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(M-'19), Santa Ana CA 92702 <br />(714) 667-2738 lnspector <br />Unil: <br />Block: t{A <br />Bldg <br />Tract 6 <br />City of Santa Ana 20 Crvic center P <br />Permit Counter: (714) 647-5800 lnspeclion Req <br />Project Address: 3714 S Ross St <br />Assessor's Patcel a1o-142-21 Lot 23 <br />Oi/ner <br />Address <br />R.bbon Ro.lo <br />37'la S Ro.. St <br />Srnt An., CA 92707 <br />(714)915-76i18Phone <br />Tenant Name <br />Conkaclor <br />Address <br />O.rngo County Servlco. db. lt ll <br />38Ol Lonawoe AYonuo <br />Culvor Clty, CA 90232 <br />(310)838{408Phone <br />State Lic #: 755,a30 <br />Lh TvDe: C-38, C-20 <br />Bus. Lic;: 164117 <br />Workers' Compensation lnsurance: <br />Carier: lnau,anco Company of tho Woat <br />Policy *: WSD505257l0l <br />Expires: 0110112022 <br />Euilding Use: <br />Job Type: <br />Nalure of Work <br />Ocorpancy: <br />Constr Type <br />Code: <br />PlanninO Condition3: <br />Planning App.oval By <br />Plan Checked 8y: <br />Permil lssued By: <br />Subjecl to Field: <br />Building Permil *: <br />web user <br />Date: <br />Datel <br />Date: <br />Every pernn $suecl shall becone wahd unless the work on tho site <br />authotized by such Fmtl is @mmenced \ttthin 360 days allet k <br />$JJrance, ot I lhe work authonzed on the sle by such pemrl s <br />suspendecl or abanclonecl lor a Wnocl ol 360 days aftet lhe lifio the work <br />lnspector MID#: 2021-165701 <br />2a <br />Totalnt# <br />01 <br />01 <br />01 <br />01 <br />R-3 <br />va <br />cPc 2019 <br />- No Balance <br />' No Balance <br />Plumbing Permit #: lolatolt <br />Pin #: a:tat!(714) 647-5853 <br />Address Range: <br />Historic: No <br />Suite Range: <br />Zoning: R1 <br />6002 5't602 <br />6002 51600 <br />6002 51602 <br />6002 57770 <br />Amount <br />23.97 <br />23 79 <br />59 30 <br />405 <br />Qly <br />1.00 <br />100 <br />100 <br />100 <br />Fse <br />$23.97 <br />$23 79 <br />$s9.30 <br />$4 05 <br />Notes Plumblng <br />$111 11 <br />$111 11 <br />$0.00 <br />Fee Total <br />Paid to Date: <br />Brhnce Due <br />Fee Typo <br />VVt. Hk (Res up to 50 gal) <br />General Plan Update <br />lssuanc, <br />Microfilm Records <br />Slngle Fimlly Ow.lllng <br />Mlacellanoou3 <br />Plumblng <br />sr <br />Misc. Receipl: <br />Misc. Receipt: <br />Misc. Receipl: