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<br />,XResrdentral lndustrral Commercral
<br />Res. Hotels, Motels, Apt. SO. n /, 1771
<br />NO.
<br />I
<br />I
<br />03
<br />Gar. or Carports Sq. Fr. ' //r'1 02
<br />Receptacles 50
<br />Switches 50
<br />Own6r-BulH6r Declrrltlon
<br />I herebv allrrm lhal I am exempl lrom the Cootraclor's Lrcens Law lor the lollowrng reason lSec
<br />7031 5, Busrness and Professrons Code Any city or county whrch requrres a permrl to conslrucl,
<br />alter, rmpiove, demolsh, or repaI any slructure, pnor to rls issuance, also requ[es the apphcanl tor
<br />such permrt lo lile a srgned slatement lhal he rs hcensed pursuant lo the provrsrons ol lhe Conlrac-
<br />tor's Lrcense Law lChapter I (commencing wrth Seclron 7000) ol Divrs,on 3 o, lhe Busrness and
<br />ProtessronsCode)orlhathersexempltherelromandthebasrstortheallegodexemptron Anyvrola-
<br />tron o, Seclron 7031 5 by any app|cant for a pe.mit sublects lhe applcanl lo a crvil penally ol nol
<br />more lhan ive hundred dollars {$5OO)
<br />n S"aron 70444 l. as owner ol the property, or my employees wrth wages as therr sole com-
<br />pensatron, wlll do the work, and the slructure rs not rntend€d or olfered lor sale
<br />n Seclron 70448 l, as owner oi the properly. am exclusvaly contraclrng wrlh hcensed con-
<br />lractors lo construcl lhe proFcl
<br />Date- Owner lsig.l---
<br />Fixtures 50
<br />Air Conditioners
<br />Each /20.00 2o-ao
<br />Approved Faclory Wrred Unit D a,O-List D C ila*7 5.00 35. oo
<br />Busways, special raceways, under lloor
<br />duct, trolley or plug-in busways ea. 110' or
<br />fraction thereof
<br />5.00
<br />Fire Signaling System. Minimum fee
<br />Outlet, smoke or heat sensor
<br />10.00
<br />.50 ,50
<br />Lighting Standards with One Lamp
<br />Each Add'l hxture on same standard
<br />5.00
<br />1.00
<br />Maintenance Permit (annual)50.00
<br />tfrK#,(?..T-Z eyiYffiru d€b - 3 gt3
<br />,',,,,,rt C7a/),tfr -Ve-A
<br />'l'' 727o9
<br />Cn- {++q
<br />LTD to.
<br />7o rtI
<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 />/€.oo
<br />Signs and high potential gas tube lighting 15.00
<br />Swimming pools, tountains, spas 35.00
<br />Switchboard, motor control center orGe@
<br />Each /
<br />15.00 /f.oa
<br />Temporary construction meter service
<br />pole
<br />Each distribution pole
<br />25.00
<br />5.00
<br />Temporary construction lighting
<br />500 lamps or less
<br />Over 500 lamps
<br />2.00
<br />4.00
<br />wo*ersCompensation fiamtio " /
<br />I hereby aflirm lhal I have a certrtrcale ol consent lo sell-rnsure, or a co.lrlrcale ol Wotker's Compen
<br />salron lnsurance Certrlred copy rs frled wrth lhe Crty burldrng rnspq;tron deparlment
<br />oar"t^pu"fu.-
<br />*," /1rf!g\
<br />,or whrch
<br />lecl to the
<br />Date Applicant lSrg
<br />is rssued. I nol employ any
<br />Compensaron Laws ol CallornE
<br />/4o
<br />',r I
<br />I certrly lhat rn the perlormance ol the wor
<br />porson rn any manner so as lo become sub
<br />Notice To Applicant:
<br />, r'll, ll' " l, I '."' i,:]
<br />Time clock or photo electric cell 3.00
<br />POWER APPARATUS : Generators,
<br />motors, transformers, rectifiers, industrial
<br />leating. cooking, or baking equipment
<br />and other apparatus as follows:
<br />Up to and including 1 HP KW KVA
<br />Over 1 and notover 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 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 />Subtotal lJ7, fg
<br />10.00
<br />Erpiration
<br />lhrs permrt shall exprre by Imrtatron and become null and vord rl lhe work aulhoized by thrs permrl rs
<br />not commenced wrthrn lB0 davs lrom lhe date ol lhrs permrl or rl work authoozed by lhrs permrt rs
<br />suspendedorabandcnedalanytrrnealtertheworkrscommencedlorapeflodollSOdavs Anew
<br />permrl shall be oblarned firsl belore such work can be reconrmenced
<br />Applicant's Declaration,:
<br />Penalty Fee (when applicable)
<br />z- .f1,4f (50.00)
<br />Plan Check 65% ol subtotal |J (minimum 20.00)
<br />aeceiptNo. ( 74 Pc#/,3d3 Date
<br />Plan Check (Adjustment)
<br />lssuance Fee
<br />PERMIT FEE (minimum $35.00)
<br />oArE // -z-8 PERMIT NO.
<br />Oate I L 2'f Xppr.ao, o. Asen, rs,s
<br />BUILDING
<br />PERMIT No STe o.f VERIFIED BY tSrg PERMIT ISSUED BY {Srg I lrbq
<br />VALIDATION IOFFICE USE ONLYI
<br />|ACCOUNT TIl 4131 / ftv LYWW 3:5Pil +lS llv.38
<br />APPUCATION AND
<br />ELECTRICAL PERMIT
<br />(TYPEWRITE OB PBINT IN INK)
<br />a o CITY OF SANTA ANA
<br />206 W. 4th St
<br />667 -2738
<br />APPLICANT FILL IN AREA BELOW
<br />\0
<br />P
<br />@C
<br />=oza
<br />oo,m
<br /><lta
<br />Lt
<br />{s
<br />ttl
<br />N
<br />I
<br />N
<br />c
<br />Distribution: 1. lnspector Copy 2. File Copy 3. Finance Copy 4. Applicant Copy cs.6l!
<br />EACH TOTAL
<br />22A_o,- 7?
<br />[oder lhe provrsrons of Chapter 9, Drvrsron 3 of lhe Busrness ando/?lu9ga+++*+Class
<br />my lcense rs rn Iull lorce and efiecl
<br />Crty Lrcens
<br />Contractor (Srg )
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