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Today's Date:
Permit Application F300N Flower Btreat
Santa Ana, CA 92703
....... __ ® 714,667,8888
County of Orange
—. , A714.667.8885
❑ RESIDENTIAL (R$)
❑ NON-RESIDENTIAL(NR)
❑ GRADING (Preliminary) (GA)
❑ GRADING (Precise) (GB)
❑ LANDSCAPING (LS)
❑ RESIDENTIAL TRACT(RT)"
❑ FENCE, WALL, RETAINING WALL (RW)
"(Separate attachment required for multiple submittal)
Address of Project:
Address
Permit #:
❑
PLUMBING (PH)
❑
MECHANICAL (ME)
❑
ELECTRICAL(EL)
❑
SWIMMING POOL/SPA(SW)
❑
SOLAR (SL)
❑
DEMOLITION (DM)
❑
SIGN (SB)
❑
OTHER
INFORMATION
City
Legal Description: LIt 7\$ TQ/Ct, \j'tj L(.( Assessors Parcel Number(APN):
Location of Site (Decimal Degrees): /
La and Longitude E 01 33687 / 117786
Latitude Longitude
Project Description: _V_IeL� \000 t. ,,,SyAA
STRUCTURE SIZE:
GARAGE SIZE SQUARE FEET:
Current Related Permits:
-or 1^floor 2^ floor
SITE ACREAGE:
Zip
,s _•�—*-.. ==Mmw wv <.''°*`k CONTACT INFORMA_
Owner Name: (N S)O.Fe.r Phone Number. C74v 631-5'933
Owner Address: 'L5'0 C31�r r'LR cS�, ft -Lou Ca.«sTR ✓ 1254 CA 26-L6
Address City
Contractor. CoEC 9,—k>Lp Zip
License #: 3 feoS$ y
Address: '�$�/ Mf)ILr-Atea4 'Qr A4TPh00"'Ih 1 ciy.cr66N b`/✓ S
\ one Number:
'.. "ontact Person: rC..(�Jhya�oh
�r ��""q� Affiliation: Y}efr�C 1 (1t,CNwt�
Phone Number: / y 7 $. �/� 8 Fax: 5� y e3/ s 533 Email: r'rb i d hV1.X�✓(G /
14
ARCHITECT4@ne5-V6(✓ —��' ��c t/--
License
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OC PUSUC WORKS/ OC PLANNING 130o N. Flower Street, Sank Ana, CA9a7o31 PERMITAPPLIUTIGN I PAGE t
P(AaWUNTY OF ORANGE I OC PUBLIC WORKS I OC PLANNING pow -A
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ENGINEER: 0IRPM y2�< l city. Phone#
Name License# S[reet#
r��
SOILS ENGINEER: / 56/city Phoneo
Applicable to Grading Permits ONLY
ENGINEERING GEOLOGIST: sueet# — / City Phone#
Name License#
CUBIC YARDAGE: CUT:
FILL: _� EXPORT:
PROJECT ACREAGE: WATER DISCHARGE I.D. NUMBER(WDID): _
TOTAL SITE ACREAGE: — DISTURBED SITE ACREAGE:
Applicable to Sigma,_ Permits ONLY:
TENANT/BUSINESS NAME: _— _ _ — — — — — — —
OCCUPANCY PERMIT NUMBER:
SIGNAGE DETAIL: ❑ Wall Sign ❑ Freestanding ❑ Single Face ❑ Double Face ❑ Illuminated ❑ Non -Illuminated
Height: Length:
Sq Ft: Ground Clearance:
ADDITIONAL INFORMATION (i.e. Sign Copy) :
DECLARATION:
DECLARATION:
I declare that the foregoing is [rue and correct to the bes f my knowledge and that all easements and right of way areas are shown.
I understand that a%n,Incorrect answer will cans ay to inspe n approval and issuance of astop-work order.
�>N' / Vdf9N8oh G Date
Print Name Signature
r STAFF USE ONLY Y
❑OTC �LANCtB�E.CK PLANNING APPLICATION ❑PCRA ❑F. C
SETBACKS
ZONING: tw" • Coa6r' �GP XCoasml
APN#: ❑Flood Plain
LEGAL: �s346 �S TQ
PA/CP: ❑ Required
PLANNER'S NAME:
Apo ara
ACTUAL
FRONT
al
SIDE (R)
qqT
-f
SIDE(L)
/
REAR
S
REQUIRED:
OC PUBLIC WORKSIOC PLANNING DPP N. Flower Sueeq Santa Ana, CA 917031 PERMIT APPLIUTION I PAGE z