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TOTALResidential rlndustrial Commercral
<br />Res. Hotels, Motels, Apt. Sq. Ft.
<br />NO.
<br />.03
<br />EACH
<br />Gar. or Carports Sq. Ft..o2
<br />Receptacles .50
<br />)ii''***vlv*-or* Wio+,;;.autp#-ffrr@i,
<br />'FlrjurrrJcrat-l M,o-.14-t Switches 50
<br />Fixtures 50
<br />Air Conditioners
<br />Each
<br />20.00
<br />Approved Factory Wired Unit
<br />List 5.00
<br />Busways, special raceways. under lloor
<br />duct. lrolley or plug-in busways ea. 110' or
<br />traction thereof
<br />5.00
<br />Fire Signaling System. Minimum fee
<br />Outlet. smoke or heat sensor
<br />10.00
<br />.50
<br />Lighting Standards with One Lamp
<br />Each Add'l ixture on same standard
<br />5.00
<br />1.00
<br />7O31 5. Busrness and Prolessrons Code Any crly or county whrch
<br />aller. rmprove, demo[sh. or reparr any structure. pflor to rls rss
<br />ol lhe propertv or my employees wrth wages as lherr sole com
<br />L ,,wr r TI,, lrr,rlrirl! ril r,r{ r,vr.\ ({rlr,r.Til11ti!! I |.,,1i rl
<br />Owner-Builder Declaratlon
<br />I hcreby allrrflr lhat I am erempl Irom lhe Contractor's L rceilse Law lor
<br />Date
<br />also requrres the apphcanl for
<br />70OO) ol DNrs,on 3 ol the Bugness andtor's Lrcense Lsw {Chspter 9 lcommencing wrth S(
<br />tron o, Secl,on 7031 5 by any applcanl I
<br />I,as(
<br />t] secrron
<br />E Secnon 7044A
<br />pensation. wrll do the
<br />ucl lh€ protect
<br />Owner lSig
<br />Mainlenance Permit (annual)50.00
<br />Service Melers
<br />Up to 400 amps. per meter
<br />Over 400 amps, per meter
<br />Over 1200 amps, per meter
<br />15.00
<br />35.00
<br />75.00
<br />Signs and high potential gas tube lighting 15.00
<br />Swimming pools. fountains, spas 7-35.00 70.oo
<br />Switchboard, motor control center or sub-
<br />panels
<br />Each
<br />15.00 It
<br />Temporary construction meter service
<br />pole
<br />Each distribution pole
<br />25.00
<br />5.00
<br />Contractor Use Only
<br />#<M4 ?a,s
<br />I hereby allirm lhgl I am [censd under lhe provrsrons ol Chapter 9, Druson 3 o, the Busrness and
<br />STATEi ZIP
<br />a^ ?zcr.7
<br />0q7A"o
<br />4(&
<br />*
<br />(.o, %.
<br />)ruo
<br />Temporary construction lighting
<br />500 lamps or less
<br />Over 500 lamps
<br />2.O0
<br />4.00
<br />Time clock or photo electric cell 300
<br />POWER APPARATUS: GeneTatoTs.
<br />motors, transformers, reclifiers, industrial
<br />heating, cooking, or baking equipment
<br />and other apparalus as follows:
<br />Up to and including 1 HP. KW KVA
<br />Over 1 and not over 10 He KW KVA
<br />Over 10 and nol over 50 HP, KW, KVA
<br />Over 50 and nol over 100 HP, KW KVA
<br />Over100 and not over 500 HP KW KVA
<br />Over 500 HP, KW KVA
<br />2.00
<br />5.00
<br />10.00
<br />20.00
<br />30.00
<br />40.00
<br />Workers Compensation Declaration
<br />I hereby allrrm lhat I have i) corlrf cale ol consanl lo sell-rnsLrre. or a cerlrlK:dte 1, Worker's Compr)n
<br />s4t,o,,1n,.,,,.,,'(,.rryr,ieo, or,r \' lyd L! llr ti,'. C I! bu,&t.' :!4t,.n rl(!drIrenl
<br />,^,,.,.,,,,.,th/4t v.r r,,,dR.,so , fJ*-
<br />. sff7 A:- , &2 B,o*^&24,
<br />I cerlrl! ltlJl n lhe Der,orm.lira{r ol lh! work lor wlrch ltrs Orrmrl rs rssrred. I shaLl rrol efirDloy Jny
<br />peTsorlrrr6nVrr)Jfrr{)rsoastobfl:omosilbrlrcttollre WarkcrsConrpitnsnlronlawsoi Cal lornra
<br />Dalc AJlplr.:ant tstq )
<br />Notice To Applicanl:
<br />ll, allIr nrnI ng lirs CIrl l a,rlr: ol I tcn]t)lron. you sl,olrid IjeLonrr !ilblccl lo lhI Worltr'\ Conrpr.n
<br />salron irrovrsrons ol Ihr t abor Corlc. yo! mrsl lorll)w lh conrply w iir sUclr provrsrons or tlr\ pc(rrl
<br />shal l)f df(.med r{rvok,rd
<br />Subtotal
<br />Penalty Fee (when applicable)
<br />Violation Fee (50.00)
<br />Plan Check 650/o of subtotal (minimum 20.00)
<br />Receipt No.Pc#Date
<br />Plan Check (Adlustment)
<br />lssuance Fee 10.00
<br />TOTAL PERMIT FEE (minimum $35.00)@.oo
<br />Expiration
<br />Applicant's Declaration
<br />'i
<br />'L ,l ll
<br />,-,",,/opy'f Ap,r,,,,,,ns,,,, s(, Grrl A,rZrA
<br />PERMIT NO.DATE - 30-
<br />PERMIT ISSUED BY {Srg )
<br />$0.m,L1t1
<br />iriJJ' ilfff5l 5 u,,,,,,,,.y s,,
<br />l0/il1/89 lrtEPl{ {13
<br />VALIDATION (OFFICE USE ONtY)
<br />(ACCOUNT ft1-413)
<br />APPLICATION AND
<br />ELECTRICAL PERMIT
<br />(TYPFWRITE OB PRINT IN INK)
<br />t o CITY OF SANTA ANA
<br />206 W. 4th St.
<br />667-2738 lfld
<br />APPLICANT FILL IN AREA BELOW
<br />@C-oz
<br />6)
<br />0oamaa
<br />Distribution: 1. lnspector Copy 2. File Copy 3. Finance Copy 4. Applicant Copy
<br />?o.oo
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