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Planning & Building Agency <br />Building Safety Division MISCELLANEOUS <br />20 Civic Center Plaza RECEIPT <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />www.santa-ana.org <br />PROJECT ADDRESS: ��� V(J� <br />Sl� SUITE # <br />PAID BY: &WtSom <br />DATE: <br />Bldg — Plan Check # <br />01116002 53600 <br />$ <br />Plmg — Plan Check # 3o 1 3 , 7 a 3 <br />01116002 53602 <br />$ s <br />Elect — Plan Check # <br />01116002 53601 <br />$ <br />Mech — Plan Check # <br />01116002 53603 <br />$ <br />Fire — Plan Check # <br />01116002 53600 <br />$ <br />Bldg Permit — Trust/Special Inspection <br />01116002 51601 <br />$ <br />Plmg Permit — Trust/Special Inspection <br />01116002 51602 <br />$ <br />Elect Permit — Trust/Special Inspection <br />01116002 51603 <br />$ <br />Mech Permit — Trust/Special Inspection <br />01116002 51604 <br />$ <br />Fire Trust <br />01116002 51601 <br />$ <br />Acc Bldg P/C # hrs. <br />01116002 57600 <br />$ <br />Acc Plmg P/C # hrs. <br />01116002 57600 <br />$ <br />Acc Elect P/C # hrs. <br />01116002 57600 <br />$ <br />Acc Mech P/C # hrs. <br />01116002 57600 <br />$ <br />Boarding Fee <br />12115002 53507 <br />$ <br />General Plan Surcharge <br />01116002 51600 <br />$ <br />Statement of Fact/Record Search <br />01116002 51601 <br />$ <br />SMIP - Category Val$ <br />08901001 24000 <br />$ <br />Xerox Copy, Microfilm <br />01116002 57770 <br />$ <br />Residential Development Fee — specify Acct. No. <br />3002 57991 <br />$ <br />Temporary Certificate of Occupancy <br />01116002 51601 <br />$ <br />30 Day Temporary Fee — Gas <br />01116002 51602 <br />$ <br />30 Day Temporary Fee — Electrical <br />01116002 51603 <br />$ <br />Bond: Demo, 30-Day, Relocation, Sign <br />09801001 24015 <br />$ <br />TOTAL <br />$ ,Q s� <br />NOTICE: Applications for plan checking submitted <br />under Section 105.3.2 of the 2010 California Building <br />Code will expire if no permits are issued within 180 da s. <br />Receipt <br />Prepared by: <br />Misc. Receipt # (} g 9 n 3 0 Validation <br />WP51 <br />Fees 2011-20121Misc Heceipts19-20-201 <br />