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City of Santa Ana 20 civic Center Plaza (M-19), Santa Ana, cA 92702 <br />Permit Counter: (714) 647-5800 lnspection Requests: 1714) 667-2738 lnspector Section: (714) 647-5853 <br />Electrical Permit #: 2lJ17o,421 <br />Pin #:3E455 <br />..) <br />Project Address: 410 W Nineteenth St <br />Assessor'sParcel: 002-102-03 Lot: 12 <br />Unit: <br />Block: C <br />Bldg: <br />Tracl: 256 <br />Address Range: <br />Historic: No <br />Suite Range: <br />Zoning: R1 <br />Contraclor <br />Address: <br />Jack Russell <br />410 West 1gth Street <br />Santa Ana, CA 92706 <br />(714) 836-96.14 <br />011 16002 51603 <br />01116002 51600 <br />01116002 51603 <br />01116002 57770 <br />Amount <br />55.37 <br />22.95 <br />57.20 <br />3.91 <br />Fse <br />$55.37 <br />$22.95 <br />$57.20 <br />$3.91 <br />Fee Type <br />Serv Meter <br />General Plan Update <br />lssuance <br />lvlicrofilm Records <br />Notes: Electrical <br />Qty <br />1.00 <br />1.00 <br />1.00 <br />1.00 <br />Owner-Builder <br />State Lic #: <br />Lic Type: <br />Bus. Lic #: <br />Workers' Compensation lnsurance <br />Carrier: <br />Policy #: <br />Expires: <br />Building Use <br />Job Type. <br />Nalure of Work <br />Planning Conditions: <br />Single Family Owelling <br />Miscellan6ous <br />Electrical <br />web user'. <br />Date <br />Date <br />Date <br />Misc. Receipt: <br />Misc. Receipt: <br />Misc. Receipt: <br />Total <br />$'139.43 <br />$139.43 <br />$0.00 <br />Ewry psrmit issued shall bocofie invehd unloss lre work on lhe site <br />authoized by such pemit ts comnenced withn360 days afrer its <br />issuance, ot t the wo* euthonzed on the site by such pefinil is suspended <br />or abgndoned lor a period ol 360 days eftet the tfie the work is <br />commenced. <br />MID#: 20'19-156644 <br />N/A - No Ealance <br />N/A - No Balance <br />Fee Total: <br />Paid lo Date: <br />Balance Due <br />Owner: <br />Address: <br />Phone: <br />Tenant Name: <br />Phone <br />Occupancy: <br />Constr Type: <br />Code: <br />R-3 <br />VB <br />cEc 2016 <br />Planning Approval By: <br />Plan Checked By: <br />Permit lssued By: <br />Subject to Field: <br />Building Permit #: <br />1211812019 <br />Account# <br />lnspector