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Permit #: 20{70869 <br />Pin #: 32756 <br />Project Address: 1417 S Main St <br />Assessor'sParcel 014-032-36 Lot 9 <br />unit. <br />Block: NA <br />Bldg: <br />Traclr 245 <br />Address Range: <br />Historicr No <br />Suite Range. <br />Zoning: CSM <br />Owner: <br />Address <br />Phone: <br />Tenant Name: <br />Conlractor: <br />Addressl <br />Medhat Ralael <br />l7'150 Euclid St. #322 <br />Fountain Valley, CA 92708 <br />(7'.t4\ 337 -O747 <br />South Main Dental Group <br />011't6002 <br />01 1 16002 <br />01 1 16002 <br />0'1 1 16002 <br />0'1 1 16002 <br />01 't '16002 <br />5160: <br />5160: <br />5160: <br />5'160C <br />5160: <br />5777C <br />Fee Type <br />Dedicated Circurl <br />Low Voltage/Comm <br />Min Fee Adj <br />General Plan Update <br />lssuance <br />Microfilm Records <br />Fee <br />$25.76 <br />$35.21 <br />$1 1.38 <br />$22.9s <br />$s7.20 <br />$3 91 <br />Eotch+ I i <br />(0lf ict <br />Accti: <br />F(cpt+3 tr29u2?4 t <br />Transqct ion Totol <br />lledh(ll kqf oe l <br />B <br />VB <br />cEc 2019 <br />Occupancy: <br />Constr Type: <br />Code.Notes.Dedicated circuit and low voltage <br />Building Use: <br />Job Type: <br />Nature of Work <br />Planning Conditions: <br />Date <br />Date <br />Date <br />Misc Recerpt: <br />Misc Receiplr <br />Misc. Receipt: <br />Total <br />Zuniga, Allissa <br />10198219 <br />o2t2512020 <br />Account# <br />Every porml tssuod shall bocome nvalKl unless lrg work o, lhe s,te <br />authonzecl by such pemi ts commenced wtthn360days 6ftet tls <br />6suance. ot il the work authonzed on lhe s e by such peml 6 susponded <br />or abandoned lgr a penod o1360 days aftet lhe ume the wod< ts <br />commenced <br />$156.41 <br />$0 00 <br />56.41 <br />lnspector MID#: 20'18-147351 <br />01116002 51600 <br />01 1 16002 51603 <br />01116002 57770 <br />$22 95 <br />$129 55 <br />$3 91 <br />Fee Total <br />Paid to Date: <br />Balance Due <br />,A City of Santa Ana 20 civic center Plaza (M-19), santaAna, cAs27o2 ''"""'")'. ,,t4l, Permrl Counter (714) 647-5800 lnspecron Requesls: 17141667-2738 lnspector Seclron (714) 647-5853 .-y <br />Planning Approval By <br />Plan Checked By <br />Permit lssued 8y: <br />Subject to Field: <br />Building Permil #: <br />Owner-Builder <br />Amount <br />25 76 <br />35 21 <br />'1 '1 38 <br />22.95 <br />57 .20 <br />3.91 <br />Qtr" <br />100 <br />1 .00 <br />100 <br />'t.00 <br />1.00 <br />1.00 <br />2/)5/2t-t2t.l <br />P hone <br />Slate Lic #: <br />Lic Type: <br />Bus. Lic #: <br />workers' Compensation lnsurance:'Carrier: <br />Policy #: <br />E(pires: <br />iron"-i: <br />R efi: <br />/2it2 <br />Commercial <br />Miscellaneous <br />Fixtures <br />AuLhi;