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NO.EACH TOTALBhesidential !lndustrial ECommercial*"iWZ L*7nh-&aaafo -h EACH FURNACE INCL. DUCTS AND VENTS
<br />Up to 100,000 BTU
<br />olrcr 100,000 BTU 20.00
<br />-z- LCITY,J.dL
<br />r
<br />Udh EACH ABSORPTION SYSTEM
<br />100,000 BTU to 1 ,000,000 BTU 25.00
<br />30.001,000,001 BTU to 2,000,000 BTUOurr-Bu[d.r O.drtbn
<br />I hereby atrirm that I am €xmpl lrom the Contracto/s License Law lor tho ,ollowing roaon (Ss.
<br />7Gi1.5, Busin6s and Prof6sions Code. Any city or county which lequiros a pcrmil lo con3lrucl,
<br />altsr, improv6. d6molish. or r6pair any slructu16. prior to it3 igguanco. also requirB tho applicanl
<br />lor such psrmit to lilo I signod statemant that he is licmsed pursuant lo lho povisions ol lho
<br />Contraclor's Licms Lil (Chapter 9 (commoncing with Soction 7m0) ol DivBion 3 ol the
<br />Businas and Prol6sims Code) or that he is exempt therstrom and the basis lor lho 8ll89sd
<br />exemption. Any vlolation of Soclion Xx}1.5 by lny spplicsnt tor a permil ilbiocts tho applicsnt to
<br />a civil panally ot not mors than live hundrod (bllars (S50O):
<br />E S*tion Zolll l. sownerottheproperly.ormyemployeswilhwsg6aslheirsolecompcr
<br />sation. will do tho rcrk. and lhe structu.e is not inlffd€d or ottsed tor sale.
<br />E S*tion 7o.l4B l, I owns ol lhe property. am exclusively contmting wilh licmsed
<br />conlrac,loB to construcl the pro,st
<br />Oate Owrer (Sig.)
<br />CmlrEton t.bc Only
<br />0
<br />cr
<br />AOORESS
<br />I hereby artirm lhat I am licensed under the provisions ol Chaptd 9, Division and\fifui"n"
<br />Cl6s -2
<br />Code. md my license B in lull lorcr end offel.
<br />5s271
<br />ProlAsrons
<br />r?*k,"
<br />Contractor (Sig.)o""l74,it't7
<br />EACH COMPRESSOR, BOILER, OR HEAT PUMP
<br />Heat Pump Compressor less than 5 HP
<br />EACH AIR HANDLING UNIT OR VAV BOX
<br />Range Hood with Duct and Fan (Type l)
<br />Hood with Duci and Fan (Type ll)
<br />Each or by
<br />Fire Damper lnstallation
<br />5HPto30HP
<br />lncidental Gas Piping
<br />31 to 50 HP
<br />Each Evaporatiw Cooler
<br />Orcr 50 HP
<br />Fire Extinguishing System
<br />Fan Coil lnstallation
<br />Air Handling less than 2,000 CFM
<br />Each Vent Fan Connected to a Duct
<br />2,000 CFM to 10,000 CFM
<br />Owr 10,0O0 CFM
<br />MISCELLANEOUS
<br />Outdoor Dual Healing or Cooling
<br />Floor Furnace
<br />Heater; Suspended, Wall or Unit
<br />Com'l Dryer Vents
<br />Decorati\€ Fireplace (Wood or Gas)
<br />sys.Repair, Alt. or Add. lo any
<br />25.00
<br />,!0.00
<br />25.00
<br />30.00
<br />10.00
<br />10.00
<br />10.00
<br />25.00
<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 />'t 5.00
<br />1
<br />Subtotal 70,n
<br />tUort.?! CoirTdlaf bn O.drtbo
<br />I hseby arlirm lhst I have a cartilicate ot @ns6l lo slt-insuro, or a caAilicateol Works's Cor
<br />I certity thal in the pe.lormancoolthe work lorwhrch
<br />po6on in any mnner to ar to bocom€ rubiect to tho
<br />Cslitomis
<br />1{o0c. To ArrLcrtl:
<br />It Erlr making lhis Crlilicrloot Eromplion. you Ehould bocoresub,el lolh€Wdlcr'8Comp€F
<br />3ation provisions ol lhe Lrboi Code. yo mGl torthwith comply with such pr@ision8 or thi3
<br />permil shall be d@mod revok€d.
<br />City
<br />Date Aprliant (Sig.)
<br />impeclion ?anmant.
<br />lshallrctmploy any
<br />Lils ol
<br />Penalty Fee (when applicable)
<br />Violation Fee (50.00)
<br />Plan Check 65% of subtotal STtSO (minimum 2O.OO)
<br />Receipt No.Pc#7 Date
<br />Plan Check (Adjustment)3.sr
<br />lssuance Fee 't0.00
<br />TOTAL PERMIT FEE (minimum $35.00)e
<br />Erpl.don
<br />This permit shall expire by limitstion and becomo null and void i, the work authoiEod by lhi3
<br />permil is not commencod wilhin t80 days from the dale ot this permil u il work authdized by this
<br />permil is susponded or obandonad al any tim€ arld lhe work is cmmnced tor I p€riod o, 180
<br />d8ys. A nil pdmit thall be obtsingd li6l betora such work can be rmommenced.
<br />Arrllc.ol't D.dfdlon
<br />I cortily lhat I have r€ad this spplication and st8t6 lhat the abov6 inlormation is corr€ct. I agr€€ to
<br />comply with all city ordinanca and slata laws rslating to building consluction. and h6r6by
<br />ol this cily lo enler upon the abovemationed property lor
<br />Applicanl or Agent (Sig.
<br />authoriz6d rapr6entolion
<br />:::rry*D^rE/l-*tr7 PEBMrrNo. 1 3756
<br />EgAi,lis" 5!ut 1,..,,,.,,,,.,n,ELPERMIT ISSUED BY (Sis )
<br />a^U'/ee* vauilo- z//'/d ? 6r IVALIOATION (OFFICE
<br />(ACCOUNT rr r-412)
<br />APPLIcATION AND I
<br />MECHANICAL PERMIT
<br />(TYPEWRITE OR PRINT IN INK)
<br />o CITY OF SANTA ANA
<br />206 W. 4th Street
<br />ffi7-2738 l*
<br />APPLICANT FILL IN AREA BELOW
<br />u)grIzo
<br />oo!
<br />m(,(t
<br />\
<br />Oislnbution: I lnspeclor Copy 2 Ftle Cogy 3 Finance Copy 4 Applicsnl Copy
<br />cs-618
<br />IPHoNE -
<br />I f'f6 -o//o 15.00
<br />/).f .oo
<br />'/?
<br />') ?/.4 ,
<br />Cerlifred @py is tiled wilh
<br />Oate
<br />Exprres Vtrilied By (Sig.)
<br />Oate Applicanl (Sig.)
<br />,T4
<br />Jfr
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