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Project Address: 2808 W Fifth S-t <br />Assessor'sParcel: .105-222-05 L,rl NA <br /> 12 <br />B ock NA <br />Bldg. <br />Tracl: NA <br />Address I?arge <br />Hisloflc No <br />Sui{e RaI!-c <br />Zclnrng M'l <br />CitY of Santa Ana 20 Civic Cenler Plaza (11-19) Santa Ana. CA92702 Ele c trica I <br />ffir <br />Pe;niit #:2017{685 <br />Pin #: 78875 <br />Ov/rrer: <br />Ad.lress <br />P ho nel <br />Tenant Name: <br />The Stanley And Yolanta Swiatek Famil <br />P O Box 354 <br />Santa Ana. CA 92702 <br />(949) 432-9353 <br />Owner-Builder <br />ct 116002 <br />011 160,J.1 <br />011 r6i.i2 <br />011150()2 <br />011 r6002 <br />(.,t) <br />, irl <br />i <br />l',ll <br />Amount <br />57 4A <br />l;ti1 <br />iJ i9 <br />59 30 <br />i t)., <br />i)lrone <br />Slate Lrc # <br />t rc rype <br />Bus Lrc #. <br />VJorkers' Conrpensation lnsurarce <br />Can ier: <br />Fr.licy #. <br />Exprres: <br />Botch+:56202 - S/f7/2n2n I0! ltFIoflice: (:TYH Trans+: 3 4Acct+: Ref+: 2111716 <br />Rcpt+:0303(1953 - 9/17/2!t2tt lt!3 Pn <br />Fnonsoct ion Totol tglr:r. 75 <br />The Stdnlee And Yolontn SBiote <br />NEDAofl8i <br />lndustrial <br />Miscellaneous <br />Re-sct meler <br />Or:ctrpartcy <br />aorslr TVoe <br />(. ode <br />Generol PIon Updqte Fee <br />frl116002- 51600(10(r- <br />EI ectr ical <br />trll160(12- 51603000- <br />n icrof i lr t Docurentscllll6002- 177700Q$- <br />ICL Check 0888 <br />Inspector to verify .quipmcnt ok for SCE <br />SCE requcst. <br />- T?:,J. /q <br />- <br />_ 54 ' t'l <br />l'91r-1. /r. <br />rc-rclcase pcr <br />ilurlding Use: <br />.Job Typei <br />Nalur€ of Work <br />Plann ing Conditions <br />"l.tnning Approval By <br />f-lan Checked By <br />Pennit lssued By: <br />Subject lo Freld. <br />Brrlding Permit #. <br />Rcceipt: <br />RecciDl <br />Rrl(]cit)i <br />Tolal <br />523 7!i <br />$ r34.31 <br />g4 0t_, <br />l.r.-rl <br />:l\,:Amsden Julle <br />F.,i,ry petml tssued sltall bed le irvaltd unless lhe ., )/i oa t/,r sr4 <br />a :letzcC by such perml !s c.)tnrnenced wlhto360 t1ay3 i:ttlPt t:s <br />ts;bance or il lhe \totk aulhdtzed on lhe stle by sucll Den\tl ts ar:t tnded <br />1 abandot)ed fot a De ocl af3!;0 dars aller lhe lirt( .t'. -,/ot'k ' <br />Inspeclor iVllD#: 2019- i54998 <br />s 162 15 <br />s0 00 <br />$162.15 <br />\i