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City of Santa Ana <br />,ierTit coTEf#I647-s800 <br />20 Civic Center Plaza (M-19), Santa Ana, CA\27O2 Building <br />lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 <br />Permit #: 10193274 <br />Pin #: 53163 <br />a;ffi I I <br />Assessor's Parcel:407 -03',t -27 <br />\!- <br />Lot: 29 Block: NA f?d 3423 <br />Bldg Address Range Suite Range: <br />Zoning: RlHistonc: No <br />Building Use: <br />Job Type: <br />Nature of Work: <br />Existing Bldg. & Use <br />Proposed Use: <br />Singls Family Dwelling <br />Reroof <br />Reroof <br />SFD Waft garage <br />R.3, U <br />VB <br />cBc 2016 <br />x-0602320257J <br />,t <br />1st FL Areal <br />2nd FL Area: <br />Other Areas: <br />Garage Area <br />Total: <br />Patiol <br />T.l.Area: <br />Yards Req'd: <br />Valuation: S7,000.00 <br />O6scription of Work: Tear-off & apply composition shingles. Handout given. Auth. filsd. <br />Planning Conditions: RePlacg sheathing, eaves, & fascia boards as needed.O,,r .-Lat?On<r"t - L Itatattt 7 rn' I Oner\l ca <br />Owner: <br />Address <br />Phone: <br />Tenant: <br />Contractor <br />Address:Address: <br />Sam Ouang Nguyen <br />14181 Donegal Drive <br />Garden Grove, cA 928114 <br />(657) 337-2888 <br />Owner-Builder <br />Phone: <br />State Lic #: <br />Lic Type: <br />Bus. Lic #: <br />Workers' Compensation lnsurance <br />Carrier: <br />Policy #: <br />Expires: <br />(!lf rce: CTYH Trons+: 87 I of I <br />A.r,: ti: Refi: 10193271 <br />I{oti!01922978 - 6/!5/2017 lz0l Pn <br />lr (nsoct ion Totol t3/t.3? <br />.,,h Ouone l{suyenPhone: <br />License #: <br />Architect / <br />Desiqner: <br />Address: <br />Phone: <br />License #: <br />,)ri,€rol Plon Updote Fee <br />rrl 1 16002" 51611(nl0u- <br />li, r I td inerl I 16r-102- 516r:rl00tr- <br />P,lde Stds Revolvine <br />rrl I 16r-r02" 5l6l2rlorJ- <br />ll,'. i.er (:qrd <br />,- i: rrrr*rrrrr *16393 <br />t?0. -'d <br />s319.76 <br />91 . (rtl <br />r371 .32 <br />Authl:03923t1 <br />vara, J Date: 06/15/2017 <br />Date: <br />Date: 06/15/2017 <br />Subject to Field: <br />Misc. Receipt <br />Misc. Receipt <br />Misc. Receipt <br />07776002 51601 Permit Fee <br />07776002 51612 Bldg. Stds. Revolving <br />07776002 51600 General Plan Update <br />07776002 51601 lssuance <br />$298.s0 <br />$1.00 <br />$20.56 <br />$51.26ki, Teri <br />Fire lnsp. Req'd: <br />Police lnsp. Req'd ffi Account#Total <br />Flood Zone Cert. Req'd: No <br />Every perfiit issued shall become invalid unless tho wo* on tho site authorued by <br />such pemit is commenced within180 days after ils issuance,or ifthe wo* authoized <br />on the site by such peml is susponded ot abandoned fot a penod oI180 days after <br />lhe time the wotk is comfiencod . <br />01116002 51600 <br />01116002 51601 <br />011 16002 51612 <br />$20.56 <br />$349.76 <br />$1.00 <br />Fee Total. <br />Paid to Date: <br />Balance Due: <br />$371.32 <br />$0.00 <br />$371.32 <br />lnspector MID#: 2016-129520 xe?Drlur}h$\ v@t+&?>- <br />Unit: <br />Occupancy: <br />Constr Type: <br />Code: <br />Flood Zone: <br /># of Stories: <br />Engineer <br />Planning Approval By: <br />Plan Checked By: . <br />Permit lssued By: \Z- <br />NPDES lnsp. Req'd{ No <br />PWA lnsp. Req'd: \/ No <br />Planning lnsp. Req'd: No <br />Landscaping lnsp. Req'd: No