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City of Santa Ana <br />Permit Counter: (714) 64 <br />P roj ect Address: 800 N Tustin Ave <br />400-202-03 Lol POR 5 <br />7-5800 lnspection Requests: (714) 667-2738 lnspector Section: (7141647-5853 <br />Unit M Bldg: Address Range Suite Range; <br />Zoning: PAssessor's Parcel Block NA Tracl 678 Historic. No <br />20 Ci,',c Center Plaza (M-19), Santa Ana, CA 92702 Bu ild ing <br />Building Use: <br />Job Type <br />Nature of Work: <br />Existing Bldg. & Use: <br />Proposed Use: <br />Commercial <br />Tenant lmprovement <br />TI <br />Com me rc ia l/Medica I Offices <br />Occupancy: <br />Constr Type <br />Code: <br />Flood Zonel <br /># of Stories: <br />Phone: <br />State Lic #: <br />Lic Type: <br />Bus. Lic #: <br />Workers' Compensation lnsurance: <br />Carrier: <br />Policy #: <br />Expires: <br />1st FL Area: <br />2nd FL Areal <br />Other Areas: <br />Garage Area; <br />Total: <br />License #; C-31657 r-t111S,1_r: <br />Patio: <br />T.l.Area. 208 <br />Yards Req'd: <br />Valuation: $10,000.00 <br />0 <br />Description of Work: Legalize interior room for an x-ray room. Auth. letter on file <br />Planning Conditions: lnterior work only. No exterior alterations or modification. irol, r,: : il <br />Engrneer ,. (;:Owner UMi Medical lmaging Conlraclor: Owner-Builder ii . i: <br />Address 1762 Westwood Blvd Address Address <br />Los Angeles, CA 90024 <br />Phone: (949) 292_1404 <br />Tenant: UMI lmaging <br />Phone. <br />License #: <br />Architect / <br />Desrqner: <br />Address. <br />Phonel <br />Foster oeslOn BrJild <br />Eric Mahohey <br />1'l054 Veotuib Blvd f189 <br />Los Arrgelos, CA 90024 <br />(3r o) 73e.8732 <br />/rlrr,tlr- <br />Planning Approval By <br />Plan Checked By: <br />Permit lssued By; <br />NPDES lnsp. Req <br />PWA lnsp. Req'd: <br />fiy <br />ri, Fred <br />ro dowski, Teri <br />Dater 09/1712019 <br />Date: 10/03/2019 <br />Date 10/08/20'19 <br />Subject to Field: <br />No Total <br />$1.00 <br />$22.95 <br />$57.20 <br />o7776od N,tWt PE|'rlitFde i rl <br />07776002 53600 Plan Check Fee <br />01776002 57770 Microfilm Records <br />07716002 51672 Bldg. Stds. Revolving <br />07776002 57600 Genetal Plan LJpdale <br />07776002 51601 lssuance <br />rr r r rr. .,.'$1{9.25 <br />$100.27 <br />$11.73 <br />No <br />No <br />Planning lnsp. Req'd: No <br />Fire lnsp. Req'd: <br />Police lnsp. Req'd Account#No <br />Landscaping lnsp. Req'd: No Flood Zone Cerl Req'd: No <br />Every pamil issuod shall become invalid unless the wo* on lhe site aulhoi2ecl by <br />such pemil is commenced v,rilhin360days atlet its issuahce,ot il the wotk aulhorized <br />on lhe site by such permil is suspended or abandoned fot a penod of360 days aftor <br />lhe ltme lhe wo* ts commenced <br />lnspector MID#: 2019-154438 <br />Fee Total: <br />Paid to Dater <br />Balance Due <br />$342.40 <br />$100.27 <br />$242.13 <br />01 't 16002 51600 <br />01 1 16002 51601 <br />0'1 1 '16002 51612 <br />01116002 57770 <br />$22.95 <br />$206.45 <br />$1.00 <br />$1 1.73 <br />S .J <br />Permit #: lO31Ol493 <br />Pin #: 46061 <br />B <br />VB <br />cBc 2016 <br />x-0602320164J <br />Misc. Receipt; <br />N,tisc. Receipt: <br />N,lisc. Receipt: <br />116. <br />lt <br />73477