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APPLICATION AND
<br />ELECTRICAL PERhJfiT
<br />(TYPEWFITE OR PsINT IN INK)
<br />o O CITY OF SANTA ANA
<br />206 W. 4rh Sr.
<br />047-5800 ffir'
<br />O Besdsnriar E rndusiial #....-""EACH TOTAL
<br />03R.r. Xor.l.. foi.l!, Apt. Sq tr
<br />O.r. o, C.Don. Sq fr a?
<br />40 50 )o:
<br />505</1,50
<br />CITY SIATE ZIP ,*r<utt{Z (* azrt1g
<br />t ):->,
<br />re$-q)1 tT .ilE
<br />JOEAODNFSS v{ t'tt:\
<br />MAILINGADOBESS
<br />23b 50 il5
<br />2000
<br />Approv€d Facbry wi,ed Unrl 500
<br />Aurway6, spocial rac.,./ry6, u.d€. lroor oucr
<br />kollay or plug.in buswaF ea. 100'500
<br />Fi.6 SignEling Sy3lom. Minimum lo.
<br />OlJllsl. Bmoko or haal s€nsor
<br />r000
<br />.50
<br />Ughrn9 sren(,8ds *ith ono L.mp
<br />Each Add'l finuro on tam6 standard
<br />5.00
<br />1.00
<br />5000Maanlonanca P.rmrt lannual)
<br />up lo aoo .mp5, p.. rrl6ler
<br />Ovar 40O ampr, pfl mcla.
<br />Ova. 1200 afipa, par mela.
<br />7 lt@-
<br />35.00
<br />75.00
<br />lo5.
<br />Signs and h'gh poionrral gas rub€ lighring 15.00
<br />35 00Swimmrng pools, lounlarns, Bpas
<br />S fichboed, flElo. conlrol canLr or lub-plnalt
<br />Each a l5 00 1o
<br />T.mporary comtruction mdor lawic6 polc
<br />Each c,iltrlbutlon pol6
<br />r5.00
<br />3.00
<br />Orn--8dd.r D.d-.rlo.r
<br />I trroby .tl'n thll I !m .x.trpr l.oh ih. Contr.cbr'. l-lc n.. L.* to. r'r tollowr! rs!o. lse
<br />7031 5, &i!!6 ..d Prol.s6^r Cod. Ary crry or counry wn.h ..q!r.! .
<br />.lror, 'mp.@, .bool'sh, d ,op5n ..y slru.turo. D.'or lo rrB rlsuanc6, ds
<br />&cn F6 lo nb . r! d n rom^r lh.r L ir I'c.ned oors.nr ro
<br />rd 3 L'@nra Le lcn pw 9lcomMi.!w h S&li@ r0o0l
<br />P@l6s,oBCod.ro, rh6rh. B.x.npr fi.6hm rnd rh6
<br />ro ol se.uo 7031 5 b, .ny .rprrc.nr ls. Fmir e
<br />n.. ol rta p.olorly, .m arclus,wly cot.&m! wlh lrcmsd cd
<br />Ownn lsih ,-
<br />I h.l!h .nm th.r I .m lir!! d uidd rh. proe3lN ol Ch.OLr 9, O's.ion 3 ol lh. Eutn t! .nd
<br />Piol.r!o.'! Codo, lnd ny lict.!. a h tull 10.6 .,!d .li.cl
<br />AOORESS
<br />CITY
<br />*_g?_
<br />lS'g
<br />L -*t
<br />h/
<br />*r'<t l
<br />Cont.lclor U.. Only
<br />ous'd! ol th. Colr--
<br />v'ro.3 ol t& 80!rn !36nd
<br />!h..lL!6d 6ro6!10.r Any uoL.
<br />he .Oplic.nl lo 6 cNil p..!hy ol nol
<br />rur. i! .or 'nllnd.d d oll€r.d ld s.lo
<br />d my oDoioyoJ $th wa!.. a3 rha, rok con
<br />o6neri6, sll do rra wdk. .nd
<br />r.s. rh.. liv. huidrsd dolr.o I 3500,
<br />D 5610 Toaaa l. .! owmr or rh.
