Laserfiche WebLink
'fi))"a417v* tJux-a h-D lnduslrial D Commercial NO.EACH TOTAL <br />each plumbing tixture/trap 5.00 <br />Dental Unit or Medical Gases 10.00 <br />OWNERub22 PHONE&Paac, <br />MATLTNG AoDFESS #twllott rHMl wulo. <br />SEWERSTATE/ZIPa, ?zC+t 1st 10O'+Conn.15.00 <br />Otmf, -Bulld.r Dadrallon <br />I hereby alrrrm that I am exmgl lrom the Contracto/s Lrcsse Law for reson (Se <br />7031 5. Business and P.ofessions Code Any city or county whrch a permrl to construct, <br />alter. rmprove. demolrsh, or reparr any slruclure. pno, to rts also requrres lhe applicant <br />tor such permrt to ile a srgned slatement thal he rs puBuant to lhe provrsrons ol lhe <br />Contraclor's Lrcense Law (Chapter 9 S&laon 7mO) ol Division 3 ol lhe <br />Eusrness and Prol6srons Code) or that he therefrom and the bas6 lor lhe alleoed <br />exemplron Any vrol8tion ot Sectron 703 8ny applicant lor e permit subiocts the applicant to <br />(bllars (3500)e crvrl p€nalty of nol moae lhan <br />E S*t,on 70444 I.as ol lhe properly. or myemployes wrth wags as theirsolecompen- <br />salron. wrll do the and the structure rs not rntendod or ollged lor sale <br />l. as owne, ol lhe propeny. am erclusNely contreling with licenged <br />lo conslrucl lhe prolecl <br />Owner (Srg ) <br />Ea. Add'l Conn.5.00 <br />Ea. Add'l 100' or Fraclion 5.00 <br />Private Sewage Disp. System <br />GAS SERVICE 1 to 4 Outlets I <br />30.00 <br />5.00 <br />Ea. Add'l Outlet <br />Repair or Replace Gas Piping <br />1.00 <br />5.00 <br />100.00 <br />5.00 <br />Conlrmlo[ t,3c Only <br />I 10.00CONTBACTOR@e, ?as A ?eua <br />PHONE <br />/rf|-db 8.00 <br />AODRESSfrt.@., de 4.00 <br />10.00'{oar,STATE/ZIP/*. qtu-?6.00 <br />I hereby alfirm thal I am licensed under the <br />Prolessions Code. and my hcense rs in lu <br />ucenseNo4h#hQ crass <br />oare lOF4 conrracror (Sig I <br />10.00 <br />8.00 <br />Pool Traps I 5.00 <br />Deck Drain System - Per Drain <br />Repair/Alt. Drainage or Venl <br />Vacuum Breakers 1-5 <br />3.00 <br />Wortrt CompaMtlon DGlrlbn <br />I t€roby altrrm thal I have a certrlicale ol consent to or a certrtrcale Worker's Com- <br />rsissuad, I shall nolemployany <br />peBon in any mnnor !o as lo b€coms subj€cl to lhs Worte/8 Compon$tion Laws ol <br />Crlitornie <br />Oale Applicant {Srg.) <br />Nollc To ADgllcal: <br />It aller makrng thrs Ceriricale ol Exemptron. you should become sublml lo lhe Worker's Compen- <br />salron provrsrons ol lhe Labor Code you musl lorthwrth comply wrlh such provrsrons or thrs <br />permrl shall be demed revoked <br />10.00 <br />a <br />5.00 <br />Over 5 1.00 <br />Backflow Device 2" or Less <br />.4//5.00 <br />Over 2"10.00 <br />Water Service Ea. 100' /10.00 <br />Subtotal uc <br />Penalty Fee (when applicable) <br />Erph.0on <br />This permit shall axpiro by limitatim and become null and void il ths worl 8uthdi26d by this <br />permitisnotcommoncadwithin 180dayslromthodaleolthispermildilworkauthorizodbythis <br />pormit is suspended or abandoned at any time atler th6 work is cmmnc€d ,or 8 p€riod ol '180 <br />days. A new permit shall be obtained lirst b€lors such work can be recommenced. <br />ADefc.rr.. D.d.rdar <br />I cortity thal I hsvs roed lhis applicetion and glete thet th€ abovs inlormalion is corret. I a9r6 to <br />@mply with all caty ordimnc€a and stElo lam relating lo building consluclion. 8nd hereby <br />authorizad reprGantelion ol thig city to enter upon the abovemsnlioned property tor inspection <br />Violation Fee (50.00) <br />Plan Check 65% of subtotal (minimum 20.00) <br />Receipt No.Pc#Date <br />Plan Check (Adjustment) <br />lssuance Fee <br />)OTAL PERMIT FEE (minimum ry5..00)_.5C <br />DATE PERMIT NO. <br />' <br />/ 5L <br />PY*lm"6GI5 ,ER,F,ED BY (s.s )PERMIT ISSUEO BY (Sis.) <br />vALroATroN (oFFrcE usE oNLY) <br />(ACCOUNT rl l-a12) <br />al?t7 <br />APPLICATION AND <br />PLUMBING PERMIT <br />(TYPEWBITE OB PBINT IN INK) <br />a o CITY OF SANTA ANA <br />206 W. 4th Streel <br />667-27fi WAPPLICANT FILL IN AREA BELOW <br />q,grIz <br />c, <br />oo! <br />maa <br />t <br />N <br />I <br />) <br />Orstribulion I lnsp*tor Copy 2 Frle Copy s r,n"n"J,6!fif0 /8*op,tt0flffll +12 130,m <br />cs-6.l Ia <br />/rlrunes <br />tr <br />Alt. or Repair of Drainage - Vent Piping <br />10.00 <br />PIPING <br />Temporary Gas Service <br />MISCELLANEOUS <br />Water Heater - Electric or Gas <br />Water Ea.100' <br />Rain Water Piping (buried) Ea. 100' <br />Water Softner <br />Lawn <br />Rain System - Per Drain <br />lnd. Waste <br />wrlh the Cily <br />9. Orvrsron 3ol the <br />Lilal oI