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City of Santa Ana <br />Permit Counter: (7 1 41 647 -5800 <br />20 Civic Center Plaza (M-19), Santa Ana, CA 92702 <br />lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 <br />Electrical Permit #: 2()1fi6424 <br />Pin #: 69607 <br />Assessor'sParcel: 400-062-05 Lot: POR I <br />unit: 107 <br />Block: NA <br />Bldg: E <br />Tract: 678 <br />Address Range: <br />Historic: No <br />Suite Range: <br />Zoning: P <br />q <br />Ownerl <br />Address <br />Phone: <br />Tenant Name: <br />Contractor <br />Address: <br />Parkcourt LLC <br />18010 Sky Park Circle #'150 <br />lrvine, CA 92514 <br />(9491752-7274 <br />Ark Mercury <br />KSM Services lnc. dba Mod( <br />12112 E 166 Street <br />Cerritos, CA 90703 <br />19491 7s2-7274 <br />01116002 <br />01116002 <br />01116002 <br />01 1 16002 <br />01 1 16002 <br />0't116002 <br />51603 <br />51603 <br />51603 <br />5'!603 <br />51600 <br />51603 <br />Qty <br />11.00 <br />14.00 <br />1.00 <br />4.00 <br />1.00 <br />1.00 <br />Fee Type Amount <br />125 Volt Receptacle 1.45 <br />Light Fixtures 1.05 <br />LowVoltage/Comm 33.88 <br />Add'l Devices/Low Volt 3.20 <br />General Plan Updale 22.08 <br />lssuance 55.04 <br />State Lic #: 949710 <br />Lic Type: C-10 <br />Bus Lic #: 370130 <br />Workers' Compensation lnsurance:Carrier: Ohio Security <br />Policy #: XWS56716035 <br />Expires: OSl17l2O19 <br />Eotch+i45073 - ?fiA/ZJtg ID; 1pg541ttofficer CTYH Tpflns+r 7? 1 of ?Ac(L+: pef+r ?t1166424Rcpti:(r?344889 - 7,/B(r,/Zr"rtg J:44 Ft1Tronsoct ion Totql t J l _{.45 <br />KSI'I Senvices Inc, dbcr flode Ar/ <br />Genero I Plon Updote <br />r.r1 1 16002- tl 60n0tt0- <br />E lt-rr;Ir i':s1 <br />011160(12- 516030(r(r- <br />ICL Check 0055 <br />Fee $22. ('rg <br />i13?.37 <br />t31J . 45 <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 Occupancy: <br />Alteration Constr TyPe <br />Outlets/Fixlures/Low Volta g'Code: <br />Date: <br />Date: <br />Date: <br />Notes: Per Notice To Correct Work. Auth. filed. <br />07 t30t2014 <br />Account# <br />eri <br />Every pefinit issued shall becomo invalid unloss lhe work ort lhe sile <br />authonzed by such pernit is commenced within 180 days attor its <br />issuance, or if the wotu authorizad on lh6 sito by such peinit is suspended <br />or abandoned for a peiod of180 days aftet lhe time tho wo* is <br />commenced <br />$154.45 <br />$0.00 <br />$154.45 <br />lnspector MID#: 2018-144675 <br />011 16002 51600 <br />0'l '1 16002 51603 <br />$22.08 <br />$132.37 <br />Proiect Address: 1801 E Parkcourt Pl <br />Fee <br />$15.95 <br />$14.70 <br />$33.88 <br />$12.80 <br />$22.08 <br />$55.04 <br />Phonel <br />B <br />VB <br />cEc 2016 <br />Misc. Receipt: <br />Misc. Receipt: <br />Misc. Receipl: <br />Total <br />Fee Total: <br />Paid to Dale: <br />Balance Due: