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Planning & f�ing Agency <br />Building Saf Division <br />20 Civic Center Plaza <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />www.santa-ana.org <br />PROJECT ADDRESS: /SD/ gr Ar—O/•-*'F,OR, <br />PAID BY: jl <br />A. <br />I( <br />&CELLANEOUS <br />RECEIPT <br />SUITE # <br />g Y srs DATE: <br />Bldg — Plan Check # <br />01116002 53600 $ <br />Plmg — Plan Check # <br />01116002 53602 $ <br />Elect — Plan Check # <br />01116002 53601 $ <br />Mech — Plan Check # yd/ Z -7 7 ') <br />01116002 53603 <br />$ / 3 y <br />Bldg Permit — <br />Inspection/Special Inspection <br />01116002 51601 <br />$ <br />Plmg Permit <br />— Inspection/Special Inspection <br />01116002 51602 <br />$ <br />Elect Permit — <br />Inspection/Special Inspection <br />01116002 51603 <br />$ <br />Mech Permit <br />— Inspection/Special Inspection <br />01116002 51604 <br />$ <br />Acc Bldg P/C # <br />hrs. <br />01116002 57600 <br />$ <br />Acc Plmg P/C # <br />hrs. <br />01116002 57600 <br />$ <br />Acc Elect P/C # <br />hrs. <br />01116002 57600 <br />$ <br />Acc Mech P/C # <br />yo/a 77 �3- 9 hrs. <br />01116002 57600 <br />$ c?- S / z <br />Boarding Fee (Community Preservation) <br />12115002 53507 <br />$ <br />General Plan Update Surcharge <br />01116002 51600 <br />$ <br />Statement of Fact/Public Records Research <br />01116002 51601 <br />$ <br />SMIP - Category Val$ <br />08901001 24000 <br />$ <br />Building Standards Revolving Fund <br />01116002 51612 <br />$ <br />Copies/Microfilm <br />01117002 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, Fireworks <br />09801001 24015 <br />$ <br />Fireworks Stands Fee <br />01116002 51501 <br />$ <br />Fire Facilities Fee <br />12015002 53700 <br />$ <br />TOTAL <br />$ <br />NOTICE: Applications for plan check submitted under Sectl <br />105.3.2 of the 2010 California Building Code will expire if no <br />,permits are issued within 180 days. <br />Receipt <br />Prepared by: CIa" z <br />Misc. Receipt # 6 4 8 5 7� I � <br />,npls April. 2013 <br />�,r rid GC.C-1 <br />Validation <br />