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Planning & fting Agency <br />Building SafeW 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 />ACELLANEOUS <br />RECEIPT <br />PROJECT ADDRESS: 1 <br />SUITE # <br />�. <br />PAID BY: 1 <br />DATE: <br />Bldg — Plan Check # <br />01116002 53600 <br />$e <br />Plmg — Plan Check # <br />01116002 53602 <br />$ <br />Elect — Plan Check # <br />01116002 53601 <br />$ <br />Mech — Ptan Check # <br />01116002 53603 <br />$ <br />Bldg Permit — Inspection/Special Inspection <br />01116002 51601 <br />$ <br />Plmg Permit — Inspection/Special Inspection <br />01116002 51602 <br />$ <br />Elect Permit — Inspection/Special Inspection <br />01116002 51603 <br />$ <br />Mech Permit — Inspection/Special Inspection <br />01116002 51604 <br />$ <br />Acc Bldg P/C # C-j rj�,-- his. <br />09801001-24045 <br />$ <br />Acc Plmg PIC # hrs. <br />09801001-24045 <br />$ <br />Acc Elect PIC # hrs. <br />09801004-�N0 `",-S <br />r YK <br />u�4�4 <br />17/2017 IQ. ELIZABETH <br />I'M i i@(4 1-177� <br />i <br />Acc Mech PIC # hrs. <br />0980106 <br />{ref i s 69050 <br />Boarding Fee (Community Preservation) <br />121150&n5d7wi' Tot$1 $472.1 <br />General Plan Update Surcharge <br />01116002 51600 <br />$ <br />Statement of Fact/Public Records Research <br />011160gZ„JPR j i ns <br />$ 1206.91 <br />SMIP - Category Val$ <br />089010(11240M 536011$X1- <br />- <br />Building Standards Revolving Fund <br />n Ghec _ - . 2 <br />011160§�]LPiL4 i3_ <br />Copies/Microfilm <br />011160W677" <br />Residential Development Fee — Specify Acct. No. <br />3002 57991 <br />$ <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 />F <br />NOTICE: Applications for plan check submitted under Section <br />105.3.2 of the 2010 California Building Code will expire if no <br />permits are issued within 180 days. <br />Receipt <br />Prepare <br />Misc. Receipt # 6 9 0 5 0 <br />TOTAL <br />hF-1lrgF- f:Ti1 <br />Plink/Counterf older/MiscReceipts/April 2016 <br />