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City of Santa Ana <br />Permit Counter: (714\ 647-5800 <br />20 Civic Center Plaza (M-19), Santa Ana, CA92702 <br />lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 <br />Mechanical Permit #: 40332890 <br />Pin #: 6{30il <br />Project Address: 1920 E Seventeenth St <br />Assessor'sParcel: 400-011-03 Lot: 3 <br />Bldg: <br />Tract 6313 <br />Address Range: <br />Historic: No <br />Suite Range: <br />Zoning: C5 <br />Owner: <br />Address: <br />Contractor <br />Address: <br />Alex G Gladkov Dental Corp <br />6818 S La Cienega Blvd #203 <br />lnglewood, CA 90302 <br />Fee Type <br />01116002 5160{ Bathroom Fan <br />0'l'116002 51604 Min Fee Adj <br />01116002 5160C General Plan Update <br />01 1 16002 51604 lssuance <br />Amount <br />30.52 <br />12.34 <br />22.O8 <br />55.04 <br />- rl/19/2tl9, IDz <br />FronB+:106 <br />Ref+: 4tJ,' - l1lr9l?01s itrtol li- tt <br />Qty <br />2.00 <br />'1.00 <br />1.00 <br />1.00 <br />Fee <br />$61.04 <br />$ 12.34 <br />$22.08 <br />$s5.04 <br />Phone: <br />Tenant Name: Orthodontic Center of Orange County <br />VCD&SONSINC <br />526 S Ross Street <br />Santa Ana, CA 9270'l <br />(714) 80r-7604Phone <br />State Lic #: 596135 <br />Lic Type: B <br />Bus. Lic #: 3442 <br />Workers' Compensation lnsurance:Cafiier State Compensation lnsurance Fund <br />Policy #: 1877843 <br />Expires: 1110112019 <br />pdate Fee <br />,00l]O- <br />04rr00- <br />r*rx6939 <br />Occupancy: <br />Constr Type: <br />Code: <br />Commercial <br />Tenant lmprovement <br />TI <br />Notes <br />Plannang Approval By: <br />Plan Checked By: <br />Permit lssued By: Zuniga, Allissa <br />Subject to Field: <br />Buildins Permit #: 10396696 <br />1111912018 <br />Account# <br />Legalize unpermitted work - new partition walls to <br />creale dental rooms, xray, office; (2) new restrooms; <br />new exterior door; demo patio cover. <br />$150.50 <br />$0.00 <br />$1s0.50 <br />Oate: <br />Mr late: <br />l\ Dale:l\ <br />Misc. Receipt: <br />Misc. Receipt: <br />Misc. Receipt: <br />Total <br />$22.08 <br />$128.42Every pemit issued shall become invalid unless the wg* on the site <br />authoized by such permit is commenced within 180 days dfter its <br />issuance, or if the wod< authotized on the site by such permit is suspended <br />or abandoned tot a peiod ot 1 80 days aftet the timo the wotk is <br />commenced. <br />lnspector MID#: 2018-143892 <br />01116002 51600 <br />01116002 51604 <br />Fee Total <br />Paid to Date: <br />Balance Due: <br />unt: 120 <br />Block: NA <br />Building Use: <br />Job Type: <br />Nature of Work: <br />B <br />VB <br />cMc 2016 <br />Planning Conditions: