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CITY OF SANTA ANA <br />PLAN CHECK - CHECKLIST <br />JOB ADDRESS:_ / 2 4/: 71 4£2- <br />TRACKING #t 1 01150?13,// 62DislS-22- DATE. 3/1€j/4 <br />FOR PLANCHECK STATUS CALL (714) 647-5800 <br />PLEASE INITIAL EACH ITFM RFI OW <br />1.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 />-42 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 />I undefstand that I shall submit separate plans, applications and plancheck 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. Gradihg 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 requifed. I uggerstand that prior to the issuance of the Building <br />permit I am required to obtaifilbubligNefks Agency approval if my project valuation exceeds$30,000 or has added*Embing.fixtures, or added bedrooms, or exceeds 500 sq.ft. <br />AGRFFID TO BY APPLICANT OR AGENTApplicant's signaT _ - <br />Print NameiC,Wou C.A,pe Addreqq tht#(f (AAIShirt bjvd . <br />Telephone Number 310 -41% -6 (01(4 Fax <br />FOR OFFICE USE ONLY: "Checklist of items discussed" APPROVALS & FEES REQUIRED: Y/N <br />1.- Planning Department <br />2._ Public Works Agency <br />3._ Fire Departmemt <br />4._ Police Department <br />5._ School District <br />6._ Health Department <br />7_ Title 24 (Energy ) <br />8._ Title 24 (Disabled Access) <br />9._ Roof Mounted Equip. <br />10.- List of Subcontr. <br />11._ Bldg. Pmt. Info. <br />12._ Summary of Appr. Reg. <br />13._ FY Information <br />14.- Constr. Act. Reg. <br />15._ Res. Dev. Fees <br />16._SMIP <br />17._ Microfilming <br />18_ Const. Debris Recyc. <br />19._ FCWP Surcharge <br />20._ LOAJOwner-Builder Ver <br />PERMIT TECHNICIAN 32?>C- <br />Form 58: 3-26-04