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CITY OF SANTA ANA <br />PLAN CHECK - CHECKLIST <br />JOB ADDRPRR- | 0 10- /4 !<0 /3TRACKING #: bo l FEE/4/' 201 53491 DATE:3-9-/4 <br />FOR PLANCHECK STATUS C.Al I (714) 647-5800 <br />21 FASE INITIAL FACH ITEM RFI OW <br />JL <br />2. <br />JL <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 />3.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 />J-4.I understand that I shall submit separate plans, applications and plane.herk 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 />J l- <br />5.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 />AGRFF,1 TO RY APPLICANT OR AGFNT <br />Applicant's Signature fm.6 ti U <br />Print Name 14 Lid Addresq 43-l 4/ lam heti, U , Suitot z , 64, 01 i <br />Telephone Number 31-3 ---60 6/15 N Fax 914-691--St <br />FOR OFFICE USE ONLY: "Checklist of items discussed" APPROVALS & FEES REQUIRED: Y/N <br />1. u.5ianning Department <br />2Public Works Agency <br />3.* Fire Departmemt <br />44- Police Department <br />5.1. School District <br />6._ Health Department <br />7/hitle 24 (Energy ) <br />8.0*Title 24 (Disabled Access) <br />9.25-Roof Mounted Equip. <br />10.-EList of Subcontr. <br />11 60'Bldg. Pmt. Info. <br />12._9Summary of Appr. Reg. <br />13._9*Y Information <br />14. t/Eonstr. Act. Reg. <br />15.Res. Dev. Fees <br />16.SMIP <br />171Microfilming <br />18.EConst. Debris Recyc. <br />19.AAFCWP Surcharge20.4#tOA/Owner-Builder Ver. <br />PERMIT TECHNICIAN Kile¢* a VL06 1- <br />Form 58: 3-26-04