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Planning & Building Agency <br />Building Safety Division MISCELLANEOUS <br />20 Civic Center Plaza RECEIPT <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />www.santa-ana.org <br />PROJECT ADDRESS: QSM 1 M <br />SUITE # <br />PAID BY: C Lyoc r1 K L�[� <br />DATE: <br />Bldg — Plan Check # <br />01116002 53600 <br />$ <br />Plmg — Plan Check # <br />01116002 53602 <br />$ <br />Elect — Plan Check # <br />01116002 53601 <br />$ <br />Mech — Plan Check # <br />01116002 53603 <br />$ <br />Bldg Permit — Inspection/Special Inspection <br />01116002 51601 <br />$ <br />Plmg Permit — Inspection/Special Inspection <br />01116002 51602 <br />$ <br />Elect Permit — Inspection/Special Inspection <br />01116002 51603 <br />$ <br />Mech Permit — Inspection/Special Inspection <br />01116002 51604 <br />$ <br />Acc Bldg P/C # hrs. <br />01116002 57600 <br />$ <br />Acc Plmg P/C # hrs. <br />01116002 57600 <br />$ <br />Acc Elect P/C # hrs. <br />01116002 57600 <br />$ <br />Acc Mech P/C # 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, Qgnfireworks <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 by: <br />Misc. Receipt # 628 5 <br />NfinK Fee 'kneculeWisc Receipts/April. 2013 <br />12115002 53507 <br />$ <br />01116002 51600 <br />$ <br />01116002,548W7507 <br />- $1/17/2014 ID: RUBEN <br />0890100 Odrr <br />ra �k�fii. /fit o <br />01116002 BtMI255536 <br />$- 11/17/2014 9:02 AM <br />0111700 ?. tthV" <br />roW <br />3002 57991 <br />$ <br />01116002:546&Aor <br />30-$avr Reloc, S $2ii1).C1i1 <br />01116002 $At <br />01116002 6"1-6G3.73****$*`622 Auti�4:G05-23- <br />09801001 24015 <br />$ ii� , C] n <br />01116002 51501 <br />$ <br />12015002 53700 <br />$ <br />TOTAL <br />Validation <br />