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CITY OF SANTA ANA <br />PLAN CHECK - CHECKLIST <br />JOB ADDRFSg · 1,5 14 40/1.WTH-c>[2- T> L_ <br />TRACKING #:/01 2/2-33-DATE·9#-/) 9 <br />FOR PLANCHECK STATUS CALL (714) 647-5800 <br />PI FASE INITIAL EACH ITEM RFI Ow <br />-f-3 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 />1*03 2.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 Buildjng & Safety Division. <br />. 1:a 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 />1 4.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 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 />AGRFFOTOBY APPLICANT OAGENT <br />»X 13Applicant's Signature -/6 \ 6,, <br />Print Name -t,omdi cirt,444 10 -ta:Un-06 86 Irviv CkAddreRR <br />Telephone Number »[135/9 - 9/034_Fax <br />FOR OFFICE USE ONLY: "Checklist of items discussed" APPROVALS & FEES REQUIRED: Y/N <br />1.kI Planning Department <br />2.- Public Works Agency <br />3._ Fire Departmemt <br />4.L Police Department <br />5._ School District <br />6._ Health Departr'hent <br />PERMIT TECHNICIAN <br />Form 58: 3126-04 <br />7._Flfie 24 (Energy ) <br />8.3£ Title 24 (Disabled Access) <br />9.. oof Mounted Equip. <br />10..st of Subcontr. <br />11._ widg. Pmt. Info. <br />12._ Summary of Appr. Req. <br />13.-JFY Information <br />13. C LL <br />=7 <br />0/i <br />14._ Constr. Act. Reg. <br />15.- Res. Dev. Fees <br />16._SMIP <br />17._ Microfilming <br />18._ Const. Debris Recyc. <br />19.*yewP Surcharge20._ LOA/Owner-Builder Ver.