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o o llpAPPLICATION AND
<br />ELECTRICAL PERMIT
<br />(TYPEWRITE OB PBINT IN INK)
<br />CITY OF SANTA ANA
<br />20 CIVIC CENTER PLAZA
<br />834-4186
<br />U
<br />APPLICANT FILL IN AREA BELOW
<br />(!
<br />E-o
<br />=o
<br />Io
<br />P
<br />\S
<br />N
<br />2zos tl,o. Art/arJOSAODEESS
<br />E nos'oe"r'a, El tnousr.,a, E) conme.crar rio EACH TOTAL
<br />n.3. Hot.l., Xot.l., Apr. Sq Fr 03/Szrntr qlz -zq)/PHONE
<br />G.r. o, C.rgon. Sq Fr
<br />50
<br />50
<br />STATE/ZIP€aala
<br />50
<br />Each
<br />20 00
<br />Approved Facrory Wned Unrt 500
<br />Busways, special rac€*ays, undor lloor oucl
<br />tolloy or plug-in butways sa 100'5.00
<br />Firs Signalin9 Systom. Minimum l6e
<br />Oullel. smoke or hsal iensor
<br />10.00
<br />.50
<br />Lighting SlanOdrds wirh One Lrhp
<br />€ach Add'l linure on Bam6 3landard
<br />5.00
<br />100
<br />Ownar-& da. Dacbrauon
<br />lh..€by6fim thar l6m ercofl l.oh rhe Conracror's Laen* L.r,or lhe ldrwng.es$n lse.
<br />7031 .5, 8uire$ and Plolssslons Codo Any cil o. .ou.rv whch r6autes 6 p€.m'r ro c@3r,ucl,
<br />,116., mprove, domotsn, o. r6Oanlnyslrucrue, pior lo it5,*u6^ce, de requres the appl6.nt lor
<br />sch p.rn{ $ lile 6 sig@d sral6m.nr rh.r he 's lsnsd pursusni lo lhe rrossons ol lhe Conr.&-
<br />ror's Lnlne L.w lchap|.r 9 lcomh€nc69 wnh S@rE. 7000, ol Div'eo. 3 o, lh. Sosness ahd
<br />ftola$ons Codol d rnd h€ $ 6x.mor rh6r€lo.n and lh€ bars lor lhe.lleged eEmpr'@ Anv v'ora-
<br />lio. ol Seion 7031 .5 by any sppraant tor a pa.mt $bj.crs rh" 6pplica.l lo s .ivil pemlty ol nol
<br />mde tEn live hund.sd dorrars I $ 500)
<br />E Se.ton 7Oa{A l, Bown6r o, rh! p.ope.iy, d mt onploys.s wi$ wag6s asrh.irsore com-
<br />pa^arlon, willdo lhe wol|,6nd |he srtuclure
<br />'s
<br />not nronded or ofie.ed,or s.le
<br />Mainlenance P6rmil {6n6ual)50.00
<br />Contrctor U!. Only
<br />PBONE Up lo 400 emps, ber m.ter
<br />Ov6. 400 arhp6, p€r malcr
<br />Ovsr 1200 amps. per mol6r
<br />siqns and high pobnliel gas lub€ lighting 15.00
<br />AODRESS
<br />swimming poors, iounr.in6, 66'35.00 4<;oc
<br />Swtchboard, moto. conlrol csntor or sub-Denol8
<br />Each
<br />15.00
<br />Tomporary construction mrlor Eervice pol6
<br />Eech distribution pol6
<br />15.00
<br />3.00
<br />I heebv nrm thar I .m lcm*d !nd.r $a Drovisions ol ChsDrg 9, DrBon 3 o, rh6 gus'ness rnd
<br />Prolessbns Cod€, .nd mv hco.ro is n iull lorca and etlEr
<br />L6.eNo.- C1... CryLr
