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Planning & Bikng 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: <br />SUITE # <br />PAID BY: ChfN I fNn <br />DATE: <br />Bldg — Plan Check # <br />011-01-5401 <br />$ <br />Plmg — Plan Check <br />011-01-5402 <br />$ <br />Elect — Plan Check <br />011-01-5403 <br />$ r7, 5 <br />Mech — Plan Check # <br />011-01-5405 <br />$ <br />Fire — Plan Check # <br />011-01-5401 <br />$ <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 # <br />hrs. <br />011-01-5621-508 <br />$ <br />Acc Plmg P/C # <br />hrs. <br />011-01-5621-508 <br />$ <br />Acc Elect P/C # <br />hrs. <br />011-01-5621-508 <br />$ <br />Acc Mech P/C # <br />hrs. <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 />$ <br />TOTAL <br />$ <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 />C its of Santa Aria <br />PD: 1/24/OSIO:CKELLY <br />LOC: CTYH - Oni <br />CAST: <br />IN"45453 <br />0035 0006 <br />00088255 1/24/0 <br />11:41)An <br />TRANSACT10N <br />TOTAL: <br />�br175.1`, <br />Building <br />$438.13 <br />BuiIdins <br />$67.51 <br />Building <br />M.918 <br />Building <br />$41.76 <br />Misc. Receipt # 45453 Validation <br />