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CITY OF SANTA ANA <br />PLAN CHECK - CHECKLIST <br />JOB ADDRESS: 320 V - ·74 %77'A/Aith. 4 k . <br />TRACKING #:10£ 2 0933 .DATE:- 3,42 (/(7 <br />FOR PLANCHECK STATUS CALL (714) 647-5800 <br />PLEASE INITIAL EACH ITEM BELOW <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 Build.ing & 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 />I understand 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. Grading Plans - 3 complete sets <br />I understand-lhat I shall visit the Public Works Department to verify whether a field <br />inspectioly6fthe property is required. 1 understand that prior to the issuance of the BuildingI j <br />permit Ipm repuired 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 A )R AGEN¥ <br />Applicant's Signatur <br />Print Name 4<6 •,tu e - 3go AM[ess 44¥\'D E -fAUD SE £-9 LAJ <br />/ 8 :C.*7'45 812(5 -Telephone Number, 937- 9¥20' 44c-jor 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 />PERMIT TECHNICIAN <br />Form 58: 3-26-04 <br />7._ Title 24 (Energy ) <br />8._ Title 24 (Disabled Access) <br />9._ Roof Mounted Equip. <br />10.1 List of Subcontr. <br />11.-25-Bldg. Pmt. Info. <br />12._ Summary of Appr. Reg. <br />13.-2PY Information <br />-23 c * <br />14.kionstr.; Act. Reg. <br />15.- Res. Dev. Fees <br />16._SMIP <br />17.25*licrofilming <br />18.-2ftoast. Debris Recyc. <br />19._ fpWP Surcharge <br />20.-ECOA/Owner-Builder Ver.