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City nf Santa Ana 20 Civrc Center Plaza (M-19) Santa Ana CA92702 Electrical Permit #: 2lJ171887 <br />Pin #: 50547Permit Counter (714) 647-5800 lnspection Requests: (7'l4t 667-2738 lnspector Sectron: (714) 647-5853 fir <br />Proiect Address: 4507 W Roosevelt Ave Unil <br />Block: NA <br />Btdg: <br />Tract 3669 <br />Address Range: <br />Historic: No <br />Suite Range: <br />Zoning: R'lAssessor'sParcel. 100-58141 Lot 50 <br />Owner <br />Address <br />Tammy Kim Nguyen <br />4507 W Roosevelt Ave <br />Santa Ana, CA 92703 <br />(7r4) 391-2915 <br />01 1 16002 <br />0't 1 16002 <br />011 16002 <br />0't 1 't6002 <br />011 't6002 <br />51603 <br />5't603 <br />51600 <br />51603 <br />57770 <br />Fee Type Amount <br />Light Switches, Occ. Se 'l 70 <br />Light Fixt ures 1.'13 <br />General Plan Update 23.79 <br />lssuance 59.30 <br />Microfilm Records 4 05 <br />Fee <br />$1 70 <br />$1.13 <br />$23 79 <br />$59.30 <br />$4 05 <br />Phone <br />Tenant Name <br />Conlraclor <br />Address: <br />Owner-Builder <br />Phone <br />State Lic #: <br />Lic Type: <br />Bus. Lic #: <br />Workers' Compensation lnsurance <br />Caftier: <br />Policy f: <br />Expires: <br />Building Use: <br />Job Type: <br />Nature of Work <br />Single Family Owelling <br />Patio Cover <br />Palio cover <br />Occupancy <br />Constr Type <br />Codel <br />R-3, U <br />VB <br />cEc 2019 Noles Electrical lor patio cover <br />Planning Conditaons: <br />Planning Approval By: <br />Plan Checked By <br />Permil lssued By. / lzdmsden, Julre'li <br />Subtect to Field ( I <br />Bu.rdinsPermit#: iotrc+aqz <br />09114t2020 <br />Account# <br />lvlisc. Receipt: <br />Misc. Receipt. <br />lvlisc. Receipt: <br />Total <br />Every pemtt $sued shall become nvahd unless the wofu on the stte <br />aulhonzed by such pefinil ts cifimenced wihn360 days after tls <br />lssuance ot il the wo authonzed on the sla by such perfitt ts suspehded <br />ot abandoned fot a penod ot 360 days aftet the time the wo ts <br />cofifiencecl. <br />$23 79 <br />$62 13 <br />$4.05 <br />$89.97 <br />$0 00 <br />$89.97 <br />lnspector MID#: 2020-161471 <br />01 1 16002 51600 <br />0'1 't 16002 51603 <br />01116002 57770 <br />Fee Totall <br />Paid to Dale: <br />Balance Due <br />Qtr <br />100 <br />'t .00 <br />1.00 <br />100 <br />1.00 <br />Date <br />Date <br />Date