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CITY OF SANTA ANA <br />BUILDING PERMIT APPLICATION WORKSHEET <br />PLEASE PRINT 3/2/05:forms/Blda.App.Worksheet <br />PROJECT ADDRESS: 10 HH FAI2.8,2-ook. 1-0 SUITE: 'SAPIN #/0/ 79589- <br />USE OF BUILDING:<EMEENTIi>COMMERCIAL INDUSTRIAL OTHER <br />MASTER ID# <br />NATURE OF WORK: NEW ADD ALTER/T.I.DEMO REROOF REPAIR SIGN MISC <br />NEW/ADDITIO;N/ALTERATION· <br />1STIL.. - - <br />2ND FL.. <br />TOTAL OF OTHER Fla <br />GARAGE/CARPORT <br />ST BASEMENT.: YES/NO <br />SF PATIO/ENCI. PATIO <br />SF RES. REMODEL: <br />SF ALTER/T.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): 7, 64 kw 1)V 90\.v *6*Lute <br />f 0 2 ,v,.0 ..4 9 v 6 - \'/'l-£ g \25A 34 4.-e· J..A 24 r 34 V-i / Y-O 711 V€ r kisI I <br />1 <br />BUILDING OWNER'S NAME:PHONE NO·OGISES &A,Jiv A 2.vt€('719) 5 42 -5948 <br />ADDRESS:CITY:STATE:ZIP· <br />iD 4.4 foi. 6-ook- Ln 544, Ab (4 4270(9 <br />TENANT'S NAME (Comm/Ind)PHONE NO: <br />CONTRACTOR'S NAME:STATE CONTR. #:LICENSE CLASS:PHONE NO: <br />(a 1 1 4 rviRA 501•r iysk.-5 1 z_© 1 6 40 /6 goo- 32-4- 1¥+B <br />ADDRESS:CITY:STATE:ZIP: <br />1 X 11 E. DI'-A•,c ·lil'0 r?,4 3-1-e. p 1:41\Ulpn (4 928'6 1 <br />WORKERS COMP. POLICY#: <br />32lev 898 <br />EXP. DATE: <br />CA/31-130-) 4 <br />INSURANCE COMPANY: <br />6'fatuk >11/ t<= <br />SANTA ANA BUS. LlC. #: <br />ARCHITECT/ENGINEER:STATE LICENSE #:PHONE NO· <br />ADDRESS:CITY:STATE ZIP: <br />CONTACT NAME: -6·1<f- vleiv.PHONE NO: (31 1 4) - 451 - 5-384 <br />E-MAIL.ADDRESS: 92„. 2...ev.r?Ma (f) 82-64 -fol-,42. £.o.v· <br />D <br />OFFICE USE ONLY:ACC OR SPC (CIRCLE ONE)HRS PER <br />OCC. GROUP:RECEJPT #AJ IA <br />BLDG. FEE $ / <br />P/C FEE PD $0 <br />TYPE OF CONSTR VALUATION: $ M 600 SUBMITTAL DATE: <br />FIRESPKR: YESi/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: