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Planning & Aking 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 />PROJECT ADDRESS: <br />PAID BY: <br />• <br />MISCELLANEOUS <br />RECEIPT <br />SUITP # <br />DATE: <br />Bldg - Plan Che # i< <br />01116002 <br />53600 <br />$ eCyL-11 l <br />Plmg - Plan Check <br />01116002 <br />53602 <br />$ <br />Elect - Plan Check # <br />01116002 <br />53601 <br />$ <br />Mech - Plan Check # <br />01116002 <br />53603 <br />$ <br />Fire - Plan Check # <br />01116002 <br />53600 <br />$ <br />Bldg Permit - Trust/Special InspeNon <br />Plmg Permit - Trust/Special lnspecti <br />Elect Permit - Trust/Special Inspection <br />Mech Permit - Trust/Special Inspection <br />Fire Trust <br />01116002 51601 <br />$ <br />01116002 51602 <br />$ <br />01116002 51603 <br />$ <br />01116002 51604 <br />$ <br />01116002 51601 <br />,$ <br />Acc Bldg P/C # hrs. 01116002 57600 $ <br />Acc Plmg P/C # hrs. 01116002 <br />5760 $ <br />Acc Elect P/C # hrs. 116002 57 0 $ <br />Acc Mech P/C # hrs. 16002600 $ <br />Boarding Fee <br />121 0 53507 <br />$ <br />General Plan Surcharge <br />0111 02 51600 <br />$ <br />Statement of Fact/Record Search <br />011 60 51601 <br />$ <br />SMIP - Category Val$ <br />0 01001 4000 <br />$ <br />Xerox Copy, Microfilm <br />1116002 770 <br />$ <br />Residential Development Fee - specify Acct. No. <br />3002 57 1 <br />$ <br />Temporary Certificate of Occupancy <br />01116002 516 <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 />NOTICE: Applications for plan checking sub itted <br />under Section 105.3.2 of the 2010 Californi Building <br />Code will expire if no permits are issued wit in 180 da <br />Receipt <br />Prepared by: <br />Misc. Receipt # 0 5$ R O 3 Validation <br />