<br />Drre- Co.rr.cio' ls'g Tomporary consituclion lighiing
<br />500 temps or t6as
<br />Ov€r 50O llmps
<br />200
<br />4.00
<br />Time clock or pholo 6loctric cell 3.00
<br />POWEA APPABATUS: Gsncr'toB, motors,
<br />tsanslormors, r6clili6B, induslml hearing,
<br />cooking, or bating aq'/ipmonl anc, olher
<br />apparalus .3 lollowi:
<br />up to and rncrudng r HP, Kw. Kva
<br />Over 1 and nol over i0 HP, l(\4, Kva
<br />Over l0 and noi ovcl 50 HP, KW. KVA
<br />Ovs. 50 and nol ovc, 100 HP. (W. KV
<br />Over 100 and nol ov6. 500 tlP, XW. XvA
<br />Ovs. 500 HP, KW. Kva
<br />2.00
<br />5.00
<br />10.00
<br />20.00
<br />30.00
<br />40.00
<br />lvoal(.'. Coll|paoaadon D.da.nho
<br />I h..6by at nm lh I hrE. cerlilEae o, cons6ni ro eli-..eE, or 3 cen'l€ale ol Wdle.'s Comp.n-
<br />si ion l.3ur.n € Cortlbd copy is lir€d uth the C'ry bu ding rnlpocion d.p.nn.nr
<br />. slrdh.ranoih'sconill. reolErempron,y@shourdb.co.nesubFcrDln€wo.t.'sco.nc€n-
<br />$r'on !.ovisros ol rhs Lrbor Cod6, yoo m6r ro.rhwirh cmplv wlrh 3u.h pr@sos d rhis p.mrr
<br />sh.ll b. d.em.d revo*ed
<br />ore Erprer voit€d ay rslq
<br />rs Bs0ed, I shall no1 o601oY anyI conrly thsr in rhe perlomEnce ol rh€ wo.k
<br />,.r3on h dnfmanmr $ as ro b..om 3u
<br />o"," ?/G,t* o,o,.",,""
<br />?grD
<br />Penally F€e (wh€n aPPlicabl€)
<br />vioretion F€e {minimum 335'001
<br />Pla^ Chsck Fee (mrnimum 31500)
<br />rco-
<br />10 00
<br />IOTAL PEi IT FEE (m,n,hum 33500)16o')
<br />&plr.doll
<br />ThB9arB(shallexp obyimLutonandbscomenullshdwidilthr*o*6urhorE€dbyth6p.rm{'s
<br />not commencod wilhrn 180 .,ays ,.oh rh! dare ol lhis pem or il *o* aurhon ed by th6 pemd
<br />'3susoondEd or.b.donodal sny time.hsth6*olk 'sc@menc.d
<br />lora penod ol r80 drvs Aea
<br />p.rh'! 3ha0 b. obl,n€d n.sl b.id. such wo( sn b. r.c@m.rced
<br />Arp{cd'. O.drrrthn
<br />I certt rhar I have r..d rn8 aDorr.rlo. 3^d sule lhal rhe ,bow 'nlo.m8lro. rs c6Er I 3qr@ ro
<br />cohrlv *'lh 3l c'tv od'M.ces and s6ie la*s.6larn9 ro buid,no consructoh, and h€'eby aulho
<br />are ropio*nranws oi th's cny ro e.l€r upon lhe 9.Openy lo. nsp.ct @ porposes
<br />PENTIT IIO r1OATE
<br />PERMIIISSI]EDBYISI9 )3il"3,i[" 3/ ze >VEfiIFIEO BY lS'9
<br />%r'"t oa /Es-c r)%4 n$rrf tltt?=
<br />VALIOAIION iOFFICE I]SE ONLY)
<br />(ACCOrJNr rlr-4r3)
<br />Drstr bulion 1 nspectorcopy 2 FaleCopy 3. Frnance Copy 4. Appl copv
<br />if
<br />o2
<br />15.00
<br />35.00
<br />75.00
<br />)R2:.*-//Q/s.
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