:INSURANCE COMPANY: <br />9010(39-13>*Fi /,4 glitz 20*-29. <br />STATE:ZIP: <br />PHONE NO <br />7/9 393 -3913 <br />LICENSE CLASS:PHONE NO: <br />C- Cfr 'AG X71-400 1 <br />STATE:ziP <br />24 4/131 <br />SANTA ANA BUS. LlC. #: <br />ARCHITECT/ENGINEER:STATE LICENSE #:PHONE NO <br />ADDRESS:CITY:STATE:ZIP: <br />CONTACT NAME:«4,0 ¥L,Ze,PHONE NO: 6 26 7-7 9-12:70 f <br />E-MAIL ADDRESS:GUS »ta-4 2 B Sk 960*41-, A.34 <br />OFFICE USE ONLY:ACC OR SPC (CIRCLE ONE)HRS PER <br />OCC. GROUP:RECEIPT#: <br />TYPE OF CONSTR:VALUATION: $ <br />FIRE SPKR: YES / NO A/C: YES / NO FLOOD ZONE: <br />RES. DEV. FEE: YES / NO PRIOR DWELLING UNIT: YES / NO COMMENTS <br />PLANNING OK TO CHECK & DATE <br />PLNG CONDITIONS: <br />BLDG. FEE $ <br />P/C FEE PD $ <br />SUBMITTAL DATE: <br />PROCESSED <br />p- 1 1 »2120\\\-1 <br />BLDG. DEPT. APPROVAL & DATE <br />f