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City of Santa Ana <br />Permit Counter (714) 647-5800 <br />20 civic center Plaza (M-19), santa Ana, c492702 Electrical Permit #: 2lJ164277 <br />Pin #: 19973lnspection Requests: (7'14) 667-2738 lnspector Section: (714) 647-5853 <br />Unil: <br />Block: NA <br />Bldg: <br />Tract: NA <br />AddressRange: 2021-2025 <br />Hisloricr No <br />Suite Range: <br />Zoning: R'l <br />rt <br />Assessor'sParcel: 399-091-20 Lot. NA <br />Owner: <br />Address <br />Tan Nguyen <br />11071 CottonrYood Ave. <br />Garden GroYe, CA 92843 <br />(714) 230-9682 <br />01116002 <br />011'r6002 <br />01 'r 16002 <br />01 I 16002 <br />01 I 16002 <br />01 1 16002 <br />01 1 16002 <br />01 1 16002 <br />51603 <br />5'1603 <br />51603 <br />51603 <br />51603 <br />51603 <br />51600 <br />s1603 <br />Fee Type <br />New Res <br />New Garage <br />Dedicated Circuit <br />Low Voltage/Res <br />Serv Meler <br />General Plan Update <br />lssuance <br />Amount <br />0.14 <br />0.'!4 <br />23.87 <br />23.87 <br />51.29 <br />21.25 <br />52.98 <br />Qty <br />1,200.00 <br />467.00 <br />4.00 <br />2.00 <br />1.00 <br />1.00 <br />1.00 <br />1.00 <br />Fee <br />$168.00 <br />$6s.38 <br />$95.48 <br />v7.74 <br />$35.35 <br />s51.29 <br />$21.25 <br />$52.98 <br />Phone: <br />Tenant Name: <br />Contraclor <br />Address: <br />Owner-Builder <br />Phone <br />Slate Lic #: <br />Lic Type: <br />Bus. Lic #: <br />Workers' Compensation lnsurance <br />Carrier: <br />Policl *: <br />Expires: <br />Single Family Dwelling <br />New <br />SFD rY/att garage <br />R-3, U <br />VB <br />cEc 2016 <br />Notes Handout given. <br />Planning Conditions <br />Planning Approval By Dale <br />Date <br />Date <br />Misc. Receipt: <br />Misc. Receipt: <br />Misc. Receipt: <br />Total <br />Plan Checked By <br />Permit lssued By <br />Subjecl to Field: <br />Building Permit # <br />10t17t2017 <br />Account# <br />93538 $537 47 <br />$0.00 <br />$537.47 <br />Every poinit issuad shall become invalid unless the wo* on the site <br />authotized by such pemit is cofimenced wilhin 1 80 days after its <br />issuance. ot il the wot* euthorized on the site by such pefinil is suspended <br />ot abandoned fot a penod ot 180 days alter the tima tho wod< is <br />commenced <br />lnspector MID#: 2017-135011 <br />01 1 16002 s1600 <br />0't116002 51603 <br />$2r.25 <br />$5'16.22 <br />Fee Total: <br />Paid to Date: <br />Balance Oue <br />Project Address: 2021 N Fairview St <br />Building Use: <br />Job Type: <br />Nature of Work: <br />Occupancy: <br />Conslr Type: <br />Code: <br />\W