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APPLICATION AND
<br />ELECTRICAL PERMIT
<br />(TYPEWRITE OR PRINT iN INK)
<br />o o
<br />APPLICANT FILL IN AREA BELOW
<br />E-o
<br />=c,
<br />o
<br />*a
<br />r
<br />h-s
<br />l$
<br />k
<br />X."^^*"'utE nesroenrrat E tnousrrrat NO EACH TOTAL
<br />F... Hot.l., fol.l., Api, Sq Fr 03
<br />O.r. o, C.rporl. Sq rl o?
<br />50
<br />50
<br />ESS
<br />STATE/Z]P
<br />ID
<br />H
<br />t-t. t^4.4-( hl7 c:4
<br />\34ttz/.q1a-
<br />S.,ACITY
<br />50
<br />20 00
<br />€ach
<br />500Approv€d F6clory wned Unrr
<br />LrBl:
<br />500
<br />10.00
<br />.50
<br />Firc Srgnanng Syltom. Minrmum lo6
<br />oiJllot, lmok€ o. hoat 60060r
<br />5.m
<br />1.00
<br />Lighhc slanderds wilh on6 lamp
<br />Each Add'l linu,a on 8am€ slandrd
<br />Ow'r.-Aldar D.cHo.l
<br />I i..!tr rlt@ tn6r t .m .xdpr lro.n lh. Cor..lo.'. Lc.u t.w ,o. dr toior.g ...r. ls..
<br />7O3t 5. 8urn .! ..'d PoLBtFs Cod.' A^y cily q .o!.ry which Equr.s . p€rhrl io connruct,
<br />.h.r, improv€, d.molsh, or..p.,anvstluclur€, pno.ro n.E.u..c.,.l!o r.quEs rh6.pplE nlld
<br />!u.h !.mrr lo fib . ,gEd n r.l1Er rh.r h.
<br />'s
<br />I'c.,r!.d Fr,!r6r ro rh. pronrio3 ol OE Can&-
<br />ro.'.1,c..! t * lch.Drd 9 lcdnnBrrrio *th S..iio.1 70OO) ol OivLnM 3 o{ the &d..s.nd
<br />Prof.&on! Cod.) or rh.r h. r! or.mI lh.or.om sd thr b.e.lor nB .lbg.d.rmptrd! A,!y eo|l-
<br />ro. ol S.ct on 7031 .5 by ..y rldir lo. . Cdryrn $acr! m .pCl(sr o . csl o.n lly ol rcr
<br />mo.. rhe th. nundod doLrs ( l SOOI'
<br />D S-oo.' roql l, s oru ol tlr o.oo.ny. o. ov lmproy-s win w'gG !. rhdr lor€ co.n-
<br />p..!rli6.. will .lo rh. wo.t, .nd rh! ltuc.ruG B not t.t6.&d d otlrlld io. sL
<br />E s*ton ro.44e r. !. ownd ot rh. prope,ry, .m.rcru.'wt co.n&mc wrh r.6xd coc.
<br />rracrE r $ codrtual rhr p.ot .r
<br />D.b Orars|o.r-
<br />Marnl6nanc6 Pe.mll (annual)50 00
<br />15 00
<br />35 00
<br />75.00
<br />1500Signs and high pot.nrial 9a3 rub€ hghring
<br />swmmhg poob, lounl&ne. 3pa3
<br />15.00
<br />Swichbord, moor contrcl ccnlar or aubpen.lr
<br />t 15.00
<br />3.00 \6pzTamporery conllrucrio. melo, aorvlca polc
<br />Each dirlrlbution polc
<br />Contr.cto. Ut6 Only
<br />l-eroNe
<br />-
<br />14<-t-Asz
<br />ADDNESS7-2//1
<br />C.w,{out <5
<br />2.. ya<-tL Sr(
<br />C IYLt-6pas14
<br />Lmpora,y conarrucllon lighling
<br />500 lalnp! or 1633
<br />Ovfi 5()O l.mpa
<br />200
<br />4.CtO
<br />Tihs clock or photo .loctic coll 300
<br />POW€F APPAFATUS| G.n.r.!orl. morors,
<br />trellslormol3, r€ctili.r6, industrial h.rling,
<br />coorinC, or bating equipmonl and othst
