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[Residential lndustnal l Commercral r,ro lencxl roro. <br />Res. Hotels, Motels, Apt. Sq Ft.h12 .03 37.ru <br />Gar. or Carports Sq. Ft.q75 02 E?d <br />Receptacles .50 <br />_#i;, 1o*ra- 7-,t Zdr, 4, - o <br />W a/4e;.EL, ri7!)o,,oJ7/i ,ru'o''x* 7112/'' 'a/'' 7ac 2(Switches <br />Fixtures <br />50 <br />50 <br />Air Conditioners <br />Each /20.00 <br />7 5.00 35.o0 <br />20.oa <br />5.00 <br />Approved Factory WiredList D 12 <br />Busways, special raceways, under floor <br />duct, trolley or plug-in busways ea. 110' or <br />fraction thereoJ <br />Fire Signaling System. Minimum fee <br />Outlet, smoke or heal sensor <br />Unrt Dtlt*ood <br />10.00 <br />,50 e7 <br />Lighting Standards with One Lamp <br />Each Add'l fixture on same standard <br />5.00 <br />1.00 <br />Owner Builder Declaralion <br />Maintenance Permit (annual)50.00 <br />Service Meters <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 />/tao <br />Signs and high potential gas tube lighting 15.00 <br />Swimming pools. fountains, spas 35.00 <br />Switchboard, motor conlrol center or @<c@Each I <br />15.00 /f, oo <br />Temporary construction meter service <br />pole <br />Each distribution pole <br />25.00 <br />5.00 <br />am licenscd lrnder the provrsrons of Chapter 9, Drvrsron 3 of lhe Busroess and <br />ITY <br />I hereby aflirm <br />a <br />ft#/'^r.1 gt;il;*.ru_ <br />BESS d oY <br />,,,fft;r3r B <br />Temporary construction lighting <br />500 lamps or less <br />Over 500 lamps <br />2.OO <br />4.00 <br />Time clock or photo electric cell 3.00 <br />POWER APPARATUS: Generators, <br />motors, translormers, rectifiers, industrial <br />heating, cooking, or baking equipment <br />and other apparatus as follows: <br />Up to and including 1 HP KW KVA <br />Over 1 and not over 10 HP, KW KVA <br />Over 10 and not over 50 HP, KW KVA <br />Over 50 and not over 100 HP, KW KVA <br />Over 100 and not o\er 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 />worken compeneatton l/laratto n f <br />I hereby aflrrm lhal I have a cerlrlcale ol consenl to sell-rnsurc, or a cerlrficale ol Worker's Compcn- <br />salron lnsrrraDce Cerlrtied copy rs trled wrlh the City burldlng rnspeclron deparlmenl <br />I certrly thal rn the performance ol the work lor whrch thrs permrt rs <br />ll. alter makrng lh's Cerlrlrcate of Exemptron, you should become sub,ect to the Worker's Compen <br />satron provrsrons ol the Labor Code, you must forthwrlh comply wrlh such provrsrons or lhrs permrl <br />shall be deemed revoked <br />,/r4,-'#/-t - ?a <br />as lo become sub,ec <br />Apphcant lSrg:::il*-rq <br />Notice To <br />salron Laws ol Cahlornra <br />I shall not employ anv <br />Oate E <br />Date_ <br />Venfied By lSig I <br />Applrcant (Srg )- <br />Subtotal l3l . tz <br />Penalty Fee (when applicable) <br />(50.00)\ffiGPh pl f,i o t <br />Plan Check 65% of subtotal (minimum 20.00) <br />fleceiipt No. L7. L 7 Pc #4 3 >3 Date <br />Plan Check (Adjustment)& <br />lssuance Fee 10.00 <br />Explratlon <br />Thrs permrt shall exprre by Imrtation and become null and vord rl the work authonzed bv lhrs permrl rs <br />nol commenced wrthrn 180 days rrom the dale ol thrs permrt of rl s,ork aulhofized by lhrs permrl rs <br />suspended or abandcned at anv trme atter the work rs commenced lor a penod ol lS0 days A new <br />permrt shall be oblarned lirsl belore such work can be recommenced <br />Applicant's Declaration <br />,'",.I l' 2' f al <br />A,,, ca,., ^,,'?,,,1, <br />*/ h/r/^r--PERMIT FEE <br />0 -z- tJDATE <br />(minimum $35.00) <br />PERMIT NO. <br />PERMIT ISSUED BY (Stg.) <br />f t't) <br />xl-Sa <br />ll/Wg 3:ffll {13 ,1+1.66 <br />VALIDAIION IOFFICE USE ONtY) <br />{ACCOUNT ,1 I,413r <br />APPLICATION AND <br />ELECTRICAL PERMIT <br />{TYPEWRIIE OR PHINT IN INK) <br />e o CITY OF SANTA ANA <br />206 W. 4rh Sr. <br />667 -2738 <br />APPLICANT FILL IN AREA BELOW Id <br />@croza <br />00am <br />@a <br />!s <br />lJ <br />Y\ <br />t+ <br />N <br />\.\ <br />v <br />Distribution: '1. lnspector Copy 2. File Copy 3. Finance Copy 4. Applicant Copy <br />I <br />///r.& <br />&-705