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city of Santa Ana 20 civic center Plaza (M-19), santa Ana, cA92702 Electrical Permit #: 2O17O4O9 <br />Pin #: 50,475Permit Counter: (714) 647-5800 lnspection Requests: (7'14) 667-2738 lnspector Section: (7'l4l647-5853 ftr <br />Project Address: 2035 N Poinsettia St Unit: <br />Block: NA <br />Bldg: <br />Tract: 1335 <br />Address Range <br />Historic. No <br />Suite Range <br />Zoning: R'lAssessor'sParcel 003-133-17 Lol 60 <br />Owner <br />Address <br />Justin Rosen <br />2035 Poinsettia St <br />Santa Ana, CA 927062921 <br />(714) 67s-9960 <br />01 I 16002 <br />01 1 16002 <br />0'1 1 16002 <br />01 1 16002 <br />01 1 16002 <br />01 1 16002 <br />01 1 'r 6002 <br />5160: <br />5160: <br />51604 <br />5160: <br />5160( <br />5160.. <br />5777C <br />Fee Typ€ Amount <br />125 Volt Receptacle 1 5'l <br />Light Switches, Occ. Se 164 <br />Light Fixtures 1.09 <br />Dedicated Circuit 25 76 <br />General Plan Update 22.95 <br />tssuance 5t 2l) <br />l\,licrofilm Records 3.91 <br />Qty <br />10.00 <br />8.00 <br />7.00 <br />1.00 <br />1.00 <br />1.00 <br />r.00 <br />Fee <br />$15 10 <br />$13.12 <br />$7.63 <br />$25.76 <br />$22 95 <br />$s7.20 <br />$3.91 <br />P hone <br />Tenant Name: <br />Contractor <br />Address: <br />Phone <br />state Lic #: 1021786, <br />Lic Type: B, A, C-8 <br />Bus. Lic #: 373199 <br />Workers' Compensalion lnsurance:Carrier: Slate Compen3antion ln3urance Fund <br />Policy #. 923493 <br />Expires: 0612A12020 <br />Building Use: <br />Job Type <br />Nature of Work <br />Single Family Dwellang <br />Addition <br />Additional / Remodel <br />Occupancy <br />Constr Type <br />Code: <br />R.3, U <br />VB <br />cEc 2016 <br />Planning Conditions <br />Planning Approval By: <br />Plan Checked By: <br />Permit lssued By: <br />Sub,ect to Field: <br />Building Permit #: <br />Zunrga, Allrssa <br />101101315 <br />Every pemtl issued shall bocome invalid unless the wo* on lhe s,,te <br />aulhonzed by such pefinl $ commenced w hn360 days aftot ls <br />issuance or I lhe work authonzec! on the sle by such pemtl ts suspenctec! <br />or abandoned fot a penod of360 days after lhe lme the wo* is <br />cofifienced. <br />$'145.67 <br />$0.00 <br />i145.67 <br />lnspector MID#: 2019-150995 <br />01 1 16002 51600 <br />01 1 16002 51603 <br />01116002 57770 <br />$22.95 <br />$118.81 <br />$3 91 <br />Fee Total <br />Paid to Datel <br />Balance Due <br />Kobolt Construclion <br />406 E. Commonwealth Ave. <br />Fullerton, CA 92832 <br />17171773-2873 <br />Noles Electricalforaddition/remodel <br />Dater <br />Dale: <br />Datel 12t17t2019 <br />Account# <br />Misc. Receipt: <br />Misc. Receipt: <br />Misc. Receipt: <br />Total