|
*o l.o"rl roro.fResidential .Ilndustrial lCommercial
<br />Res. Hotels, Motels, Apt. Sq. Ft./.7+ Z .03 3 7.21
<br />Gar. or Carports Sq. Ft.r%-02
<br />Receptacles 50
<br />o, aO
<br />ijlj" r,-*, 7-. D.Ua* 4k., D
<br />#ktfu^*"- 40,, r,ifr- " r+tatr o
<br />3 3tr Vez,t -r;-,-*K J -'"ii,o$ )h,er-*- A"'r44 Switches 50
<br />Fixtures 50
<br />Air Conditioners
<br />Each
<br />20.00 f0, n
<br />Factory Wired Unil y'tztApproved
<br />LiSt 7 5.00 3f'o-oL-
<br />Busways, special raceways. under floor
<br />duct, trolley or plug-in busways ea. 1 1 0' or
<br />fraction thereof
<br />5.00
<br />Fire Signaling System. Minimum lee
<br />Outlet, satfdk?or heat sensor
<br />10.00
<br />.50 ,-Q
<br />Lighting Standards with One Lamp
<br />Each Add'l ixture on same standard
<br />5.00
<br />1.00
<br />Owner-Bulldor Docla?atlon
<br />I hereby aflirm that I am exempl lrom the Contractor's Lrcensc Law for lhe lollowrng reason (Sec
<br />7O3l 5. Busrness and Prolessons Code Any crty or county whrch rcqures a permrt lo conslruct,
<br />alter. rmprove. demolrsh, or reparr any slruclure, pflor to rts issuance, also requIes lhe applrcanl lor
<br />such permrl to lrle a srgned slatemeni thal he rs lrcensed pursuanl to lhe provrsrons ol the Conlrac-
<br />lor's Lrcense Law (Chapler 9 icommenc,ng wrlh Secton 7000) ol Drvrs,on 3 ol lhe Busrness and
<br />ProtessronsCod€)orthathersexempttherefromandthebasrstortheallegedexemplron Anyvrola-
<br />tron ol Seclron 7031 5 by any applcanl lor a permrl sublecls lhe apphcanl to a crvil penallv ol not
<br />more lhan frve hundred dollars I S 5OOl
<br />E S""r,on 7044A l, as owner ol the properly. or my emplovees wrlh wages as lhef sole com-
<br />pensalron. wrll do lhe work, and lhe slruclure rs nol rnlended or ollered ror sale
<br />t] Secton 70448 l. as owner ol the properly, am exclusrvely contraclrng wrth lrcensed con-
<br />lractors toconslruct the protect
<br />Date--.- Owner lSrg l-
<br />Maintenance Permrl (annual)50.00
<br />Service Meters
<br />Up to 400 amps, per meter
<br />Over 400 amps, per meter
<br />Over 120O amps, per meter
<br />/15.00
<br />35.00
<br />75.00
<br />/St o<)
<br />Signs and high potential gas tube lighting 15.00
<br />Swimming pools, fountains, spas 35.00
<br />motor control center or@Swittboard,
<br />aanels'
<br />Each
<br />15.00 /-fu o-2
<br />Temporary construction meter service
<br />pole
<br />Each distribution pole
<br />25.00
<br />5.00
<br />K*%ttuzfrk=lab.8.ffi^<-fu,uL
<br />Sa, ffiA-at-,- ---- -]CZ ?zzt-
<br />I hereby aflrm lhat I am licenscd ender lhe provrsrons of Chapter 9. Drvrsron 3 ol the Busrness and
<br />c,tyrcensc OJ24Zf
<br />Contractor Use Only
<br />CON TRACTOR PHONE
<br />JTz-7r/3
<br />CITY r,lAIt r,l,
<br />_ Contraclor lSrg )
<br />eL
<br />k,and mv lcense rs in full forc€ and ellect.
<br />-femporary construction lighting
<br />500 lamps or less
<br />Over 500 lamps
<br />2.00
<br />4.00
<br />Time clock or photo eleclric cell 3.00
<br />POWER APPABATUS : GeneTatoTs.
<br />motors, translormers, rectifiers. industrial
<br />heating, cooking, or baking equipment
<br />and other apparatus as tollows:
<br />Up to and including 1 HP KW. KVA
<br />Over 1 and nol over 10 HP, KW KVA
<br />'10 and not over 50 HP KW KVA
<br />50 and not over 100 HP KW, KVA
<br />100 and not over 500 HP. KW KVA
<br />Over 500 HP, KW KVA
<br />Over
<br />--94rOver
<br />2.00
<br />5.00
<br />10.00
<br />20.00
<br />30.00
<br />40.00
<br />workers Compenaatlon De{Jratio n I
<br />IherebyallrrmlhalIhaveacerlrlrcaleolconsenltosell rnsure,oracerlrfrcaleo{Worker'sCornpen
<br />I cerlrry lhat rn lhe performancc ol the work for which
<br />ll. atter making lhrs Certrfrcate ol Exemptron. you should
<br />salron provrstonsol lhe Labor Code, you must forthwrlh comply wrlh such provrsrons or thrs permrl
<br />shall be deemed revqked
<br />ts
<br />satron lnsLrrance Cerlifrod copy rs flled wrth lhe C burldrng rnspeclron deparlmenl
<br />Notice To
<br />I shall nol employ any
<br />Lawsol Cahlornra
<br />sublecl to lhe Worker's Compen.
<br />Date Exp,res /:L?v",,r,"0 ev $,s,.
<br />,",J/*f,3 App,,can,,s,s,
<br />Subtotal /7/.6c
<br />funalty Fee (when applicable)
<br />Violation Fee (50.00)
<br />Plan Check 650/0 of subtotal f f ^f g (minimum 20.00)
<br />Reeiptxo.676 / ec * 4i7 23 oare
<br />Plan Check (Adjustment)
<br />lssuance Fee -10.00
<br />(minimum $35.00)FEE / */. L4
<br />Erplratlon
<br />Thrs permrl shall exprre by lrmrlalron and become null and vord rl the work aulhonzed by lhrs permrt rs
<br />nol commenced wrthrn 1 80 days lrom lhe dalc of ihrs permrl or rl s,ork authonzed t y lhrs permrl rs
<br />suspended or abandcned al any trme aller lhe work rscommenced lor a penod ot lSO days A new
<br />permrt shall bc oblalned irsl belore such work can be recommenced
<br />Applicanr's Oeclaration
<br />j
<br />,",1[' Z'{1 App, can,.,, Asenr
<br />ilze represenlatrvesol lhrscrty loenter upon lrr,t, i]J
<br />oArE // -2 -t7 PERMIT NO.23551
<br />?Yh?,lif,fi:6r/VERIFIED BY lSrg )PERMTT TSSUED BY (Srg.)_vb Yt
<br />1t-t )
<br />tu
<br />LI/WW 3:35P1{ 413 1141.66
<br />VALIDATION {OFFICE USE ONLY}
<br />(ACCOUNT #11-413)
<br />APPLICATION AND
<br />ELECTRICAL PERMIT
<br />ITYPEWRITE OB PHINI IN INK)
<br />o o CITY OF SANTA ANA
<br />206 W. 4rh St.
<br />667 -2738
<br />3 W
<br />APPLICANT FILL IN AREA BELOW
<br />@groz
<br />oollmaa
<br />(\
<br />t'
<br />(\
<br />(\
<br />S
<br />Distribution: l.lnspectorCopy 2. FileCopy 3. FinanceCopy 4. ApplicantCopy
<br />{
<br />..1
<br />\
<br />N..
<br />SvN
<br />N
|