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REQUEST FOR,.FOUNDATION ONLY" PERMIT <br />PRoJEGTADDRESS: 2//6 6. 1,,/ 4*J <br />PLAN CHECK NO: /O //O /Z <br />I certify that I am the owner of the above property. I acknowledge that I am <br />requesting a "Foundation Only" permit from the Building Safety Division prior to the <br />completion of the full plancheck process. I acknowledge that the issuance of a <br />"foundation onlt' permit does not imply approval of any building components or the <br />complete project. ln requesting a loundation onlf permit, lwaive the right to claim <br />a right of approval of any building components or the complete project as a result of <br />the issuance of a foundation only' permit. <br />I acknowledge and accept that I am solely responsible for any changes to the plan <br />or foundation which may be required subsequent to a complete plancheck. ln <br />requesting this loundation onlt' permit, I waive any right to file a claim and/or <br />action against the City of Santa Ana ('City'') and/or its employees alleging the City <br />and/or its employees be held responsible for any costs or liability incuned because <br />of the issuance of this permit or any changes required subsequent to a complete <br />plancheck. <br />I further acknowledge and understand that this request for a 'foundation only" <br />permit is made exclusively to the Building Safety Division- I acknowledge and <br />understand that it is my sole responsibility to seek and acquire any additional <br />required permits and/or approvals for this project from other applicable goveming <br />agencies and/or City departments. <br />Subscribed to this Z {day of or-A &.r 20/ <br />Owne/s Sign re <br />HO15A: 1l-2SB <br />Owner's Address €o -TA- <br />Gl/ 4oe <br />Print Owner's Nan{e <br />lJo t s/"4 s/, t.il zaa <br />Form to be attached to Bulldlng Plans.