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Planning & Being Agency <br />Building Safety Division <br />20 Civic Center Plaza <br />P.C. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />www.santa-ana.org <br />• <br />MISCELLANEOUS <br />RECEIPT <br />PROJECT ADDRESS: I `S 3� P Lai, SUITE #_ <br />PAID BY: /"Id Wa-yf Roo -A,., DATE. o� <br />Bldg — Plan Check # <br />Plmg — Plan Check # <br />Elect — Plan Check # <br />Mech — Plan Check # <br />Fire — Plan Check # <br />01116002 53600 $ <br />01116002 53602 $ <br />01116002 53601 $ <br />01116002 53603 $ <br />01116002 53600 $ <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 -Ml <br />$ <br />Acc Plmg P/C # hrs. <br />011 160024�1" 8021410 <br />$ <br />Acc Elect P/C # hrs. <br />01116002157W" °f 7 o <br />-$ <br />Acc Mech P/C # h rs. <br />01111600257800 ROOF I h,$ <br />Boarding Fee <br />12115002 �53607 <br />$ <br />General Plan Surcharge <br />01116002 ; jWQ <br />$ <br />Statement of Fact/Record Search <br />01116002 3'11`-'' . <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 />C UAvGE of A <br />5-1(001 <br />$ <br />TOTAL <br />$ S <br />NOTICE. Applications for plan checking submitted <br />under Section 105.3.2 of the 2010 Califomia Building <br />Code will expire if no permits are issued within 180 days. <br />Receipt <br />Prepared by: 1'� Gt -7 <br />Misc. Receipt # f) 5 8 u 3 2 Validation <br />