02262024-6200 S. Anaheim Blvd., Suite 217
Anaheim, CA 92805
714) 765-5166 • fax (714) 765-4105
www.anaheim.net
Request for Public Records
Page 1 of1CityofAnaheim
Office of the City Clerk
STEP 1:COMPLETE all fields on this form. This form is to facilitate and expedite the processing of your public records request.
Describe identifiable records in the possession of the City; your request must be sufficiently focused and specific to
allow the City to locate the requested record(s).
STEP 2:SUBMIT completed form by mail, fax, email or in person to Custodian of Records, Office of the City Clerk,
200 S. Anaheim Blvd., Suite217, Anaheim, CA 92805; tbass@anaheim.net fax: (714) 765-4105
STEP 3:WAIT to receive a response from the City. The City shall determine within 10-days from receipt of a public records
request, whether the request, in whole or in part, seeks copies of discloseable public records in possession of the City
GC 7927.535(a)]. Please note that if you are requesting the opportunity to inspect records, you will be requested to
make an appointment to return at a later date/time to view the documents.
Charges for the direct cost of duplication will apply . Documents will not be copied until payment has been received. If
payment is not received within 20 days after invoice is sent, you may be required to submit a new request. Please see
backside for additional information.
REQUESTER INFORMATION
Full Name:Date:
Company Name:
Mailing) Address: City/State/Zip Code:
Phone number: Email:
Preferred method of contact in the event of questions:
Bahman Rohanizadeh 2/26/24 9:57 AM
Nova Group
92604
net949-
email
DESCRIPTION OF REQUESTED RECORD(S): (Describe the specific public record(s) e.g., date, type, time period covering documents requested etc)
Please provide information for 301 S. Anaheim Blvd as follows:
1). Original Building Permits and certificate of occupancies
2). Any hazardous materials related information from Anaheim Public Utilities and Anaheim Fire Department
Kindly provide the information via email.
I understand that I will be contacted once documents have been identified. If production of records is requested, an estimated cost will be
provided to me and I agree that I will be required to submit payment for duplication costs (and mailing) prior to the production of the
requested documents.
Please note that information contained in any PRA request is a public record and may be subject to public inspection pursuant to the
California Public Records Act.
I wish to inspect City records Will Pick-Up Records
Electronically Signed/Submitted 2/26/24 9:57 AM
SIGNATURE OF REQUESTER
X Please Mail