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Planning & icing Agency <br />Building Safety 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 />MISCELLANEOUS <br />RECEIPT <br />PROJECT ADDRESS: 02 l SUITE # <br />PAID BY: DATE: <br />Bldg — <br />Plan Check # : f Q� <br />-7 cf `f F 01116002 <br />53600 <br />$ O �' _ <br />Plmg <br />— Plan Check # <br />01116002 <br />53602 <br />$ <br />Elect <br />— Plan Check # <br />01116002 <br />53601 <br />$ <br />Mech <br />— Plan Check # <br />01116002 <br />53603 <br />$ <br />Fire — <br />Plan Check # <br />01116002 <br />53600 <br />$ <br />Bldg Permit — <br />Trust/Special Inspection <br />01116002 51601 $ <br />Plmg Permit <br />— Trust/Special Inspection <br />01116002 51602 $ <br />Elect Permit <br />— Trust/Special Inspection <br />01116002 51603 $ <br />Mech Permit <br />— Trust/Special Inspection <br />01116002 51604 $ <br />Fire Trust <br />01116002 51601 $ <br />Acc Bldg P/C # <br />hrs. <br />01116002 57600 <br />$ <br />Acc Plmg P/C # <br />hrs. <br />01116002 57600 <br />$ <br />Ace Elect P/C # <br />hrs. <br />01116002 57600 <br />$ <br />Acc Mech P/C # <br />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 />$ 0 00 <br />NOTICE: Applications for plan checking submitted <br />under Section 105.3.2 of the 2010 California Building <br />Code will expire if no Dermits are issued within 180 da <br />Receipt <br />Prepared by: Ll�lVv o Z <br />Misc. Receipt # () � 8 S- - g Validation <br />