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PAID BY: DATE: _—' /-- 1,fj< <br />Bldg — Plan 6beck # 01116002 53600 $ <br />Plmg — Plan C ck # 01116002 53602 $ <br />Elect — Plan Che # 01116002 53601 $ <br />Mech — Plan Check 01116002 53603 $ <br />Fire — Plan Check # 01116002 53600 <br />Bldg Permit — Trust/Speci Inspection 01116002 51601 $ <br />Plmg Permit — Trust/Specia nspection 01116002 51602 $ <br />Elect Permit — Trust/Special I ection 01116002 51603 $ <br />Mech Permit — Trust/Special Ins ction 01116002 5160 $ <br />Fire Trust 01116002 51 1 $ <br />Acc Bldg P/C # hrs. 01116002 600 $ <br />Acc Plmg P/C # S. 0111600 57600 $ <br />Acc Elect P/C # hrs. 011160 2 57600 $ <br />Acc Mech P/C # hrs. 0111 02 57600 $ <br />Boarding Fee 12 5002 53507 $ <br />General Plan Surcharge 0 116002 51600 $ <br />Statement of Fact/Record Search 1116002 51601 $ <br />SMIP - Category Val$ 901001 24000 $ <br />Xerox Copy, Microfilm 0 16002 57770 $ <br />Residential Development Fee — specify Acct. No. 002 57991 $ <br />Temporary Certificate of Occupancy 0111 0251601 $ <br />30 Day Temporary Fee — Gas 011160 51602 $ <br />30 Day Temporary Fee — Electrical 0111600 1603 $ <br />Bond: Demo, 30-Day, Relocation, Sign 098301001 015 $ <br />TOTAL $ <br />NOTICE. Applications for plan checking s mitted <br />under Section 105.3.2 of the 2010 Califor is Building <br />Code will Mire if no permits are issued ithin 180 da s. <br />Receipt <br />Prepared by: <br />Misc. Receipt # 5 80 4 8 Validation <br />WP51 <br />Fees 201 1-2012/Misc Rece+ptsl9-20-2011 <br />