|
commerciar l* lEA.Hl rorALFFesidential lndustrral
<br />Res. Hotels, Motels, Apt. Sq Ft.l.l ,O 03
<br />Gar. or Carports Sq. Ft U4 ?02
<br />E7o
<br />?.72
<br />Receptacles 50
<br />f7df 5*ro- 7p -/4*r$r
<br />, a**.-2.- _fyl - O/to
<br />73 /-f ?*oq*A: .?.2-"'b;rn- >tua--
<br />JOB ADDRESS
<br />STATE/ZIPO- rxtt Switches 50
<br />Fixtures 50
<br />Air Conditioners
<br />Each I 20.00 P.oo
<br />Da.wApproved
<br />LiSt
<br />Factory Wired Unit
<br />ila41 7 5.00 JScto
<br />Busways, special raceways, under floor
<br />duct, trolley or plug-in busways ea. 110' or
<br />fraction thereol
<br />5.00
<br />Frre Signalrn&System. Mrnimum lee
<br />Outlet,6moll 9r heal SenSor I 10.00
<br />.50 .s;'t2
<br />Lighting Standards with One Lamp
<br />Each Add'l fixture on same standard
<br />5.00
<br />1.00
<br />Owner-Eullder Decla?atlon
<br />I hereby alltrm thar I am exempl lrom lhe Contractor's Lrcense Law lor the followrng reason lSec
<br />7031 5, Busrness and Prolessrons Code Any crly or county whrch requrres a permrl to conslrucl,
<br />alter, rmprove, demo|sh. or reparr anv structure, pilor to rls rSsuance, also requrres lhe applrcanl tor
<br />such permrl to frle a srgned statement lhal he rs |censed pursuanl lo th€ provrsrons ol the Conlrac-
<br />lor's Lrcense Law lChapter I (commenc.ng wrlh Seclron 7000) ol Drvrs,on 3 ol lhe Busrness and
<br />ProfessronsCodelorthalhersexempltherelromandthebasrslorlheallegederemplron Anvvrola-
<br />tron ol Secton 7031 5 by any applEant lor a permrt sublects the applrcanl to a crvrl penalty 01 nol
<br />more than five hundred dollars ( S500|
<br />n Sect,on7044A l,asownerollheproperly,ormyemployeeswrlhwagesaslhersolecom-
<br />Densalron, wrll do the work, and lhe struclure rs nol rntended or oflered ,or sale
<br />n Seclron 70448 l, as owner ol the property, am exclusively contraclrng wrth lrcensed con-
<br />liaclors lo conslruct the project
<br />Dale--- Owner (Srg )---.--
<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 />/.fo o
<br />Signs and high potential gas tube lighting 15.00
<br />Swimming pools, fountains, spas 35.00
<br />Switchboard, motor control center o@@Each /
<br />15.00
<br />/600
<br />Temporary construction meter service
<br />pole
<br />Egch distribution pole
<br />25.00
<br />5.00
<br />'+"o^ ;2*L, n|,;)t''t
<br />I
<br />, fia*e.-tt
<br />L//H{ecI
<br />I hereby atfrrm thal I am lcensd !nder the provrsrons ol Chapter I, Drvrsron 3 ol the Business and
<br />ADDR ESS
<br />CITY :,rdr-wq:7?ofb#+-?-?
<br />and mv lEense rs in
<br />Lrcense No b7-
<br />oateI Conlractor 4empor ary 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: Generators.
<br />motors, transtormers, rectif iers, 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 notover 10 HP, KW KVA
<br />z 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.OO
<br />5.00
<br />10.00
<br />20.00
<br />30.00
<br />40.00
<br />I hereby affrrm that I havo a ceilricate of consgnt lo slf-rnsure, or a certrlrcate of Worker's Compen
<br />$lron lnsurance Certified copy rs filed wrth the City burldrng
<br />li, alter makrng lhrs Certricale ol Exemptron, you should become sublect to the Worker's Compen-
<br />$llon provrsrons of the Labor Code, you musl lorthwrth cotrrply wrlh such provrsrons or thls permrl
<br />shall be deemed revoked
<br />workers Compensation Decl(lLtion
<br />V
<br />rgl
<br />lor which thrs
<br />ron depailment
<br />Notice To
<br />s rssued, I shall
<br />Laws
<br />,1 #aam,:;._
<br />employ any
<br />Subtotal 2
<br />Penalty Fee (when applicable)
<br />Violation Fee (s0.00)
<br />Plan Check 650/o of subtotal 7 2 . 7 jt*inimum 20.00)
<br />ReceiptNo L7 l7 Pc# f,])) oate
<br />Plan Check (Adlustment)
<br />lssuance Fee 10.00
<br />TOTAL PERMIT FEE (minimum $35.00)Bz.rt,","1l2'9q App can, ., Asen,'r rfuV
<br />E x l)iralion
<br />Applicanr's Declaration
<br />,:
<br />r,,l)' L' Ii,,1, r|,:,,,
<br />oArE / l-2'a?PERMIT NO.
<br />/A- | ,',nr,,, sslrtt)uY Slr) >\'orJa
<br />clf JY I n/w,/w srtrtrFtl lts lll?.Ea
<br />, 5t(/2 VERIFIED BY (Srg )
<br />VALIDATION IOFFICE USE ONLY)
<br />iACCOUNT#11.413)
<br />o oAPPLICATION AND
<br />ELECTRICAL PERMIT
<br />(IYPFU,/RITE OR PFINT IN INK)
<br />CITY OF SANTA ANA
<br />206 W.4th St.
<br />667-2738 /W
<br />L APPLIcANT FILL IN AREA BELOW
<br />@g-ozo
<br />00amaa
<br />qt
<br />\\
<br />\
<br />N.
<br />F
<br />l-
<br />t
<br />)t
<br />Distribution: 1. lnspector Copy 2. File Copy 3. Finance CopV 4. Applicant Copy c s 613
<br />Crty Lrcense
<br />lotce1u ll and ellect oCI 6l "l .?9,dffi.
|