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City of Santa Ana <br />Permit Counter: (7'14) 647-5800 <br />20 Civic Center Plaza (M-19), Santa Ana, CA 92702 <br />lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 <br />Electrical Permit #: 2O163E36 <br />Pin #: 95174 <br />\{ <br />Project Address: 3401 S Harbor Blvd <br />Assessor'sParcel: 414-262-08 Lot: POR 3 <br />Unil: <br />Block: NA <br />Bldg: <br />Tracl: WILLIAMS <br />Address Range: <br />Historic: No <br />Suite Range: <br />Zoning: P <br />Owner: <br />Address: <br />Phone: <br />Tenant Name: <br />Contraclor <br />Address: <br />Kaiser Fondation Health Plan lnc <br />1707 Barcelona Circle <br />Placentia, CA 92870 <br />(7',t41. 572-57'.to <br />Kaiser Permanents <br />Kaiser Foundation Health Pl <br />1707 Barcelona Circle <br />Placentia, CA 92870 <br />(909) 4274700 <br />Fes Type <br />011 16002 51603 Air Conditioner <br />01116002 53601 P/C - 65% <br />01 l 16002 51600 General Plan Update <br />01'116002 51603 lssuance <br />Amount <br />0.65 <br />21 .25 <br />52 98 <br />Fee <br />$839.52 <br />$545.69 <br />$21.25 <br />$52.98 <br />Qty <br />9.00 <br />839.52 <br />1 .00 <br />1.00 <br />Phone <br />Slate Lic #: 370871 <br />Lic Type: B <br />Bus. Lic #: 2108 <br />Workers' Compensation lnsurance: <br />Carrier: Dept of lndustrial Relatlons <br />Policy #: 1053 <br />Expires: O1lO1l2O1A <br />A-3, B <br />ll B, SPK Story lncrease <br />cEc 2016 <br />PAID <br />sEP 01 201/ <br />City of Santa Ana <br />Notes: fees pd on M-69995 <br />Building Usei <br />Job Type: <br />Nature of Work <br />Planning Conditions: <br />Planning Approval By <br />Plan Checked By: <br />Permit lssued By: <br />Subjecl to Field: <br />Building Permil #: <br />Commercial <br />Alteration <br />Roof mtd equipment <br />Davis, Scotl <br />\If Hernandez, Kathy <br />Date: <br />Oate: <br />Oate: <br />10193710 <br />$ <br />Occupancy: <br />Constr Type <br />Code: <br />08t09t2017 <br />09to1t2017 <br />Account# <br />Misc. Receipt: 69879 <br />Misc. Receipt: 69995 <br />Misc. Receipt: <br />Total <br />Every permit issued shall becorne invelid unless the wo* on lhe sile <br />authonzed by such pamil is commenced within 180 days allet ils <br />issuance, ot il tho wo* authoized on lhe site by such pennil is suspended <br />or abandoned lot a period ol 1 80 days aftet the tine lhe wo* is <br />comngnc:Ed. <br />$1,459.44 <br />$1,459.44 <br />$0.00 <br />lnspector MID#: 2O17-1378'lO <br />N/A - No Balance Fee Total: <br />Paid to Date: <br />Balance Oue: