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Planning & Aing 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 />0 <br />MISCELLANEOUS <br />RECEIPT <br />PROJECTADDRESS: o� ��� ly� �] �� SUITE #12 <br />PAID BY: L����������� _ DATE: p��p(� 1� <br />Bldg — Plan Check # n 160 kDJES 10 01116002 53600 $ <br />Plmg — Plan Check # 01116002 53602 $ <br />Elect — Plan Check # 01116002 53601 $ <br />Mech — Plan Check # 01116002 53603 $ <br />Bldg Permit — Inspection/Special Inspection <br />01116002 51601 $ <br />Plmg Permit — Inspection/Special Inspection <br />01116002 51602 $ <br />Elect Permit — Inspection/Special Inspection <br />01116002 51603 $ <br />Mech Permit — Inspection/Special Inspection <br />01116002 51604 $ <br />Acc Bldg P/C # <br />hrs. <br />01116002 57600 <br />$ <br />Acc Plmg P/C # <br />hrs. <br />01116002 57600 <br />$ <br />Acc Elect P/C # <br />hrs. <br />01116002 57600 <br />$ <br />Acc Mech P/C # <br />hrs. <br />01116002 57600 <br />$ <br />Boarding Fee (Community Preservation) <br />General Plan Update Surcharge <br />Statement of Fact/Public Records Research <br />SMIP - Category Val$ <br />Building Standards Revolving Fund <br />Copies/Microfilm <br />Residential Development Fee — Specify Acct. No. <br />Temporary Certificate of Occupancy <br />30 Day Temporary Fee — Gas <br />30 Day Temporary Fee — Electrical <br />Bond: Demo, 30-Day, Relocation, Sign, Fireworks <br />Fireworks Stands Fee <br />Fire Facilities Fee <br />NOTICE: Applications for plan check submitted under Section <br />105.3.2 of the 2010 California Building Code will expire if no <br />permits are issued within 180 days. <br />Receipt <br />Prepared <br />12115002 53507, $ <br />01116002 51600 r t $ <br />01116002 51601 $ <br />08901001 24000 $ <br />01116002 51612 $ <br />01117002 57770 <br />3002 57991 536010% <br />01116002 5160,r*****V$*897: <br />01116002 51602 $ <br />01116002 51603 $ <br />0980100124015 $ <br />01116002 51501 $ <br />12015002 53700 $ <br />TOTAL <br />Misc. Receipt # 616 9 0 1`/ Validation <br />