Laserfiche WebLink
CITY OF SANTA ANA <br />BUILDING PERMIT APPLICATION WORKSHEET <br />PLEASE PRINT <br />PROJECT ADDRESS:/// ..5 />0,£51€0/<BLVD.SUITE: <br />USE OF BUILDING. RESIDENTIAL gERCIALIZ> INDUSTRIAL OTHER <br />3/2/05:forms/Blda.App.Worksheet <br />SAPIN #10 1/7 £19663 <br />19/3-1/0691 <br />MASTERID# <br />NATURE OF WORK: NEW ADD ALTER/T.I.DEMO REROOF REPAIR CZEED MISC <br />NFW/ADDITION/Al TFRATION· <br />1 ST FL.SF BASEMENT: YES/NO SF NO. OF STORIES. <br />2ND FL..SF PATIO/ENCL. PATIO:SF BLDG. HEIGHT: <br />- TOTAL OF OTHER Fla SF RES. REMODEL: SF PROPOSED USE: <br />GARAGE/CARPORT:SF ALTER/T.I.: SF <br /> JOB DESCRIPTION (non-residential projects see reve,Be side of this application) : ·aQ©.0-3•"334,6£.006#29/ <br />BUILDING OWNER'S NAME: ,.H##06 6(kdAM-<17·Ic- Ault··i cvvf <br />ADDRESS:CITY:_54.5- ,£ ZegA ge #0267 YA,vAAe* 113\-D <br />TENANT'S NAME (Comm/Ind):C ..0.2*f.- <br />CONTRACTOR'S NAME·STATE CONTR. #i <br />.1%21/..52€0,0.44 87 0-91-0 <br />ADDRESS. CITY·62' U. 124:*,40 /0 er Id*9/vcr- <br />WORKERS COMP. POLICY#:EXP. DATE: /INSURANCE COMPANY: <br />/89,324-,14 .C ///lotl'5 f M£ ¥ 442 <br />ARCHITECT/ENGINEER:STATE LICENSE #: <br />ADDRESS:CITY <br />PHONE NO-7/ t,971-- 10)02*147 <br />STATE:ZIP22-801 <br />PHONE NO: <br />LICENSE CLASS PHONE NO: <br />04,5 1/t 1379 Loo <br />STATE. r /)Z\P: f.23£,5./ <br />SANTA ANA BUS. LIC. # <br />PHONE NQ: <br />STATE:ZIP: <br />CONTACT NAME:-r 6 0 Wo w A-£ D PHONE NO:(721) 14 2.-4702 <br />E-MAIL ADDRESS: <br />OFFICE USE ONLY:ACC OR SPC (CIRCLE ONE)HRS PER BLDG. FEE $ <br />OCC. GROUP:RECEIPT #PLC 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 &trhydmedPLNG CONDITIONS: