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[Resroentrat lndustrial Commercral
<br />Res. Hotels, Motels, Apt. Sq Ft. / 23L
<br />NO.EACH
<br />03
<br />.02
<br />o
<br />TOTAL
<br />Gar. or Carports Sq. Ft 4zl
<br />Receptacles 50
<br />.]OB ADDiIESS
<br />3 7 o * Je^A. L.%q,.,,&rA (
<br />)lk#/"r".^ aa*r.,.i. i, i jo y o
<br />37 t 5' /r;AryLo il
<br />b-a- )fl4* di."
<br />*r
<br />zL ab Switches .50
<br />Fixtures .50
<br />Air Conditioners
<br />Each I 20.00 20,oo
<br />Approved Faclory Wired Unit g ALrst D D. *oaa-7 5.00 3f,oo
<br />Busways, splcihl raceways. under floor
<br />duct, trolley or plug-in busways ea. 1 10' or
<br />lraction lhereof
<br />5.00
<br />Fire Signaling System. Minimum fee
<br />Outlel, smoke or heal sensor I
<br />10.00
<br />,50 tfo
<br />Lighting Standards with One Lamp
<br />Each Add'l fixture on same standard
<br />5.00
<br />1.00
<br />Owner Btrilrler Det:laration
<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 />,/f, D
<br />Signs and high potential gas tube lighting 15.00
<br />Swimming pools, fountains, spas 35.00
<br />motor control center or@Swrtchboard@
<br />Each
<br />/r 5.00 /f.oo
<br />Temporary construction meter service
<br />pole
<br />Each distribution pole
<br />25.00
<br />5.00
<br />Tpmporary construction lightrng/500 lamps or less
<br />Over 500 lamps
<br />2.OO
<br />4.00
<br />Time clock or photo electric cell
<br />POWER APPARATUS : Generators,
<br />molors, transformers, 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 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 />am licensed rrnder lhe orovrsrons ol Chapler 9. Drvrsron 3 ol the Busrness and
<br />I herebv aflrm lhat I have a cerlricale ol conserrt lo sell-rnsure, or a ce.ttrcale ol Worker's Compen-
<br />salron lnsr/raoce Certrfied copy rs filed with lhe Cily burlding rnspeclron departmenl
<br />person rn any manner so as lo become subJecl lo the Worker's Compensatron Laws ol Calitornra
<br />Notice To Applicant:
<br />rl.r'r'l
<br />PHONE
<br />ADDRESS
<br />STATE/ZIP
<br />I hereby aflrrm t
<br />Crty Lrcense
<br />?,
<br />..L
<br />oj
<br />tb,-u o
<br />e4
<br />Only
<br />-to
<br />,:}:?
<br />'t3?3czrq)
<br />Venled BY s'g
<br />Applrcan S,g
<br />ol lhe lor :nol employ any
<br />lor (Srg I
<br />Dale Applrcanl lSrg )
<br />-
<br />eaat-?t|Lrcense
<br />Date-
<br />a I?un
<br />o"r"t,p,u&!b*-
<br />i:,!j,^q:,ffi^
<br />Subtotal /31, Ll I
<br />10.00
<br />//->-8
<br />,5rl4/ o VERIFIED BY {Srg }PERtvltT TSSUED BY {Sig )
<br />/,ilY 3
<br />I
<br />DATE
<br />6L )r!. tZ
<br />lL/v./99 3:55Pil 413 lt+1.+8
<br />Penalty Fee (when applicable)
<br />Violation Fee
<br />Plan Check 65% of subtotal
<br />Pc#Receipt No
<br />Plan Check (Ad,iustment)
<br />lssuance Fee
<br />PERMIT FEE
<br />(50.00)
<br />Date
<br />(minimum 20.00)
<br />(minimum 535.00)
<br />PERMIT NO.
<br />Expiration
<br />Applicant's Declaration
<br />rlt,
<br />BUILDING
<br />PERMIT Nr
<br />VALIDATION IOFFICE USE ONLY)
<br />IACCOUNT f11-413)
<br />APPLICATION AND
<br />ELECTRICAL PERMIT
<br />(TYPEWBITE OR PIIIN ]. IN INK)
<br />o a CITY OF SANTA ANA
<br />206 W. 4th St.
<br />667-2738 tk*
<br />,r APPLICANT FILL IN AREA BELOW
<br />IDgrozo
<br />ooImaa
<br />U
<br />l.
<br />CS 613Distribution: l.lnspectorCopy 2. FileCopy 3. FinanceCopy 4. ApplicantCopy
<br />I
<br />Wo*ers Compenserlon Dech$tlon U 3.00
<br />,.,,, I|z-gjApp c.,.,As.o, s,s @ 6uFr,,*
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