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20 Civic Center PIaza (M-19), Santa Ana, C492702 <br />lnspectaon Requests; (714\ 667-2738 lnspector Section: (714) 647-5853 <br />Electrical Permit #: 20165754 <br />Pin #: 10,479 <br />City of Santa Ana <br />Permit Counter: (714) 647-5800 <br />Proiect Address: 1545 W Seventeenth St <br />Assessor'sParcel: 399-121-39 Lot: 1l <br />Bldg: <br />Tract MABURY <br />Address Range: 1311-1601 <br />Historic: No <br />q <br />U nit: <br />Block: 293-38 <br />Phone: <br />Tenant Name: <br />Contractor <br />Address: <br />Justin Storm <br />777 S, Harbor Blvd. <br />La Habra, CA 90631 <br />(916) 893-1 536 <br />CVS Pharmacy, lnc. <br />Bryon James Hamad <br />7962 Chaffee Rd <br />NORTHFIELO, OH 44067 <br />(2161 s44-3O72 <br />011 16002 <br />01'1 16002 <br />01'1 16002 <br />01116002 <br />011 16002 <br />5160: <br />51603 <br />5160: <br />5160C <br />5160;' <br />Fee <br />$18.85 <br />$49.58 <br />$33.88 <br />$22.08 <br />$5s.04 <br />Fee Type <br />'125 Volt Receptacle <br />Dedicated Circuit <br />Low Voltage/Comm <br />General Plan Update <br />lssuance <br />Amount <br />1.45 <br />24.79 <br />33.88 <br />22.O8 <br />55.04 <br />Qty <br />13 00 <br />200 <br />100 <br />'1 00 <br />100 <br />Phone <br />State Lic #: 948312 <br />Lic Type: B <br />Bus. Lic #: 370385 <br />Workers' Compensalion lnsurance:Carrier: Exempt <br />Policy #: <br />Expires: <br />Bqtch+ I {5.'i99 - <br />0f I i.e: a-:TYH <br />R{pt+ 1023637,11 <br />&/27 /2fi18 <br />Trflns+:157 <br />- 8/2? /2ttLB <br />iD: {:{.:lrl <br />zrj16575 <br />3r 33 f'll <br />$.91t..5?fr(tfiso,-t ion Tot.o I <br />[1r9on ifl,ne9 H(lfiod <br />6enerol Plsn Updale F€e <br />tll I 16002- 516t-1rr000- <br />E lectr icql <br />0 1 1 I 611112- i1603trj0- <br />ICL (:heik $0010895 <br />ICL Che,:k l:[:r3t3l <br />Building Use: <br />Job Type: <br />Nature of Work: <br />Planning Conditions: <br />Planning Approval By: <br />Plan Checked By: <br />Permit lssued By: <br />Subject to Field: <br />Building Permit #: <br />Commercial <br />Tenant lmprovement <br />T.l. - Accessibility <br />Occupancy: <br />Conslr Type <br />Code: <br />\..hrn"nue., xatnv 04t27 t2018 <br />Account# <br />$179.43 <br />$0.00 <br />$179.43 <br />Every permit issued shall become invalid unless the work on the site <br />authoized by such pemit is commonced within180 days after ils <br />issuance, ot il the wo* authonzed on the site by such permit is suspended <br />ot abancloned fot a period of 180 days 1ftet the time lhe work is <br />commenced. <br />lnspector MID#: 2018-143056 <br />011 16002 51600 <br />011 16002 51603 <br />$22.08 <br />$157.35 <br />Suite Range: <br />Zoning: C2 <br />Owner; <br />Address: <br />$4 "$JrM <br />V B, SPK <br />cEc 2016 <br />Date: <br />Date: <br />Date: <br />Misc. Receipt: <br />Misc. Receipt: <br />Misc. Receipt: <br />Total <br />Notes: <br />Fee Total <br />Paid to Date: <br />Balance Due: