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th7:n crw oF sANrA ANA 4? - ( I n r\ (.,. / "DEVELOPMENT FEES WORKSHEET.. PLUMBING PERIVIIT " I <br />NEW BUILDING E ALTERATToNS/ADomous a ?gto'"(nr.(6 <br />tq. <br />q".J <br />r) <br />ProlectAddress: 4290 W. fipsi grusar T;q^JtpooD Pcr*B,nc. Eu..Contractor: <br />Tenant Name Address: /O/ !. Planr,n Bu4. SUtry-72p <br />Building Owner: ESS(..]!/- Poa,p,il,T\ Tw\f City: pcat*'wn4 St.: C/4 Zip: lzgTg <br />Address: l?t{(, I DE{t-o-: Are. Co.ru ll0 Contractor License No.: 05l7tZ- <br />City: f,pu,n5 St.: f,.A Zip: 1zt-ctr{Contractor e-mail: (t./ Othn"uoa/P/u*L,n , ca -t <br />Phone: qq? -?4 3 - oozG Phone: ?t4-?00-5VOf <br />Contact Person: CkO.t- Lq^,r Lt <br />Contact Phone: 7N -CO-rb^{ <br />Contact E-Mail Strongly Recommended PLEASE PRINT: <br />@r/ @ )o.,*aa[p1y*t>tas , Lora <br />ITEM N0.TOTAL NO EACH TOTAL <br />Fixtures Miscellaneous <br />Water Closet or Bidet 13.69 Water Heater Res E Comm E L 21.42 <br />Urinal 10.47 Water Heater Tankless 63.12 <br />Tub, Shower, or Tub/Shower 21.42 q\r.+q6-\Ah{#leater over 50 gallons t 87 .87 <br />Whirlpool Tub or Foot Spa 21.42 Water Service/Piping- each 100'42.85 <br />Sink, Lavatory, Laundry or Utility 12.23 Re-pipe (residential) - each 100'42.85 <br />Clothes Washing Machine 13.45 Primary/Secondary Roof Drain Set 42.85 <br />Dishwasher 11.52 DecUArea Drain 9.26 <br />Garbage Disposal 10.26 Rain Piping (buried) - each 100'20.85 <br />Floor Sink + _ Floor Drain =15.53 Storm Drains - each 100'27.54 <br />Drinking Fountain (one location)8.62 Water Softener - Residential <br />Cap Fixture (each)6.69 Water Softener - Commercial 42.85 <br />Sewer Lawn Sprinkler Valve (each)9.78 <br />New Sewer - first 100'62.18 Backflow less than 2"21.42 <br />Each 100' Sewer (or any portron)21.42 Backflow 2" and above 42.85 <br />Additional Sewer Connection Sewage Ejector 63.12 <br />Repair/Alter Sewer Sump Pump 63,12 <br />Cap Sewer Hose Bib with Vacuum Breaker 14.89 <br />Grease,&Vaste I nterceptor 36,15 <br />Gas Dental Unit 31 .10 <br />New Gas System (flrst 4 outlets)42.85 Medical Gas Piping - each 100'48.85 <br />Each Additional Gas Outlet Alteration to Drain/y'ent 42.85 <br />Extend or Alter Gas System oJ.tt Appliance Not Listed 63.12 <br />Repair Gas Piping 42.85 SUBTOTAL U <br />Cap Gas Outlet - each 8.1s P/C 65% OF SUBTOTAL $ <br />Swimming Pools lVlN. FEE - (Nonresidential)$ 70.64 <br />Pool Trap ISSUANCE & GeneralPlan surcharge $ 52.98+21.25=$74.23 <br />TOTAL <br />BLDG PMT#RECEIPT #DATE <br />$Pool Pi in <br />Pool Heater <br />42.85 <br />OCCUPANCY,'*l z') t I <br />CONST TYPE )t <br />EACH ITEM <br />21.42 <br />6.80 <br />P/C FEE PD: <br />ffice Use <br />=I <br />ts- <br />= <br />lt.uT <br />42.S5 |I so.ra I <br />I I 21.42 | <br />[--l_-6es4 <br />I