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CITY OF SANTA ANA <br />PLAN CHECK - CHECKLIST <br />JOB ADDRFRR·2 )01 +J 13 V}in <br />TRACKING #:lot 11-19/- q.1-DATE:12-10 -)1 <br />FOR PLANCHFCK STATUS CALL (714) 647-5800 <br />PLEASE INITIAI FACH ITEM RFI OW <br />11- <br />/1. <br />_26. <br />I agree to pay a plancheck fee established for this project with the understanding that this <br />payment is not a guarantee that a permit will be issued and that this fee is not refundable <br />once a plancheck has commenced. <br />I understand that I may request an "Accelerated Plancheck" at an additional cost to me. <br />This plancheck will be performed by an in-house plan checker with the intention of reducing <br />plancheck time for the Building & Safety Division. <br />I understand that the project valuation (from which plancheck and permit fees are <br />calculated) will be reviewed during the plancheck process and that said valuation shall be <br />adjusted up or down in accordance with established fee computation regulations. <br />Al 4 I understand that I shall submit separate plans, applications and plane.heck fees for the <br />following when plan check is required: <br />a. Electrical Plans - 2 complete sets c. Mechanical Plans - 2 complete sets <br />b. Plumbing Plans - 3 complete sets d. Grading Plans - 3 complete sets <br />I understand that I shall visit the Public Works Department to verify whether a field <br />inspection of the property is required. 1 understand that prior to the issuance of the Building <br />permit I am required to obtain Public Works Agency approval if my project valuation exceeds <br />$30,000 or has added plumbing fixtures, or added bedrooms, or exceeds 500 sq.ft. <br />AGRFFn TO BY APPLICANT OR AGFNT <br />Applicant's Signature./£---- CL,f <br />Print Name /10#1 /7) A;14/6L#f.Jl,' Ad,Nt™A 9 342/ fiejlt< CvY\e. -TO-A CA ekf <br />- Telephone Number 449- 9% 62630 Fax <br />. FOR OFFICE USE ONLY: "Checklist of items discussed" APPROVALS & FEES REQUIRED: Y/N <br />1.Planning Department 7..kfritle 24 (Energy ) <br />2.25'Public Works Agency 8.321-itle 24 (Disabled Access) <br />3.271:ire Departmemt 9.-ERoof Mounted Equip. <br />4.-Ef'Police Department 10.-kfist.of Subcontr. <br />5.--Id'School District 11.-€13ldg. Pmt. Info. <br />6-Health Department 12..ESummary of Appr. Reg. <br />1 3.-EfRY Information <br />14.XEonstr. Act. Reg. <br />1 U!* Res. Dev. Fees <br />V.16.- SMIP <br />17.--vMicrofilming <br />18.-E-Const. Debris Recyc. <br />19.-5FCWP Surcharge <br />20,*LOA/Owner-Builder Ver. <br />KcllePERMIT TECHNICIAN l/4 4 -1/ 2-- <br />Form 58.3-26-04 <br />g <br />-\