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D r CITY OF SANTA ANA <br />BUILDING PERMIT APPLICATION WORKSHEET <br />PLEASE PRINT 3/2/05:forms/Bldg.App.Worksheet <br />PROJECT ADDRESS: 0.141 E. Q.A··a_ Cl,1-r a- Are SUITE:SAPIN # [01 X Ktal <br />USE OF BUILDING:RESIDENTIAL COMMERCIAL INDUSTRIAL OTHER <br />MASTER ID# <br />NATURE OF WORK:NEW ADD ALTEFUT. I.DEMO REROOF REPAI --CER>MISC <br />NFW/ADDITION/Al TFRATION· <br />1ST FL.. <br />2ND FL.. <br />TOTAL OF OTHER FLS: <br />GARAGE/CARPORT: <br />SF BASEMENT: YES/NO <br />SF PATIO/ENCL. PATIO: <br />SF RES. REMODEL: <br />SF ALTERIT.I. <br />SF NO. OF STORIES: <br />SF BLDG. HEIGHT: <br />SF PROPOSED USE: <br />SF <br />JOB DESRIPTION (non-residential projects see reverse side of this appligation): InsU-1 \ Ll nel,3 roun ckrnaunl,e,k s igr.s , 1- rMonument 4 2. D drection.a.\ <br />BUILDING OWNER'S NAME PHONE NO:= Re,Aux,ok uc PAOW- 140·Wulon_e_ L.L. C--C.A4© 31 - 25©0 <br />ADbRaSS:CITY STATE ZIP:46%5 Ha.c AAe¢ CA-* SNe 906 Kja,br*+ flpack C e-q 146 0 <br />TENANT'S NAME (Comm/Ind):PHONE NO: <br />LU-lAude_ Apts <br />CONTRACTQR'S NAME:STATE CONTR. #:LICENSE CLASS:PHONE NO:©Le- 11 a.r EI 4*1110.\-con. 5 9 100 1 3,cl.45 (714 1 q64-0 RZ- <br />ADDRESS: <br />03 1 BEAn,stran-3 <br />WORKERS COMP. POLICY#: <br />9932591 <br />ARCHITECT/ENGINEER: <br />14,!le< Conse\*inci <br />Dv- <br />EXP. DATE: <br />6-4-14 <br />Erine€S <br />CITY:STATE:ZIP: <br />C.ofena_CA 91881 <br />INSURANCE COMPANY:SANTA ANA BUS. LIC. #: <br />AcoRD <br />STATE LICENSE #:PHONE NO: <br />503 146- 1150 <br />ADDRESS: <br />9576 5.u.gag-bof %14& Sk /DO <br />CONTACT NAME:fle™ L€Ln€/ <br />CITY©STATE: <br />r or#lan.k CA <br />PHONE NO: <br />ZIP: <br />97119 <br />E-MAIL ADDRESS:7/Cdze-95 relojecA.£-0- sk-cov <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: $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:n <br />PLANNING OK TO CHECK & DATE RI nG nEPT. APPROVAL & DATE <br />,PLNG CONDIIIONS: