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City of Santa Ana 20 Crvic Center Plaza (M-19), Santa Ana cA92702 Electrical Permit #: 20169704 <br />Pin #: 26777Permit Counter: (714) 647-5800 lnspection Requests (714) 667-2738 lnspector Sectionr (714) 647-5853 <br />Project Address: 210 E Sixteenth St unrt 3 Bldg: Address Range: 208-210 <br />Tract: GOODWIN'S ADD Historic: No <br />Suite Range: <br />Zoning: SP3Assessor'sParcel 398-125-02 Lot POR 1 & POR 2 Block D <br />Owner: <br />Address <br />Mercy Houae <br />P.O. Bor '1905 <br />Santa Ana, CA 927021905 <br />(714) 836-7188 <br />01 1 16002 5160: <br />01116002 51603 <br />01 1 16002 5160t <br />01 1 't 6002 5160: <br />Fee Type <br />FWU <br />Min Fee Adj <br />General Plan Update <br />lssuance <br />Amount <br />25.76 <br />50 50 <br />22 95 <br />57 .20 <br />Qly <br />1.00 <br />'t.00 <br />1.00 <br />1.00 <br />Fee <br />$25.76 <br />$s0 50 <br />$22.95 <br />$57.20 <br />Phone <br />Tenant Name: <br />Conlraclor <br />Address <br />AllenJoy lnc dba Groenleaf I <br />6727 S Greenleaf Ave <br />Whinier, CA 90601 <br />(562) 698-0201 Bot.:h+ <br />(lf f ice <br />Rcpt+: <br />Tronso <br />3 i2tl60: (:TYH <br />I / t7 / 2ttt9 <br />Irons+ t 17 <br />tiel i :- I / 17 /2(t19 <br />iD: NGAR(:IAto{ <br />2t <br />1i <br />3( <br />r1697t| 4 <br />State Lic #: 975600 <br />Lic Type: C-20 <br />Bus Lic #: 347009 <br />Workers' Compensatlon lnsurance: <br />Carrier: Security National <br />Policy A: SWC12/19562 <br />Expires: 0llOgl2O2O <br />0:l 750 <br />ct ion <br />2:35 F'fl <br />fotol <br />dbo 6reenlecl <br />1 <br />ll r enJo!Heo <br />uenetql <br />ll1 l16rru, <br />up00De Fee <br />ar|,lifl'rll- <br />Electr ico I <br />(1116(rtr2_ <br />ICL Che,:lr <br />l.liu-tl-l- <br />t|42r:163 <br />Building Use: <br />Job Type: <br />Nature of Work <br />Fourpler <br />Miacellaneoua <br />FWU <br />R-1 <br />VB <br />cEc 20't6 Notes: changeout arc <br />Planning Conditions <br />Planning Approval By: <br />Plan Checked By <br />Permit lssued By: <br />Subjecl lo Field: <br />Building Permit #: <br />Guevara, Jerry 09t17t2019 Misc. Receipt: <br />Misc. Receipt: <br />Misc. Receipt: <br />_ Total <br />Hernandez, Kathy o911712019 <br />Account# <br />Every pemit Bsuod sholl becomo invalicl unless the wotk on lhe site <br />authgized by such pem B commoncad withn360dgys after its <br />Bsuance or if lhe work authonzecl on the s e by such permit is suspondod <br />ot abandonad lor a ponod o1360 days aftet lhe hfie the wo* ts <br />comnolracd <br />$156.41 <br />$0.00 <br />9156.41 <br />lnspector MID#: 20'19-'154446 <br />01 1 16002 51600 <br />01 1'16002 51603 <br />$22 95 <br />$133.46 <br />Fee Totat <br />Paid lo Date: <br />Ealance Due: <br />I )8 <br />Phone: <br />t22.9: <br />t133.4r <br />$J98. 4:Occupancy. <br />Constr Type <br />Code. <br />Date <br />Date: <br />Date