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@ Cify of Santa Ana <br />Permit Counter: (714) 647-5800 <br />20 Cavic Center Plaza (M-19), Santa Ana, CA 927b2 Plu mbing Permit #: 3O140684 <br />Pin #: 1O4O7lnspection Requests: (7 141 667-?7 38 lnspector Section: (714) 647-5853 <br />Project Address: 2128 S Hickory St Unit: <br />Block: 13 <br />Bldg: <br />Tract: 560 <br />Address Range: <br />Historic: No <br />Suite Range: <br />Zoning: RlAssesso/sParcelr 015.1'13-19 Lot: 15 <br />Owner: <br />Address: <br />Nancy Lazaro-Loeza <br />2128 S Hickory St <br />Santa Ana, CA 927072912 <br />17141278-2778 <br />01116002 <br />01116002 <br />01116002 <br />01116002 <br />01116002 <br />01116002 <br />51602 <br />51602 <br />51602 <br />51602 <br />51600 <br />51602 <br />Qty <br />1.00 <br />1.00 <br />1.00 <br />'1.00 <br />1.00 <br />1.00 <br />Feo <br />$14.22 <br />$22.25 <br />$12.70 <br />$22.25 <br />$22.O8 <br />$55.04 <br />Phone: <br />Tenant Name <br />Contractor <br />Address: <br />Owner-Builder <br />Phone <br />State Lic #: <br />Lic Type: <br />Bus. Lic #: <br />Workers' Compensation lnsurance <br />Carrier: <br />Policy #: <br />Expires; <br />tlLL/2119'16nsi:40 <br />Refi:- Slll/20t1. <br />)to <br />(t <br />hen <br />rl1: <br />PIt <br />r tlpdcte Fee <br />16000@- <br />Buildinq Use: <br />Job Type: <br />Nature of Work <br />Single Famlly DrYslllng <br />Addition <br />Addition <br />Occupancy; <br />Constr Type <br />Code: <br />R-3, U <br />VB <br />cPc 2016 <br />itNotes:r*16697 Authi <br />Planning Conditions: <br />Planning Approval By <br />Plan Checked By: <br />Permit lssued By: <br />Subjecl to Field: <br />Building Permit #: <br />Verduzco, Violet <br />1019909s <br />r.\ <br />-J <br />Date <br />Date <br />Date 03/t 1,2019 <br />Account* <br />Misc. Receipl: <br />Misc. Receipl: <br />Misc. Receipt: <br />Total <br />Every permit issued shall becgme invalid unless lhe wo* of, the site <br />authotized by such pennit is @mnoncgd within I 80 ddys after its <br />issuenca, ot il tho wod< auatbtized on ltl€ site by such peinit is suspended <br />or abandoned for a pedod of 1 80 days afrot the lme the wo* is <br />commencod. <br />$ 148.54 <br />$0.00 <br />$148.54 <br />MID#: 2019-148731 <br />0'1116002 51600 <br />01116002 51602 <br />$22.O8 <br />$126.46 <br />Fee Total: <br />Paid to Date: <br />Balancg Due: <br />{ <br />Fee Typo Amount <br />Waler Closet 14.22 <br />Shower/Balhtub 22.25 <br />Sink 12.70 <br />Add'l Sewer Conneclion 22.25 <br />General Plan Updale 22.08 <br />lssuance 55.04 <br />lnspector