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. Pr.iject Address: 't417 S Main St Unit: <br />Block: NA <br />Bldgl <br />Tract: 245 <br />Address Range: <br />Historic: No <br />Suite Range: <br />Zoning: CSM <br />q <br />Assessor'sParcel: 014-032-35 Lot 9 <br />-Owner: <br />Address: <br />Owner-Builder <br />Fee Type Amount <br />125 Volt Receptacle 1.40 <br />Light Switches, Occ. Se 1.52 <br />Light Fixtures 1 01 <br />Air Condilioner 93.28 <br />General Plan Update 21.25 <br />lssuance 52.98 <br />Qt-v <br />7.00 <br />3.00 <br />4.00 <br />'! .00 <br />1 .00 <br />1 .00 <br />Fos <br />$9.80 <br />$4.56 <br />$4.04 <br />$93.28 <br />$21.25 <br />$s2.98 <br />Phone: <br />Tenant Name: <br />01 1 16002 <br />01116002 <br />01116002 <br />01116002 <br />01 1 16002 <br />01116002 <br />51603 <br />51603 <br />51603 <br />51603 <br />51600 <br />s1603 <br />Phone <br />State Lic #: <br />Lic Type: <br />Bus. Lic #: <br />workers' Compensation lnsurance <br />Carrier: <br />Policy #: <br />Expires: <br />Building Use: <br />Job Type: <br />Nalure of Work <br />Planning Approval By <br />Plan Checked By: <br />Permit lssued By: <br />Subject to Field: <br />Building Permit #: <br />Commercial <br />Miscellaneous <br />Fixtures <br />B <br />VB <br />cEc 2016 <br />Occupancy: <br />Constr Type <br />Code:Notes <br />\u\ <br />Orozco, lvan '10t23t2017 Misc. Receipt: <br />Misc. Receipt: <br />Misc. Receipt: <br />Total <br />Hernandez, Kathy <br />Every pennit issued shall becoma invahd unless lhe wolr( oll lho s/le <br />authoized by such peinl is commonced wilhin180 days after its <br />issuance. or if the wo* authoized on tho sile by such peftnit is suspended <br />ot abandoned for a penod ol 1 80 days after the time lhe worl< is <br />commenced <br />10123t2017 <br />Account# <br />$185.91 <br />$0.00 <br />9185.91 <br />lnspector MID#: 20'17-139481 <br />o1 1 16002 51600 <br />01 1 16002 51603 <br />$21 25 <br />$ 1A4 66 <br />Fee Total: <br />Paid to Dale: <br />Balance Due <br />City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, cA 92702 Electrical <br />Permit Counter: (714) 647-5800 lnspection Requests: (714\ 667-2738 lnspeclor Section: (714) 647-5853 <br />Permit#:2lJ16/lJ2l) <br />Pin #: 61686 <br />Medhat Rafael <br />17150 Euclid St. #322 <br />Fountain Valley, CA 92708 <br />(7141337-O747 <br />South Main Dental Group <br />Contractorl <br />Address: <br />Date: <br />Date: <br />Date: <br />Planning Conditions: