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_.JPResidential Elndustrial !Commercial NO.EACH TOTAIU'?ryPa?" 5rr*7n wrui-d, -G EACH FURNACE INCL. DUCTS AND VENTS <br />-o//62 <br />STA Z:L <br />15.00 <br />20.00 <br />Up to 100,000 BTU <br />EACH ABSORPTION SYSTEM <br />Orer 100,000 BTU <br />25.00100,000 BTU to 1,000,000 BTU <br />1,000,001 BTU to 2,000,000 BTU 30.00 <br />EACH COMPRESSOR, BOILER, OR HEAT PUMP <br />Heat Pump Compressor less than 5 HP /25.00 2 S,q: <br />Ow€ullbrO.cattbn <br />I her6by at i.m lhal I am exmpt lrom tlE Contreclor's Licmsa L8w lor tha tollowing rsrsm (Se. <br />7(x}1.5. Bu3rna$ and ProtGsions Cod€. Any cily or counly which requirer a permit lo conglrucl. <br />alter, improvo, damolish, or ropair any structura, prior to its isuance, ds r6quir6 th€ applicanl <br />lor such parmil to ,il€ a signGd slatemonl thst he is liconsod puBuanl lo ths provisions ot th€ <br />Conlractor's License Lil (Cheptil 9 (@mm6ncing with Strtion 7@0) ol Oivision 3 ol th€ <br />Businsss and ProlBsifis Cods) or that he is exempt th€rstrom and th6 basig lor th6 sllegod <br />exemption Any vblrlim o, Sect|on 7031 5 by any epplicant lor a permit subiec,ts the applicant toI civil panally ol not mqe than tivo hundr€d dollars (35m): <br />E S*tion TOaaA l. as ownor ol lhe propsrty. or myamploys wilh wag8 alhair solecomp€ft <br />salion. will do tho wort, and tho slructure is rct intmded or olldod lor sele. <br />t] S*tlon 70448 l, s owner ol the propsrty, am exclusively conlrrcting wilh liconsed <br />contraclors lo construcl the prol*t <br />Oate Owner (Sig ) <br />I hereby allirm that I am licensed undar lhe provisions ol Chapter 9, Division 3 <br />?roltssions Code. md my ficens is in lull lqe 8nd(t?k rc?7/z c,n" c-zo <br />Cmlirtm t.b. Only <br />0 <br />and*W'"o"etfect <br />Licms <br />ADDRESS <br />CITY <br />o,r" 121? 42 contrscro, <br />t|orlr.r3 Coltp3rr.lbn O..rrtbn <br />I htreby aflirm that I havo I cartitictlo o, @nmt lo $lt-insur6, or e csrtilicato ot Worldl Com- <br />I certify that in lhe perfo.mance o, the work lor which <br />person in any manner I 6 to be@me subiecl to the <br />Calilo.nia <br />Nolk. To Appllcil: <br />l, atts makrng thrs Cerlrlacale ol Exemplron. you should become subitrt to the Worker's Compen- <br />satron provrsrons ol lhe Labo. Code. you must lorthwtlh comply with such provtsions or thts <br />permrt shall be demed revoked <br />wrlh lhe <br />Dale Applicant (Sig.) <br />I shall not employ any <br />Comp€nsation Lils ot <br />ciYlflNo*tonrdooa'rmont. <br />EACH AIR HANDLING UNIT OR VAV BOX <br />Outdoor Dual Packaged Healing or Cooling <br />Bepair, Alt. or Add. to any Heating/Cooling sys <br />Hood with Ducl and Fan ftype ll) <br />10.00 <br />(minimum $35.00) <br />Each or by <br />(s0.00) <br />61) <br />5HPto30HP <br />Fire Damper lnstallation <br />31 to 50 HP <br />Owr50 HP <br />Air Handling less than 2,000 CFM <br />2,000 CFM to 10,000 CFM <br />Over 10,000 CFM <br />MISCELLANEOUS <br />Floor Furnace <br />Heater; Suspended, Wall or Unit <br />Com'l Dryer Vents <br />Decorative Fireplace (Wood or Gas) <br />Range Hood with Duct and Fan (Type l) <br />Each Vent Fan Connected to a Duct <br />Fan Coil lnstallation <br />Fire Extinguishing System <br />Each Evaporatire Cooler <br />lncidental Gas <br />25.O0 <br />4,0.00 <br />30.00 <br />10.00 <br />10.00 <br />10.00 <br />15.00 <br />15.00 <br />15.00 <br />15.00 <br />15.00 <br />10.00 <br />15.00 <br />15.00 <br />20.00 <br />15.00 <br />'15.00 <br />10.00 <br />15.00 <br />1 <br />20.dn <br />Subtotal <br />TOTAL PERMIT FEE <br />Fenalty Fee (when applicable) <br />lssuance Fee <br />Violation Fee <br />Plan Check (Adjustment) <br />Plan Chec* 650/0 of subtotal (minimum <br />DateReceipt No.Pc# <br />Erphtabn <br />This permit shall expire by limit8tion and bscome nult and void i, the work suthoiized by this <br />lnrmil is not commonced within 180 drys trom the data ol this permit or it work authorizod by this <br />tprmit is sustEnd€d or sbandoned at any time artd the work is commenced lor I p€riod ol 1OO <br />days. A n* pdmit ghall be obtsinad ti6t bslore such work can be rmommenced. <br />Adc.nl'. D.d-.rbn <br />I certity that I have raad this applicatim 8nd state thet the 6bove intormstion is ctrret. I agre to <br />comply wilh all city ordimncB and state lils retaling to building cof,stuctbn, and horeby <br />aulhorizod repr€aontation ol this city lo cnta upon th€ abovc-mmtioned propdly ,tr insp€clio <br />l^-z^90 Applicent or Agent (Sig.) <br />purpos6 <br />Dale PERMIT NO,DATE /2 <br />k/<rHtvtry-/uiJ- <br />Bilt?i$" s19 vER F'Eo BY PERMIT ISSUEO BY (S'g ) <br />-n!:'>- 4 <br />1-4t <br />APPLICATION AND e <br />MECHANICAL PERMIT <br />(TYPEWRITE OR PRINT IN INK) <br />o <br />APPLICANT FILL IN AREA BELOW <br />Drstnbution I lnspector Copy 2 Frle Copy 3 Frnance Copy 4 Apptrcanl Copy <br />CITY OF SANTA ANA <br />206 W. 4th Street <br />667-2738 <br />(Dg-ozo <br />oo! <br />maa <br />a <br />cs-6r8 <br />25.00 <br />/ <br />I <br />€ <br />W/-l.oo <br />o