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City of Santa Ana <br />Permit Counter: (714) 647-5800 <br />20 Civic Center Plaza (M-19), Santa Ana, C492702 Electrical Permit #: 2Ot 66962 <br />Pin #: 7215lJlnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 <br />Project Address: 2620 W Seoerstrom Ave Unil: A <br />Block; NA <br />Bldg; <br />Tract: 8236/8868 <br />AddressRange: 2600-2830 <br />Historic; No <br />Suite Range: <br />Zoning: R4 <br />q <br />Assessor'sParcel: 933-071-59 Lot 2,611,2, 4,5 <br />Owner: <br />Address <br />Lori Tillman <br />2620 W. Segerstrom Ave, #A <br />Santa Ana, CA 92704 <br />(7141423-1062 <br />01 1 16002 51603 <br />01 1 16002 51603 <br />0't 1 16002 51600 <br />01 1 16002 51603 <br />Fee Type <br />Light Fixtures <br />General Plan Update <br />lssuance <br />Amount <br />1.05 <br />24.79 <br />22.O8 <br />55.04 <br />Qty <br />1.00 <br />1.00 <br />1.00 <br />1.00 <br />Fee <br />$1 .05 <br />$24.79 <br />$22.08 <br />$55.04 <br />Phone <br />Tenant Name <br />Contractor <br />Address: <br />Slater General lnc <br />8502 East Chapman Ave., #: <br />Orange, CA 92869 <br />(714) 6s3-s030 <br />Bat ch + <br />0ff i ce <br />Rcp ti i <br />9/21/2018 I0 <br />Trons+: 50PhoneRefi: 2016 <br />9/21/?Alg 12t{l <br />t336.State Lic #: 946654 <br />Lic Type: B <br />Bus. Lic #: 353370 <br />Workers' Compensation lnsurance:Carrier: Benchmark lnsurance Company <br />Policy #: CST5011908 <br />Expires: O1lO1l2O19 <br />ronsoct ion Totol <br />tlster ienePol Inc <br />Building Use: <br />Job Type: <br />Nature of Work <br />Multi-Family (5 or more uni Occupancy: <br />Miscellaneous Constr Type <br />Remodel Bathroom Code: <br />U, R-2 <br />VB <br />cEc 2016 Noles: Remove & replace fixtures in downstaiE bathroom. <br />Planning Conditions: No change in tloor plan. <br />Planning Approval By Misc. Receipt: <br />Misc. Receipt: <br />Misc. Receipt: <br />Total <br />Plan Checked By <br />Permit lssued By <br />Subject to Field: <br />Building Permit #:6 5 $102.96 <br />$0.00 <br />$102.96 <br />Every pemit issuod sha becofie invalid unless the wo* on tho site <br />authoized by such pemit is commenced within160 days aftet its <br />issuahce, or if the work authoized on the site by such pemil is suspended <br />or abahcloned fot a peiod o1180 days after the time the wo* is <br />commenced <br />lnspector MID#: 2018-'t43185 <br />01 '1 16002 51600 <br />011 16002 51603 <br />$22.08 <br />$80.88 <br />Generol Plon updote Fee <br />nl1160(2- i1600000- <br />Elecln <br />1r1116001- i1603000- <br />lCL ,-hecir 1103629 <br />Date: <br />Date: <br />Date:o9t24t2018 <br />Account# <br />Fee Total: <br />Paid to Date: <br />Balance Due: