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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:JUU 6 135 66 <br />USE OF BUILDING:,RESIMERFIAL COM| <br />L j <br />SUITE:SAP\N# 10($5 // ltv-4 2-0 161 -/13%.22.9VIERCIALINDUSTRIALOTHER <br />MASTERID# <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 ALTER/T.1.SF <br />JOB DESCRIPTION (non-residential projects see reverse side of this application) :1-3-,c 0604 "ouln-4 cAk,Dix:rino\4€46 0004- raD UP'Z€- , <br />* (6 i -1-08 <br />BUILDING OWNER'S NAME: -.t ./n L PHONE NO: <br />6 1\ vi 60 N C vt 1 714-750 <br />ADDRESS:CITY:STATE:2-+16 Bo\olo_- lia €.wek Ana,CA <br />-3-2-4 1 <br />ZIPlu1O6 <br />TENANT'S NAME (Comm/Ind):PHONE NO:hld» <br />CON-tRACTOR'S NAME:STATE CONTR. #:LICENSE CLASS:PHONE NO: <br />9 vn Sees Gruup &(AC 9-1)51, C 9 , Clt 6 <br />ADDRESS:CITY:STATE:ZIP: <br />4st W Ld v.,ber-6 12£,t <502.(-1-rE? V c-(A 9171 1 <br />WORKERS COMP. POLICY#: 44 !7PI£\Oul-906\EXP. DATE: - <br />0 \ /10»\ f 15 <br />INSURANCE COMPANY:SANTA ANA BUS. LlC. #: <br />5tntD Nout, L ),AS-JVB,U--· <br />ARCHITECT/ENGINEER:STATE LICENSE #:PHONE NO: <br />4100\ Er,c:jip"Lvi070 (17490 1 t v -6 37 b -6 La-D <br />ADDRESS:CITY:STATE:ZIP: <br />11-0 i w · 081192 At,2-·All,A,141- 1»05 ¥L+0 -1 <br />CONTACT.'NAME:ir 0 1,1 010#44 63,«PHONE NO:626 -310 +S'126 <br />.D <br />E-MAIL ADDRESS:'14·ACIA!' GtVI/efocet,g{0.4/. GOV"L <br />v0 <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: $(U,lb'D SUBMITTAL DATE:4lkillq <br />FIRE SPKR: YES / NO A/C: YES/NO FLOOD ZONE: ,/<PROCESSED 2>.21-- <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: