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Planning & Bang Agency <br />Building Safety Division <br />20 Civic Center Plaza <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />www.santa-ana.org <br />• <br />MISCELLANEOUS <br />RECEIPT <br />PROJECT ADDRESS: ! �►�- Y' �� proSUITE # I U - / -` TJ <br />PAID BY: - �4 r frl i� (1• "J,Ij -S DATE: <br />Bldg — Plan Check # <br />Plmg — Plan Check # <br />Elect — Plan Check # <br />Mech — Plan Check # <br />Fire — Plan Check # <br />011-01-5401 $ <br />011-01-5402 $ <br />011-01-5403 $ <br />011-01-5405 $ <br />011-01-5401 $ <br />Bldg Permit — Trust/Special Inspection <br />011-01-5911 <br />$ <br />Plmg Permit — Trust/Special Inspection <br />011-01-5912 <br />$ <br />Elect Permit — Trust/Special Inspection <br />011-01-5913 <br />$ <br />Mech Permit — Trust/Special Inspection <br />011-01-5915 <br />$ <br />Fire Trust <br />011-01-5911 <br />$ <br />Acc Bldg P/C # 1-3 <br />h rs. �^ <br />011-01-5621-508 <br />$ <br />Acc PI mg P/C # <br />h rs. <br />011-01-5621-508 <br />$ <br />Acc Elect P/C # <br />h rs. <br />011-01-5621-508 <br />$ <br />Acc Mech P/C # <br />h rs. <br />011-01-5621-508 <br />$ <br />Boarding Fee <br />121-01-5579 <br />$ <br />Statement of Fact/Record Search <br />011-01-5911 <br />$ <br />Microfilming of Records $ <br />per <br />011-01-5911 <br />$ <br />SMIP - Category Val$ <br />089-01-3611 <br />$ <br />Xerox Copy <br />11-508-6311 <br />$ <br />Residential Development Fee - Specify District # <br />301-01-5070 — <br />$ <br />Temporary Certificate of Occupancy <br />011-01-5911 <br />$ <br />30 Day Temporary Fee — Gas <br />011-01-5912 <br />$ <br />30 Day Temporary Fee — Electrical <br />011-01-5913 <br />$ <br />Bond: Demo, 30-Day, Relocation, Sign <br />098-01-3611-507 <br />$ <br />TOTAL. <br />$ F 17 % r3 <br />NOTICE: Applications for plan checking issued under <br />the provisions of Section 107.4 of the California Building <br />Code will expire if no permits are issued within 180 days <br />Receipt <br />Prepared by: <br />f'D:1i28."2i�lE5ID:f;t1AFFE1 Lt1C: i.1 iH - , <br />1ja172 GCiCi1 00053ti57 1"2Z, 2005 a:'31A'11 <br />JRAi SACTION r0jAL: iv 4,;yj <br />Building <br />Building <br />Cy, <br />c HANU—E F <br />Misc. Receipt # 45506 <br />Validation <br />