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Planning & Bong 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 />MISCELLANEOUS <br />RECEIPT <br />PROJECT ADDRESS: j,�,C) `,� �',(q �Q� _ _ SUITE # <br />PAID BY: A 1n f-M a h 0 Y1-7_(721 _ 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 />$ <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 PI mg P/C # <br />hrs. <br />011-01-5621-508 <br />$ <br />Acc Elect PIC # <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 $ 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 />$ q �' <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 />l i t•5 o+ Santa Anti <br />PD: 1/26/Ij5IDZUELLY LOC: (:TYH - 001 <br />GUST: IHV:45485 <br />0070 00u l (10088503 1/26/05 12:53F 11 <br />TRANSACTION TOTAL: $295.55 <br />Building $295.55 <br />CA $300.00 <br />CHANGE <br />Misc. Receipt # 45485 Validation <br />