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Project Address: 1155 W Centra! Ave <br />Assessor'sParcel: 410421-01 Lot: NA <br />Bldg: <br />Tracl: NA <br />Address Range: <br />Historic: No <br />Suite Range: <br />Zoning: C2 <br />b?unit: 201 <br />Block: NA <br />city of santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA\27O2 Plumbing <br />Permit Counter: O14) 647-5800 lnspection Requestsi (7141667-2738 lnspector Section: 014) 647-5853 <br />Permit #: 3O33E3OO <br />Pin #: 5667E <br />Owner: <br />Address: <br />Phone: <br />Tenant Name: <br />Contractor <br />Address: <br />AMUSEMENT INOUSTRY, INC <br />5665 LONG BEACH BL <br />Long Boach, CA 90805 <br />(310) 639-7130 <br />Owner-Builder <br />011 16002 51602 <br />01116002 51602 <br />0'l t16002 51602 <br />01116002 51600 <br />01116002 5'1602 <br />Fo6 Typ€ <br />Backflow < 2" <br />Oental Unit <br />Field Verification <br />General Plan Update <br />lssuance <br />Amount <br />21.42 <br />3'l .10 <br />'t5/..26 <br />21.25 <br />52.98 <br />Foc <br />$85.68 <br />$124.40 <br />$ 154.26 <br />$21.25 <br />$52.98 <br />Qty <br />4.00 <br />4.00 <br />1.00 <br />1.00 <br />1.00 <br />Phone <br />Stale Lic #: <br />Lic Type: <br />Bus. Lic #: <br />Workers' Compensalion lnsurance: <br />Carrier: <br />Polic, #: <br />Expires: <br />Planning Conditions: <br />Planning Approval By: <br />Plan Checked By: <br />Permit lssued By: <br />Subject to Field: <br />Building Permil #: <br />Evory pom,it issued shall becgme invalid unless tho '!toi< on the site <br />aulhotized by such pemil is commencid within 1 80 days aftet its <br />issuanco, or if lhe wo* authoized on the site by such pemit is suspended <br />or abandoned Igt a peiod ol 1 80 days afrot the tme the wod< is <br />cdnnpr@d. <br />lnspector MID#: 2017-137434 <br />Commercial <br />Alteration <br />Dental units <br />Date: <br />Date: <br />Date:Chavez, Oave_?.Q-07 t17t2017 <br />Account# <br />Botchi:39(30 - 7/17/2917 JD: ororol€el5 <br />0ilicer CTYH hsn5!: 100 I ol I <br />Accti I Reft: 3033S304 <br />Rcati:01943129 - 7/17/2017 12.22 Pi <br />Tronsact ion Totol t438.57 <br />AliUSEllE[T II{DUSTRY, IHC <br />4 backflows and 4 denial units. Owner authorization <br />on file. <br />$438.57 <br />$0.00 <br />$438.57 <br />Building Use; <br />Job Type: <br />Nalure of Work <br />Occupancy: <br />Constr Type <br />Code: <br />B <br />V B, SPK <br />cPc 2015 <br />Notes <br />Misc. Receipt: <br />Misc. Receipt: <br />Misc. Receipl: <br />Total <br />01 1 '16002 51600 <br />01116002 5't602 <br />$21.25 <br />$417.32 <br />Fee Total: <br />Paid to Dale: <br />Balance Due: