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Project Address: 2200 N Grand Ave <br />Assessor'sParcel; 396-191-02 Lot POR G.L. RUSSE <br />Bldg: Address Range: <br />Tract: A.B. CHAPirAl,l Historic: No <br />Unit: <br />Block: A <br />Suite Range: <br />Zoning: C5 <br />city of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA127O2 Plumbing <br />Permit Counter: C/14) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 <i"\ <br />Owner: <br />Address <br />Contraclor: <br />Address: <br />Tenant Name: <br />Zos H Rozar <br />3810 E Coast HYvy, Sulte 2 <br />Corona Dol Mar, CA 92625 <br />(949) 723-1075 <br />JLC Assoclates lnc. <br />3198-A Alrport Loop Orlve <br />Costa Mesa, cA 92526 <br />(7141 2414430 <br />0't 1 <br />011 <br />011 <br />011 <br />011 <br />01 t <br />0't 1 <br />01 1 <br />0't 1 <br />01 1 <br />16002 <br />16002 <br />16002 <br />16002 <br />16002 <br />16002 <br />16002 <br />16002 <br />'16002 <br />16002 <br />51602 <br />51602 <br />51602 <br />51602 <br />51602 <br />51602 <br />51602 <br />53602 <br />51600 <br />51602 <br />Amount <br />14.22 <br />'10.87 <br />12.70 <br />10.66 <br />'16.14 <br />44.51 <br />44.51 <br />0.65 <br />22.O8 <br />55.04 <br />Qty <br />8.00 <br />3.00 <br />10.00 <br />1.00 <br />3.00 <br />1.00 <br />'l.00 <br />421.47 <br />L00 <br />1.00 <br />Fee <br />$113.76 <br />$32.61 <br />$ 127.00 <br />$'10.66 <br />$48.42 <br />$44.51 <br />$44.5'l <br />$273.96 <br />$22.08 <br />$55.04 <br />Fee Type <br />Water Closet <br />Urinal <br />Sink <br />Garbage Disp <br />Floor Drain <br />Sewer Alter/Repair <br />Alter OrainNent <br />?tc - 650/0 <br />General Plan Update <br />lssuance <br />State Lic #: 645576 <br />Lic Type: B <br />Bus. Lic #: 0177048 <br />Workers' Compensation lnsurance: <br />Carrier. Everost National lnsurance Company <br />Policy #: 7600015914 <br />Expires: 0'110112019 <br />Building Use: <br />Job Type: <br />Nature of Work <br />Commsrcial <br />Tonanl lmprovsment <br />TI <br />Occupancy: <br />Constr Type <br />Code: <br />B <br />III B, SPK <br />cPc 2016 <br />Notes <br />Planning Conditlons: lnterior tenant lmprovement <br />Planning Approval By: <br />Plan Checked By: <br />Permit lssued By: <br />Subjecl to Field: <br />CSG Consultants <br />Amsden, Julie <br />Buildins Permit #: 101 9641 1 <br />Ewry ponnit issued shall become invalid unless tho worr( on fhe s,le <br />authoized by such pomit is comnpnctd within 180 days aftet its <br />issuance, or il tho wod< authonzed on tho site by such petnit is suspended <br />ot ebandoned lor a peiod ol 1 80 days altet the time the work is <br />cgrnmor,@d. <br />lnspector MID#: 2018-143316 <br />Date: <br />Date: 06/25r20'lE <br />Date: 071021201E <br />Account# <br />Misc. Receipt: 71127 <br />Misc. Recaipt: <br />Misc. Receipl: <br />Total <br />01 1 16002 51600 <br />011 16002 51602 <br />522 08 <br />$458.86 <br />Fee Total: <br />Paid to Date: <br />Balance Due: <br />$772.55 <br />$291.61 <br />t480.94 <br />Permit #: 3O139577 <br />Pin #: 79{OO <br />Phone <br />Phone