<br />rpparalur as lollow!:
<br />Up ro.nd including 1 HP, Kw, XvA
<br />Ov6r 1 and noi ovor 10 l.iP, KW, KVA
<br />Ov., 10 and nol ovcr 50 HP, XW, KVA
<br />Ovo.50 end nol ov6, 10O HP, (W, KVA
<br />Ova! 10O and nol ova. 500 HP, Kw. Kva
<br />Ove, 500 HP, KU/. KvA
<br />2.00
<br />500
<br />r0 00
<br />20 00
<br />30.00
<br />40 00
<br />frrort .t Cdrlo-radoo Daclr.arro.r
<br />IrErby.lrrm,Er r h.6r6rol. .olc@s^r loeni^sr.. drc.d'l@r6ol llb.r.r'!c6pd
<br />*&;4- ora*,,",n, C\- B-,A-, rv.y'-
<br />f,odc. To ASDb.rt
<br />n. .tur m.rnlg lh6 C.rfi€.r. oI Erdprih, yoq lho{ld !.co.i[ eJbi€cr ro rh6 \ lo.k.r'r Comp.n
<br />..lrd pdidoru ol lh. Llbd Cod., you mun lonhnh comp, wrh !4h p.d.M! o. th3 o.m'r
<br />ddl b. .h6.d ,!l,!Ld
<br />Subrotal /s-
<br />Pon.tiy Fac (whon eppticabla)
<br />v,olal,on Fso (h,nmum t3500)
<br />B.n Ch.ck F.c (minimum i15.00)
<br />10 00
<br />TOTAL PERIIT FEE (m,nrmum 935.00)
<br />CrCradoar
<br />lhi! rdlnrr !h.ll .l,(6 by lmrt!non ohd b6om. null fid vod rl th. wk.urhd[.d by rh6 o.rn'r 6
<br />rct c@nBrc.d arhi. l8O d.y3 tr@ lho d!t. ol trE p.nrn d ,ort .uttutld br thir o.rmir 's&!o..d.d d.b.nd6.d.r..v nm6 .llo.0E wl 6 cmc.d lor. penod oi 180 d.vs Ale
<br />!am[ !h.ll b. obrs'.ad trGr b.ld. luch wst on b. remmm.d
<br />arC.-t'a Oacb..doi
<br />I @dt th.r I h.6 l'rd rh! .oolE6!o.r .nd 3r.16 rh6r tf, .boE in,orm.r'on k .qrel. I .9r.. to
<br />comrlY *rn .I clry o.didrc.r lnd t$r. hwr cLt rC ro bd'LinC c@tlrEmn. f,d hr.by lurto
<br />n . l.p...6nD!\niot ri.. ciry ro..r* uCon Ol aboFmco0o.rd ,oFrry lo. ru,!.ton 0!lD0!.6.
<br />OATE 9 -)-a - P1 PEBXIT TO,
<br />PEFMIT TSSUEO 8Y lS'9 IVEfiIFIEDSY ISq )
<br />6IJrLONG
<br />VALIOAIION iOFFICE USE ONLYI(accouNr l 413r
<br />Distribution: 1. lnspoctor Copy 2.FileCopy 3. FinanceCopy 4. Applacant Copy
<br />CITY OF SANTA ANA
<br />206 W. 4rh Sr.
<br />647-5800 ,h,^-
<br />Buaways, apocial laceway!. undor lloor ducr.
<br />trollcy or plugrn bu8way! ea. 10O'
<br />Up to 40O amp., p€, mder
<br />Ova, 400 .mpl, p.. mrlpr
<br />Ovar 1200 amp!. p€r malcr
<br />35.00
<br />Raccror No- PC No-
<br />le (1
<br />I h.r.by ,i'm rh.r I !6 I'c.nrd on&, 6€ C.ovrerss ol Ch.pr.r 9, DMrlo. 3 ol rh. Bue..$ md
<br />Pror..lonr cod., md my lic..r. E rn lull iorc. rnrt .tlocr
<br />,*F".t:!a_ ,n* P 12 q,l*5!r1
<br />o"" L-z* e",_,"", O- b -l-,* -A
<br />I c.nily ttlr n th6 oonorma.c. ol the wort lor whlch rhB o..m a! 'su.d, I Cr.ll .or omplov .ny
<br />p..soo in liy merer 5 .! ro b.cori€ .uq.d o dr wrtr'! cornp..xton L.*! ol c.lildn .
<br />#3 ^**,. ^,",,,",LEl^-{
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