<br />E s*,jo.l zosa ,
<br />t€.
<br />Tamporary conltruction llghtlng
<br />50O lamDa o, l€a!
<br />Ovor 5OO lamD6
<br />2.OO
<br />4.00
<br />nma clock o, photo alactric call 300
<br />2.00&
<br />20.00
<br />30.00
<br />40.00
<br />l0
<br />(D
<br />POWEB APPABATUS: Gcnoraloll, molo€,
<br />tln5lormar3. roclllbrs, indualial hoallng,
<br />cookrng, or bakng €quipm.nl and olh.r
<br />apparalur as lollo'ffi:
<br />uP b and incruding 1 HP, xw. xvA
<br />Ovar I and not ov.. l0 HP, xw. Kv
<br />Ovrr l0 rnd nol ovd 50 HP. Kw. XvA
<br />Ov.l 50 .nd nol ov€r 100 HP, XW, XVA
<br />Ovcl 1m and nol ov€r 500 HP. KW, XvA
<br />Ov, 5O0 HP. (W. KYA
<br />rn lh. porldroM or rh. work lor wnEh fi[ !6mt 13 EMd. I .ha{ nol amploy r.y
<br />!...o.! i. ..y h..r.. !o a. lo b.@tu &bl.cr ro fi. !.rod.r'3 Cornoonertr tls ol Cdilo.nt
<br />tlodo.Tolprlcr&
<br />, .,r.i rn*60 rh6 C..rif.rl ol Er.mpt$. yd lhoold boc@. $bt6r lo nE \rJort.r'! Cornp.c
<br />urion Fwoois ol &. L.bo. codo, yo! mld lonhsh .o.npry wiln !!cn c.ov.ion. or thi. ps6'r
<br />/[n b. iL.md r.rot6d
<br />Cdr sd.opy E lihd wlh rh.
<br />Ih.r.bvlnmlhrrIh.E.cerrnt Lorcont.nl
<br />O.r- APplE.nr lsig I
<br /><t)
<br />Subroral !r1,-
<br />Ponart F€6 {whon applicabl6}
<br />Mol.ri{rn Fs. (minlmurn !35.00)
<br />Pian Chcck Eco (minimum al5O0)D
<br />R.coipl No- rc No
<br />r0.00
<br />'mum 135.00)TOTAL IT *t\3)
<br />Erpdon
<br />Thsp..mh!h.ll.rpl6t{hhrialirn.ndb.co..una,rdvddrith.worrauihoir.dbylnrip.mill'
<br />nol Mm.ncod $tfnn 180 diyi ,.orn dr. d.rc o, ,ro p.mn o. n wort &|hon .d by di! p.mn it
<br />rJa...Ld o. 3b.ndo6.d 3r ..y nm. !tLr ,r *o.i rs cqrt@rc.d lo. ! !...d ol 180 dlYs A ,w
<br />o..m.r ,!oll !. obllrmd nGr b.t@ !@h *dt can b. .!c6m*td
<br />Acdcrr/.D.ffi.r
<br />I c.ntly th.t I h.v. l..d rh'. .lplrc.tio. .,rd 5.r. dt r th. .!ov. hldn rioo il cmer. I .!..! ro
<br />co.nply sth .lr oty o.din.^c.i rnd srrl6 bw. ill.tio ro hrird'nC co.rtrrvcr,o.r, .id h.r.by .ulnd
<br />pon lh.6b@-h6.r'o6d O.op.(y ld n$eli@ porpoe!:W::-*t 7l2r-/2 |xo.
<br />PtRMIIISSUEDBYtSiC r
<br />I
<br />I
<br />'1
<br />")x
<br />6utrorNG v1 VEFIFIED 8Y ls.s
<br />VAUOAIION IOfFICT USE CNLYI
<br />tAccouNrtr-413t
<br />II
<br />I I
<br />II'L.
<br />iD'
<br />II II
<br />?^8y,7
<br />Oislribution: l.lnspocto(Copy 2. Filo Copy 3. Financo Copy 4. ApplicantCopy
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