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City of Santa Ana <br />Permit Counter: (714) 647-5800 <br />20 civic center Plaza (M-19), santa Ana, cA92702 <br />lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 <br />Plumbing Permit #: 3O139684 <br />Pin #: 39112w <br />AssessofsParcel: 014-032-36 Lotr 9 <br />Unit: <br />Elock: NA <br />Btdg: <br />T/acl: 215 <br />Address Range: <br />Historic: No <br />Suite Range: <br />Zoning; CSi/l <br />Owner <br />Address; <br />Phone: <br />Tsnant Name: <br />Contractor <br />Address: <br />Medhat Rafael <br />17150 Euclid St. #322 <br />Fountain Valley, CA 92708 <br />17't1l337.o747 <br />South Main Dental Group <br />Owner-Builder <br />Fee Type <br />01116002 5160i Water Closet <br />01116002 5160i Sink <br />0'1116002 5160C General Plan Update <br />01116002 51602 lssuance <br />Amount <br />14.22 <br />12.70 <br />22.O8 <br />55.04 <br />Fee <br />$14.22 <br />$76.20 <br />$22.08 <br />$55.04 <br />Qty <br />1.00 <br />6.00 <br />1.00 <br />1.00 <br />Phone <br />State Lic #: <br />Lic Type. <br />Bus. Lic #: <br />Workers' Compensalion lnsurance: <br />Carrier: <br />Policy #r ? <br />Expires: <br />Building Use: <br />Job Type: <br />Nalure of Work <br />Planning Conditiong: <br />Planning Approval Bf <br />Plan Checked By: <br />Permit lssued By: <br />Subjecl lo Field: <br />Building Permit #: <br />Commercial <br />Miacellaneous <br />Fixtures <br />B <br />VB <br />cPc 2015 Notesr change out <br />$ x"rnrnd".. x"tt v <br />Dale: <br />Date: <br />Oate:0711?i20',18 <br />Account# <br />Misc. Receipt: <br />Misc. Receipt: <br />Misc. Receipt: <br />Total <br />Every pennil issued shall becamo invalid unloss tho wo* oI, thg sila <br />authotized by such pennit is commonciad within 180 days aftet its <br />issuance, ot il the wo* authotized on the site by such Nrmit is stspended <br />ot abandonad lor a perid ol I 80 days aftet the lmo tllo wotk is <br />@mnlf,.r'rc8d. <br />$167.54 <br />$0.00 <br />$167.54 <br />\ <br />lnspector MID#: 2018-1446'15 <br />01116002 51600 <br />01116002 51602 <br />$22.08 <br />$'145.46 <br />Fee Total <br />Paid to Date: <br />Balanco Due: <br />Project Address: 1417 S Main St <br />{ilrn <br />Occupancy: <br />Conslr Type: <br />Code: