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City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, cAg27o2 Building <br />Permit Counter: (714) 647-5800 lnspection Requests: (714\ 667-2738 Inspector Section: (714) 647-5853 <br />Permit #: 1(J194215 <br />Pin #: 3O{4O <br />Project Address: 3801 S Harbor Blvd <br />Assessor's Parcel 4',t4-261-12 Lot POR 3 Block NA <br />Unit: C Bldg: <br />Tract: WILLIAMS <br />Address Range: 3751-3801 <br />Hisloric: No <br />Suite Range: <br />Zoning: Ml <br />Building Use: Commercial Occupancy: B 1st FL Area: <br />Job Type: Tenant lmprovement Constr Type: V B, SPK 2nd FL Area: <br />Nature of Work: Tl Code: CBC 2016 Other Areas: <br />Existing Bldg. & Use: Commercial Flood Zone: X-0602320258J <br />Garage Area: <br />Proposed Use: Optometry Office # of Stories: Total: O <br />Description of Work: Tl includes new intorior partitions to create new lab, offices, & waiting aroa. Add (2) new sinks. <br />Planning Conditions: <br />Patio: <br />T.l.Area: 250 <br />Yards Req'd: <br />Valuation: S9,000.00 <br />Owner: <br />Address <br />P hone <br />Tenant <br />D&SlnvestmentLlc <br />3751 S Harbor Blvd., fD <br />Santa Ana, CA 927047902 <br />1714) 435-1210 <br />Crystal Vision <br />Contractor: WinNguyenConstruction <br />Addressi 13172 Sandra Place <br />Garden Grove, CA 92843 <br />Phone: 1714t 326-3121 <br />State Lic #: 955157 <br />Lic Type: B <br />Bus. Lic #: 363678 <br />Workers' Compensation lnsurance: <br />Carrier: Exempt <br />Policy #: <br />Expires: <br />Engineer <br />Address <br />Phone. <br />License #: <br />Architect / <br />Desiqner: <br />Address: <br />Phone: <br />License # <br />win Nguyen Derign Group <br />Ha Nguyen <br />13172 Sandra Place <br />Garden Grove, CA 92843 <br />17141326-3124 <br />Plannlng Approval By <br />Plan Checked Byl.\ <br />Permit lssued ,ti <br />-NPDES lnsp. Rds'd:\._ <br />PWA lnsp. Req'd: <br />Planning lnsp. Req'd: <br />Landscaping lnsp. Req'd: <br />Dale. 1011012017 <br />Oate. 0912712017 <br />Date: 10/10/2017 <br />Subject to Field: <br />lvlisc. Receipt <br />Misc. Receipt <br />NIisc. Receipt <br />0 77 7600 2 <br />0 77 7600 2 <br />0 77 7600 2 <br />o7775002 <br />0777600 2 <br />o7775002 <br />57607 <br />53600 <br />57770 <br />5 7672 <br />5 7600 <br />57607 <br />Permit Fee <br />Plan Check Fee <br />Microfllm Records <br />Bldg. Stds. Revolving <br />General Plan Update <br />lssuance <br />$149.2s <br />$200.54 <br />$10.86 <br />$1.00 <br />$21.25 <br />$52.98 <br />No <br />No <br />No <br />No <br />bl <br />eri <br />Fire lnsp. Req'd: <br />Police lnsp. Req'd <br />Flood Zone Cert. Req'd: No <br />No <br />No Account# <br />70074 <br />Total <br />Every pennil issued shall becorno invalid unless lhe work on the sito authonzed by <br />such pemit is comfienced wilhin180 days aftot its issuance,ot if the woi< authoized <br />on the sile by such permtt is suspended ot sbandoned for a pedod ot180 days ahet <br />the time the wo* is comrnenced . <br />s435 88 <br />$100 27 <br />$335.61 <br />lnspector MtD# 2017-138762 <br />011 '16002 <br />01'1 16002 <br />01 '1 16002 <br />01 1 16002 <br />01 1 16002 <br />51600 <br />51601 <br />516'1 2 <br />53600 <br />57770 <br />$21.25 <br />$202.23 <br />$1.00 <br />$100 27 <br />$r 0.86 <br />Fee Tolal: <br />Paid to Datel <br />Balance Due: <br />Orozco, lvan